What to Know About Pope Leo's Lung Cancer Diagnosis

Dr. Stefano Margaritora, professor of thoracic surgery at the Catholic University of Sacred Heart, led the team that operated on the Pope at Gemelli, which has long provided care for Popes. The surgery was prompted after the Pope’s medical team, led by Dr. Luigi Carbone, found a suspicious nodule and performed tests that suggested it could be cancerous, according to a statement released by the Vatican. During the 90-minute operation, Margaritora removed the lower lobe of the Pope’s right lung, and further testing of the tissue confirmed adenocarcinoma.

Lung adenocarcinoma is the most common type of lung cancer worldwide, accounting for 40% to 45% of lung cancer cases globally. Adenocarcinomas belong to a broader category of lung cancers known as non-small cell lung cancer, which tend to grow more slowly and spread less quickly to other parts of the body. Detecting adenocarcinomas early can help keep them from progressing to advanced disease.

Current recommendations in the U.S. and most of the world advise low-dose CT scans to screen for lung cancer in high-risk people only: those 50 years or older who have smoked heavily in the past or who currently smoke. Many non-smokers are diagnosed with lung cancer when they get a chest CT for another reason, such as after an accident or other injury. Some advocacy and patient groups are pushing for expanded screening among those at higher risk so that more people can benefit from early detection, including those who are younger and may have been exposed to other factors that can increase lung cancer risk, like radon in the environment. “The best chance to cure lung cancer is when it’s Stage 1 and very early,” says Dr. David Jones, chief or thoracic surgery at Memorial Sloan Kettering Cancer Center, who was not involved in the Pope’s care. “That’s what screening can help with.”

The Pope woke up from surgical anesthesia without any complications, and requested dinner while conversing with Vatican staff. He will be observed as additional tests are performed on his removed cancer tissue to guide doctors on what treatments might be needed next. The Vatican anticipates the Pope will remain at Gemelli for one week.

If the cancer is more advanced, a number of relatively new options for lung cancer are available, including targeted therapies designed to specifically attack certain mutations in cancer cells, or immunotherapy, which activates the immune system into destroying cancer cells. “The innovation in treatments for lung cancer have been profound,” says Karen Knudsen, CEO of the Parker Institute for Cancer Immunotherapy. Adenocarcinomas tend to have high numbers of mutations, which make them good targets for the immune system to recognize as foreign. That also makes them promising targets for checkpoint inhibitors, a new category of cancer therapy that releases the brakes on immune cells and allows them to better detect and destroy cancer cells. “Our knowledge base is improving, and there are better outcomes for non-small cell lung cancer because of immunotherapy,” says Knudsen.