What to Know About Pope Leo's Lung Cancer Diagnosis

Surgeons Removed Part of the Pope's Right Lung and Reported He Has Adenocarcinoma

After discovering a lump in Pope Leo XIV's lung, surgeons at the Gemelli Hospital in Rome operated on Tuesday, which revealed the pope had cancer.

Dr. Stefano Margaritura, professor of thoracic surgery at the Catholic University of the Sacred Heart, led the team that operated on the pope at Gemelli, a team that has long cared for popes. According to a statement released by the Vatican, the surgery was performed after the papal medical team, led by Dr. Luigi Carbone, found a suspicious nodule and performed tests that suggested it might be cancerous. During the 90-minute procedure, Margaritora removed the lower lobe of Pope's right lung, and further tissue tests confirmed adenocarcinoma.

Lung adenocarcinoma is the most common type of lung cancer worldwide, accounting for 40-45% of lung cancer cases worldwide. Adenocarcinomas belong to a broader group of lung cancers known as non-small cell lung cancer, which tend to grow more slowly and spread to other parts of the body at a slower rate. Early detection of adenocarcinomas can help prevent their progression to advanced disease.

Current recommendations in the United States and most of the world recommend low-dose CT for lung cancer screening only in high-risk individuals: those who have smoked for 50 years or older or are current smokers. Many non-smokers get lung cancer when they have a CT scan of the breast for another reason, such as after an accident or other injury. Some advocacy and advocacy groups are pushing for widespread screening among those at risk so that more people can benefit from early detection, including those who are younger and may be exposed to other factors, such as radon in the environment, that can increase the risk of lung cancer. "The best chance of curing lung cancer is when it's stage 1 and very early," says Dr. David Jones, chief or chief of thoracic surgery at Memorial Sloan Kettering Cancer Center, who was not involved in Pope's care. "That's what screening can help with."

Jones says the pope's smoking history is not widely known, but lung adenocarcinoma occurs in both smokers and nonsmokers. "Lung adenocarcinoma is by far the most common type of lung cancer in non-smokers," he says.

Why did the surgeons remove part of the Pope's lung?

Surgeons decided to remove part of the pope's lung "to ensure a radical resection," according to a Vatican statement. This meant doctors wanted to make sure they removed any tissue that might be cancerous, giving Pap the best chance of preventing the disease from coming back.

The Pope woke up from the surgical anesthesia without any complications and asked for dinner while talking to Vatican staff. As additional tests are performed on his removed cancerous tissue, he will be monitored to guide doctors on further treatment. The Vatican expects the Pope to stay in Gemelli for a week.

What is the treatment of lung adenocarcinoma?

Pap's treatment options depend on what additional tests on his tumor show. For some patients with stage 1 cancer that hasn't spread to the lymph nodes, surgery and monitoring for recurrence may be enough, Jones says.

If the cancer is more advanced, a number of relatively new options are available for lung cancer, including targeted therapies designed to attack specific mutations in cancer cells, or immunotherapy, which activates the immune system to kill cancer cells. "Innovation in lung cancer treatment has been profound," said Karen Knudsen, CEO of the Parker Institute. Adenocarcinomas tend to have a large number of mutations, which make them good targets for the immune system to recognize as foreign. This also makes them promising targets for checkpoint inhibitors, a new class of cancer treatment that releases the brakes on immune cells, allowing them to better identify and destroy cancer cells. "Our knowledge base is improving, and there are better outcomes for non-small cell lung cancer because of immunotherapy," Knudsen says.

Jones says some patients can rely on targeted therapies alone and avoid chemotherapy, while others may need chemotherapy with immunotherapy, depending on how much cancer surgeons have been able to remove and whether the cancer has spread to lymph nodes.

Can Pope Leo resume his papal duties?

The Vatican reports that the pope was active before the surgery, playing tennis and walking regularly. Now that treatment options are available for his cancer, experts believe he should be able to return to his daily activities. "Advances in treatments all point to a better prognosis and quality of life for lung cancer patients," says Jones. "And given his history of physical activity, even after having a lobe removed from his lung, he should be able to do what he wants to do with very little limitation."