Pope Leo's lung tumor raises questions about cancer risk for nonsmokers

An oncologist says that if the lung cancer is stage 1, Pope Leo XIV has about a 90 percent chance of cure, but the pathology results will determine the next stages.

A lung cancer surgeon talks about what Leo's pap operation suggests about his chances of recovery

Dr. Larry Robinson, an oncologist at Moffitt Cancer Center in Tampa, Florida, reacts to the Pap diagnosis and how lung cancer can develop in people who have never smoked.

Pope Leo XIV has been diagnosed with lung cancer following a scheduled operation, the Vatican announced on Tuesday.

After a thoracotomy, where surgeons removed the lower lobe of Pope's right lung, tissue examination confirmed the diagnosis of lung adenocarcinoma.

According to the press office of the Holy See, the diagnosis was suspicious based on tests performed before the operation.

Pope Leo was diagnosed with lung cancer after surgeons removed part of his right lung, the Vatican says.

According to reports, the Pope does not smoke and has no history of smoking. The Centers for Disease Control and Prevention reports that most lung cancer deaths (80%) are caused by smoking.

According to the American Lung Cancer Foundation, lung adenocarcinoma is the most common type of lung cancer, accounting for about 40 percent of all lung cancers in the United States. It is also the most common type among non-smokers.

Have you never smoked? You may still be at increased risk for lung cancer

About 80 percent of lung cancers occur in people who smoke or have smoked, said Robinson, who has not treated Pope. However, he noted that lung cancer also occurs among people who have never smoked—including about 10 percent of male patients and 25 percent of female patients.

"But [Pope] had surgery and a lobectomy, so that's usually only done with people who have localized disease, and he probably had localized disease. And hopefully it's stage 1 cancer," the doctor added.

If the pap cancer is stage 1, the oncologist said, there is a "high chance" of cure - about 90%, depending on the size of the tumor. The fact that he went straight into surgery suggests that there was probably no evidence that the cancer had spread.

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"We have to wait for the pathology to determine ... if he has stage 1 cancer and if he needs additional treatment after that," Robinson said.

Size matters in lung nodules and lung cancer—the larger the cancer, the worse the outlook because it's more likely to progress and spread.

According to experts, not all cases of lung cancer are caused by smoking. (iStock)

Not all cases of lung cancer are caused by smoking. Experts say other factors such as family history and genetic predisposition can play a role in this.

Recent research has shown that a rare genetic mutation in the EGFR T790M gene increases the risk of developing lung cancer by 25 times compared to people who do not have the mutation, according to findings published in the journal Science.

Among people who have never smoked, carriers of the mutation are about 62 times more likely to develop lung cancer compared to never-smokers who are not carriers.

Family history and environmental exposure can increase the risk of lung cancer. (iStock)

Robinson added that other types of smoking, such as pipes and cigars, can increase the risk of lung cancer, as can heavy marijuana use.

According to this cancer specialist, another risk factor is exposure to environmental toxins such as diesel exhaust and radon.

"Unfortunately, probably more than half of never-smokers who get lung cancer end up with stage 4 disease," Robinson said. "And it's higher than people who are smokers or ex-smokers, so they generally start at a worse stage."

According to Robinson, in most cases, lung cancer will have no symptoms in its early stages. However, in those who do have symptoms, the most common ones involve the lungs, including a persistent cough, shortness of breath, or coughing up blood.

This cancer specialist noted: Unexplained weight loss can be caused by any type of cancer. Neurological symptoms such as persistent headaches may also require a visit to the doctor.

The most common symptoms are related to the lungs, including a persistent cough, shortness of breath, or coughing up blood. (iStock)

According to the doctor, lung cancer is rare in young adults, which is why annual screening CT scans are usually recommended starting at age 50 for people who are at risk.

People at risk include current smokers with a history of at least 20 pack-years, as well as ex-smokers who have quit within the past 15 years.

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"Unfortunately, only about 15 percent of people who are eligible get screened," Robinson said.

"Hopefully in four or five years, a screening CT scan will only be approved after a positive blood test at your doctor's office." According to the doctor, this approach could make screening easier and potentially help identify more lung cancers.

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