Pittsburgh Specialists Say Early Detection Gives Pope Leo XIV Reason for Optimism After Lung Cancer Surgery

Word that Pope Leo XIV has lung cancer and has undergone surgery has prompted concern around the world. In Pittsburgh, two cancer specialists weighed in on what the diagnosis means and what recovery may look like.

The Vatican announced Tuesday that the first American pope, who is 71, had been diagnosed with adenocarcinoma of the lung. Dr. Benny Weksler, system director of thoracic surgery at AHN, and Dr. Liza Villaruz, chief of thoracic medical oncology at UPMC Hillman Cancer Center, said a comparable nonsmoking patient of similar age, absent unknown complicating factors, would have several reasons for hope.

Weksler said adenocarcinoma is the most common form of lung cancer today, in both smokers and nonsmokers. The CDC says it accounts for about 45% of all cases. NBC News reported that the pope is not known ever to have smoked. Weksler noted that if lung cancer in nonsmokers were counted as its own disease, it would rank as the fifth most common cancer in the United States by some estimates.

In the pope's favor, his cancer was reportedly found early and was localized, according to his address in St. Peter's Square on Sunday. "The key with all lung cancer cases is always early detection," Weksler said. "So when we do have early detection, the prognosis is very good."

The Vatican said Wednesday that the pope had a successful 90-minute operation Tuesday at Rome's Gemelli Hospital, with no complications, to remove a lung nodule. The surgery took out the lower lobe of his right lung. Villaruz said that when a cancer is caught this early, removing an entire lobe can be curative without further therapy. The size of the nodule has not been made public. Weksler said patients with tumors under two centimeters and no cancer in the lymph nodes can reach better than 80% five-year survival.

Weksler said a lower lobe represents roughly 25% of lung capacity, while a segmentectomy would remove less than 10%. The effect depends on several factors, including the tumor's location, but most patients with normal or near-normal lung function live normally after a lobectomy and usually face no restrictions. The Cleveland Clinic says recovery can take up to a month after a two- to three-day hospital stay. The Vatican has said the pope will be hospitalized for a week, and on Wednesday it reported that he was doing respiratory therapy and walking around his room.

Villaruz said age can complicate surgery for many 71-year-olds with chronic conditions, but the pope is by all accounts very healthy, has never smoked and is physically active. "So the hope is that his recovery will go smoothly," she said.

Whether he will need more treatment remains unclear. Villaruz said results of further testing on the removed lobe should reveal the tumor's actual size and whether lymph nodes were involved. If they were, additional therapy might be recommended to lower the chance of recurrence.

Why nonsmokers develop lung cancer is largely unknown. "If I knew that, I would have a Nobel Prize," Weksler said. The New York Times has reported that numerous members of the pope's family have had cancer. Weksler said family history matters more in some cancers than others, and that it is hard to separate from the fact that families often smoke together. Many believe family history slightly raises lung cancer risk, he said, but the link is less clear than with other cancers.

Both doctors urged the public to treat the news as a prompt to get screened for lung cancer, particularly long-term smokers and people whose immediate family has a history of smoking or lung cancer.