As soon as Pope Leo XIV's surgery was completed at the Gemelli Hospital in Rome, it was confirmed that a lung adenocarcinoma had been removed. This type of lung cancer is currently the most common. Due to the interest that the news has logically aroused, perhaps some clarifications from the oncological environment will help.
Lung adenocarcinoma affects both smokers and non-smokers. It has a very diverse prognosis. If it is completely removed by surgery in the early stages, is small in size and has not spread to the lymph nodes, the chance of cure is much greater than in more advanced stages (when it spreads to other organs in the body). Depending on the extent of the tumor, four phases or stages of lung cancer are defined. Tumors are classified into these stages based on anatomical criteria: the size of the tumor (T), the possible infiltration of nearby lymph nodes (N, nodes) and the presence or absence of metastases (M). Based on the TNM indices, the tumor is classified as stage I, II, III or IV. The stage is indicative of the prognosis, that is, the possibility of the tumor recurring after surgical removal and compromising future survival.
In the case of Leo XIV's tumor we still have very little data. The initial impression is very favorable since it has been able to be completely removed surgically. But, to more precisely define its stage and prognosis, it is necessary to know in detail the size of the tumor, its location, if tumor cells are found in any of the nodes, etc. The medical team will have this data shortly and will be able to recommend the most appropriate indications.
Furthermore, the latest classification from the International Association for the Study of Lung Cancer (IASLC) suggests that the biological characteristics of the tumor - specifically, the presence of some mutations - also influence its future behavior. These molecular prognostic factors are the subject of intense research. On the other hand, some of these genetic characteristics of the tumor can guide personalized treatments. Surely in the laboratories of the Gemelli hospital they are also now studying these possible genetic alterations in the tumor removed from the Pope.
With all this information, anatomical and molecular, the specialists who treat you will be able to better define the prognosis and the possibility of future recurrences. Furthermore, depending on the stage of the tumor that has been removed, and its molecular characteristics, they will decide the treatment strategy. Therapeutic decisions can vary from mere close monitoring with periodic check-ups, to some type of treatment with chemotherapy, immunotherapy or therapy directed at the genetic mutations that the tumor cells may have.
As it is an isolated and completely removed tumor, this possible treatment is called adjuvant or complementary therapy. Its objective is to eliminate tumor cells that may have remained in the body, and that cannot be detected in medical tests. Therefore, it would be a preventive treatment. However, as has been noted, the decision on how to proceed after surgery will depend on the data that clinicians obtain in relation to the tumor. According to the news received, the Pope is feeling well, and this is very positive for his subsequent developments.
It is also very positive that the tumor was detected in early stages. It is worth emphasizing, once again, the importance of early detection of cancer, and in this case lung cancer. It is also a good occasion to underline the relevance of early detection and screening protocols, including lung cancer screening. Many studies have demonstrated the effectiveness of lung cancer screening in a very robust manner, which has led various professional medical associations and official institutions around the world to recommend launching these programs.
For now, as long as there is no more information or communications from the medical team, we have to wait; It is up to us believers to pray and, for all of us, to accompany Leo XIV with affection. It is important to promote confidence that, as usually happens in early lung tumors, the final result will be excellent; and that the Pope can soon forget about his lung cancer (which he has described as one of "God's surprises") to continue dedicating himself to his intense pastoral work, so necessary and so hopeful, as we have seen in our country and, more recently, in France.
*Luis Montuenga Badía is a professor and senior researcher at the Cancer Center of the Clínica Universidad de Navarra (CIMA).
