Pope Leo XIV underwent minimally invasive surgery at Gemelli Hospital in Rome, Italy, to remove lung adenocarcinoma. The tumor was reportedly discovered during a routine examination, and the procedure was completed without reported complications. Although Pope described the tumor as being at a very early stage, its stage has not been confirmed. Vatican-affiliated media, including Vatican News, and several international media outlets have reported the details of the procedure, citing a bulletin from the Vatican press office.

Whether surgery is sufficient or additional cancer treatment is needed depends on the final pathology report, which is not yet available.

Surgeons at Gemelli Hospital removed the lower lobe of the right lung using a video-assisted technique. The procedure was performed with curative intent, and the goal was to completely remove the tumor. The operation lasted approximately 90 minutes, and the Pope spent approximately 3 hours in the operating room. He recovered from anesthesia without complications.

Intraoperative histologic examination confirmed the suspected diagnosis of adenocarcinoma. A frozen-section examination is commonly used for this purpose, although the Vatican has not specified which method was used. Adenocarcinoma is a type of non-small cell lung cancer that arises from glandular cells in the respiratory tract. The medical statement described the resection as “radical.” In response to inquiries from international media, the Vatican press office explained that this procedure was intended to remove all suspicious tissue.

Tumor Discovered During a Routine Examination

According to Pope, the tumor was discovered during a routine examination. He described it as well circumscribed and at a very early stage. However, this was his own assessment and not a confirmed pathologic classification. Whether he had symptoms was not explicitly reported. A hospital stay of approximately 1 week was planned after surgery.

Early detection is important for lung cancer. When a tumor is confined to the lung, the lymph nodes are unaffected, the tumor can be completely removed, and the prospects for cure are generally favorable.

Final Pathology Will Determine Next Steps

The Vatican has not disclosed the tumor stage or whether the cancer had spread. Information regarding lymph node involvement and the need for additional treatment is unavailable. According to the surgeon, the final pathology report may take several days.

The report will determine the size of the tumor, the extent of local invasion, and whether the resection margins are free of cancer. These findings determine the pathologic tumor, node, and metastasis (TNM) staging classifications. The ninth edition of the TNM staging system has been in effect since January 1, 2025. The T category was unchanged in this edition, whereas the N2 category was subdivided into N2a and N2b. Histologic features also matter, including the predominant growth pattern, tumor grade, and high-risk characteristics. These include micropapillary or solid components, vascular or pleural invasion, and spread through air spaces, in which tumor cells are found in air spaces outside the tumor edge.

It is also unclear which tests were performed preoperatively. The Vatican has not reported whether the Pope underwent PET-CT, brain imaging, or assessment of the mediastinal lymph nodes. The diagnosis was not confirmed histologically until the operation. His lung function, comorbidities, and smoking history were not officially disclosed. According to CNN, Pope is a nonsmoker, although the Vatican has not confirmed his smoking history.

Why Early-Stage Disease Seems Plausible

The available information is consistent with a possible, but unconfirmed scenario: a completely resected stage I adenocarcinoma without lymph node involvement and no significant high-risk features. The tumor was reportedly discovered during a routine examination, and Pope described it as being at a very early stage. Surgery also appears to have been performed with the intent of cure, without any known preceding cancer treatment. The length of hospital stay does not establish the disease stage; its duration had been announced before the operation.

Structured follow-up would be recommended. If the cancer is at a higher stage or has high-risk features or an actionable driver mutation, additional treatment may be considered depending on the tumor’s characteristics and stage. Options include osimertinib for tumors with specific EGFR mutations, alectinib for tumors with ALK rearrangements, atezolizumab or pembrolizumab after surgical resection, and platinum-based chemotherapy in eligible patients.

According to the German oncology information platform Onkopedia, the 5-year postoperative survival rate for stage IB lung cancer is 73%, according to the eighth edition of the Union for International Cancer Control classification. The prognosis for stage IA disease is more favorable.

These figures describe outcomes across patient groups and cannot predict an individual’s outcomes. Age, physical fitness, comorbidities, and tumor biology also influence prognosis. A specific estimate for Pope would therefore be speculative until the final pathology findings are available.

During lobectomy, the entire lobe of the lung is removed, and the remaining lung tissue takes on a greater share of the work of breathing. Recovery depends on lung function and overall health. Video-assisted surgery generally places less strain on the chest wall than open surgery; however, lobectomy remains a major procedure. According to one expert, recovery may take longer than expected. During the first few weeks, patients may experience reduced exercise capacity, pain, and shortness of breath.

Recovery may also affect the planned trip to South America from early to mid-November. Oncologists often advise avoiding air travel for 3 weeks after this type of surgery. This interval would end around the time of the planned trip, leaving uncertainty about whether travel can proceed as scheduled.

This story was translated from Medscape’s German edition.