What to know about Pope Leo’s lung cancer

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Pope Leo XIV had surgery Tuesday at Agostino Gemelli University Policlinic in northwest Rome to remove a nodule that was determined to be pulmonary adenocarcinoma, the most common type of lung cancer.

The Vatican said surgeons removed the cancerous growth, along with the lower lobe of his right lung.

Pulmonary adenocarcinoma accounts for about 40% of all lung cancer cases. It’s a form of non-small cell lung cancer, and it usually grows and spreads to other parts of the body more slowly than small cell lung cancer does.

Surgery is typically the first step when someone has this form of cancer. The right lung, which is larger, has three sections called lobes, and the left has two; doctors will often remove the lobe the growth is found in to get rid of the tumor and to improve chances of a cure. The body eventually adapts to compensate for this loss of function.

It’s not always clear what causes this type of lung cancer. Although smoking can raise the risk, other risk factors include exposure to radon gas – the most common cause of lung cancer other than smoking – and particle pollution.

Pulmonary adenocarcinoma is most often diagnosed in people who have never smoked. It is also more common in women, younger patients and people of East Asian ancestry.

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Adenocarcinoma is a leading cause of cancer-related death because doctors often don’t discover it until it’s at an advanced stage.

But on Sunday, the pope told a crowd that doctors had detected a growth in his lungs at “a very early stage.”

Based on what we know now, the pope should have a good prognosis, said Dr. Juanita Mora , the national medical spokesperson for the American Lung Association.

“The fact that Pope Leo had a localized case of adenocarcinoma with an early-stage detection works in his favor,” Mora said. “Especially after surgical removal.”

Mora said Leo’s recovery may be a “little bit longer” because the lungs will have to adjust to the removal of one lobe.

“Initially, it will be a little harder for him to breathe until the left lung starts to compensate for it,” Mora said. Having lessened lung capacity may not make much of a difference for his breathing.

Working in his favor, Mora said, is that the pope is not a smoker and is an otherwise healthy 71-year-old who plays tennis and exercises his lungs.

Mora said he will have to do respiratory therapy exercises . He also will need to be careful to avoid respiratory infections as best he can because they could affect him more without part of his lung.

She noted that Leo’s predecessor, Pope Francis, also had a lobectomy on his right side after a severe tuberculosis infection when he was young.

“So obviously, a lot of people live and can fully do everything in terms of function and capacity, even with a lobectomy.”

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After this type of surgery, patients normally remain hospitalized for a few days until their vital signs and oxygen levels are stable, then typically continue recovering at home. Because it was a lobectomy, some pain is also expected.

Whether Leo can take a planned trip to Latin America next month will depend on what tests find in the next few days, Mora said.

In these cases, doctors examine samples from the lymph nodes around the lung, in addition to lung tissue, to determine the stage of the adenocarcinoma. Cancerous cells in the lymph nodes or any sign that the cancer has spread would help determine whether the pope needs treatment beyond surgery, such as chemotherapy or radiation.

Doctors also will conduct genetic and biomarker testing to determine how to treat the cancer further, if necessary. Knowing a person’s particular biomarkers can help target immunotherapy if needed.

Biomarker testing has significantly improved lung cancer treatment, Mora added, but in the US, only 15 states require medical insurers to cover such testing, even when someone has lung cancer.

“We’re hoping, though, that it’s just an isolated cancer where he’s one and done, in which now we see a survival rate of 80% to 98% when it comes to surgical removal,” Mora said of Leo. “But now we will have to wait for these tests.”

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教皇利奥十四世周二在罗马西北部的阿戈斯蒂诺·杰梅利大学医院接受了手术，切除了一个被确诊为肺腺癌的结节，这是最常见的肺癌类型。

梵蒂冈方面表示，外科医生切除了癌性肿瘤以及他右肺的下叶。

肺腺癌约占所有肺癌病例的40%。它是一种非小细胞肺癌，其生长和扩散到身体其他部位的速度通常比小细胞肺癌慢。

对于这类癌症，手术通常是第一步。右肺较大，分为三个肺叶，左肺只有两个；医生通常会切除肿瘤所在的肺叶，以清除肿瘤并提高治愈率。身体最终会适应并补偿这种功能丧失。

导致这类肺癌的原因并不总是很明确。虽然吸烟会增加患病风险，但其他风险因素还包括接触氡气（除吸烟外最常见的肺癌致病因素）和颗粒物污染。

肺腺癌最常诊断于从未吸烟的人群。此外，女性、年轻患者和东亚裔人群的发病率也较高。

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腺癌是癌症相关死亡的主要原因之一，因为医生往往在癌症发展到晚期时才发现它。

但周日，教皇告诉人群，医生们“在非常早期的阶段”就发现他的肺部有肿块。

美国肺脏协会全国医学发言人胡安妮塔·莫拉博士表示，根据我们目前所了解的情况，教皇的预后应该良好。

莫拉说：“教宗利奥所患腺癌局限于局部，且发现较早，这对他是件好事。尤其是在手术切除之后。”

莫拉表示，利奥的康复期可能会“稍微长一些”，因为他的肺部需要适应切除一个肺叶的情况。

莫拉说：“一开始，他呼吸会稍微困难一些，直到左肺开始代偿。”肺活量减少可能不会对他的呼吸造成太大影响。

莫拉说，对教皇有利的是，他不吸烟，而且是一位身体健康的71岁老人，他打网球，锻炼肺部。

莫拉说他需要进行呼吸康复训练。他还需尽可能小心避免呼吸道感染，因为失去部分肺脏后，感染可能会对他造成更严重的后果。

她指出，利奥的前任教宗方济各年轻时也曾因严重的肺结核感染而接受了右肺叶切除手术。

“所以很明显，很多人即使做了肺叶切除手术，也能正常生活，并且在功能和能力方面完全能够做任何事情。”

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这类手术后，患者通常需要在医院住院几天，直到生命体征和血氧水平稳定后，才能回家继续康复。由于是肺叶切除术，术后出现一些疼痛也是正常的。

莫拉表示，利奥能否按计划下个月前往拉丁美洲，将取决于未来几天的检测结果。

在这种情况下，医生除了检查肺组织外，还会检查肺部周围淋巴结的样本，以确定腺癌的分期。淋巴结中是否存在癌细胞，或者癌症是否扩散，都有助于判断教皇是否需要手术以外的治疗，例如化疗或放疗。

医生还会进行基因和生物标志物检测，以确定必要时如何进一步治疗癌症。了解患者特定的生物标志物有助于在必要时进行靶向免疫疗法。

Mora补充说，生物标志物检测显著改善了肺癌的治疗，但在美国，只有15个州要求医疗保险公司承担此类检测的费用，即使有人患有肺癌。

“不过，我们希望这只是孤立性癌症，他只得过一次就痊愈了，如果是这种情况，手术切除的存活率目前在80%到98%之间，”莫拉谈到利奥时说。“但现在我们只能等待这些检查结果了。”