Pope Leo XIV had the lower part of his right lung removed after doctors diagnosed him with lung adenocarcinoma.
While lung cancer is a major killer, if caught early, survival rates can be high, as was the case with Pope’s tumor. Here are some things to know.
What is lung adenocarcinoma?
The Vatican announced that the pope had been diagnosed with lung adenocarcinoma, one of several forms of lung cancer.
There are two main types: small cell lung cancer and non-small cell lung cancer. Adenocarcinoma is the most common subtype of non-small cell lung cancer, accounting for the vast majority, said Dr. Charu Agarwal, an oncologist at the Abramson Cancer Center at the University of Pennsylvania School of Medicine.
What is the cause of lung adenocarcinoma?
Although smoking is the leading cause of lung cancer, Agarwal noted that an increasing number of patients with no history of smoking have been diagnosed with lung cancer in recent years.
“We found that there are different biological reasons that may lead to uncontrolled cell growth that can lead to lung cancer,” Agarwal said.
Other risks include exposure to radon gas, asbestos, radiation, secondhand smoke and air pollution, according to the American Cancer Society.
What is the survival rate for lung adenocarcinoma?
Survival rates depend greatly on the stage of cancer when it is discovered. According to the National Cancer Institute, if diagnosed early (also called stage I), the five-year survival rate is 64%. If it has spread to other parts of the body, survival rates decrease. The stage 2 regional survival rate was 38.2%, the stage 3 distant survival rate was 10%, and the stage 4 unknown survival rate was 5%.
Other factors such as tumor size, pathology, and the individual’s overall health also influence patient prognosis.
“The cure rate for early-stage lung cancer is getting very, very high,” Agarwal said. “The earlier the cancer is diagnosed, the easier it is to cure.”
How is lung cancer detected?
According to the Cancer Society, symptoms of lung cancer often don’t appear until the cancer is in its advanced stages. These symptoms may include a persistent cough, chest pain, hoarseness, shortness of breath, and recurring pneumonia or bronchitis—symptoms that must be investigated.
“The vast majority of lung cancer patients are diagnosed when they have stage IV disease because they don’t develop symptoms until stage IV disease,” Agarwal said. “For example, until they have cancer that metastasizes to different organs, causing pain or takes over part of the lung, causing difficulty breathing.”
Agarwal said most early-stage lung cancer cases are discovered “accidentally.” These “incidental findings” occur when someone’s X-ray or other scan shows a spot in the lungs that requires further investigation. Doctors find these tumors before symptoms appear, possibly early enough that the cancer is still small and has not spread. In the case of the pope, a nodule was found in his lung during another examination.
The U.S. Preventive Services Task Force recommends annual screening with a low-dose CT scan (a type of
But Agarwal noted that these guidelines put patients who have never smoked at a disadvantage “because we really don’t have a good way to detect early-stage lung cancer.”
She added: “I think the most important thing to remember is that no one should ignore a new persistent cough, shortness of breath or pain and should be evaluated by a doctor.”
How to treat?
Surgery is the mainstay of early detection of lung cancer and is increasingly used even in advanced stages. The pope had the lower part, or lobe, of his right lung removed to ensure all cancer was removed.
The right lung has three parts or lobes, while the left lung has two. Each lobe has its own airway branches and dedicated blood vessels, and when one lobe is removed, “the other lobes actually take on some of the work,” said Dr. Ben Hari, a thoracic surgeon at Allina Health in Minneapolis.
The lungs gradually compensate over several months, until most people, especially those who are already physically active, notice little to no change after exercise, he said.
In the United States, the average length of stay after lung cancer surgery is two nights, Zhang said. This depends in part on how quickly the patient can get up and move around, how much pain there is, and how long the tube is needed to drain air and fluid from the chest.
Whether additional treatment is needed depends on the stage of the tumor, which depends on factors such as its size, whether it shows signs of spreading through lymph nodes, and whether there are markers on the cells that indicate the tumor may be aggressive. Additional treatment may be chemotherapy, used before surgery to shrink the tumor, or after surgery to attack any remaining cells. Other options include radiation therapy, immunotherapy, or targeted drugs that target specific molecular drivers of the tumor.
Agarwal noted that November is Lung Cancer Awareness Month and urged people to get screened.
“Anyone with lungs can get lung cancer,” she said.