Pope Leo’s Lung Cancer Diagnosis Highlights Importance of Early Detection

Pope Leo will not need further treatment for adenocarcinoma after doctors removed the lower portion of his right lung during a 90-minute surgery. 

The pope was released from Gemelli Hospital in Rome on Oct. 17, four days after surgery. 

Follow-up testing confirmed the cancer was localized and had not spread. In a statement, the Vatican said, “A subsequent oncological assessment has confirmed that no further treatment is necessary.” 

Following the update, Lary Robinson, MD, director of Moffitt Cancer Center’s Lung Cancer Early Detection Center, answers common questions about lung cancer and the importance of screening. 

Who should be screened for lung cancer? 

The U.S. Preventive Services Task Force (USPSTF) recommends annual lung cancer screening beginning at age 50 for adults ages 50 to 80 who have no symptoms, have a smoking history of at least 20 pack-years and currently smoke or quit within the past 15 years. A pack-year is defined as smoking an average of one pack of cigarettes per day for one year. For example, smoking one pack a day for 20 years equals 20 pack-years. 

The American Cancer Society and the National Comprehensive Cancer Network use the same age and smoking-exposure thresholds but do not require former smokers to have quit within the past 15 years. An estimated 14 million people in the United States are eligible for screening under USPSTF guidelines, but fewer than 20% receive the recommended low-dose CT scan of the chest. 

What does lung cancer screening look like?  

Lung cancer screening is performed annually using a low-dose CT scan, which uses significantly less radiation than a standard diagnostic chest CT. The radiation exposure from a low-dose screening CT is less than half the amount of background radiation people receive from the environment, including cosmic rays and radiation from the sun, each year. 

The scan takes only a few minutes, is painless and does not require an injection or contrast dye.

Lary Robinson, MD

The scan takes only a few minutes, is painless and does not require an injection or contrast dye. Screening should be conducted through a structured program that can appropriately evaluate any lung nodules found and discuss potential risks, including false-positive results, additional testing, overdiagnosis and minimal radiation exposure. 

What are common warning signs of the disease?  

Warning signs include a persistent or worsening cough, coughing blood, unexplained chest pain, shortness of breath, hoarseness, unexplained weight loss, recurring pneumonia or bronchitis, and new wheezing. These symptoms can have many benign causes and do not necessarily indicate lung cancer. However, persistent symptoms or symptoms without an obvious explanation should be evaluated promptly. 

Are non-smokers still at risk?  

Routine CT screening is not currently recommended for people who have never smoked because clinical trials have not established that its benefits outweigh its potential harms in this population. Important risk factors include substantial exposure to radon, secondhand smoke, asbestos, air pollution, and certain occupational carcinogens, as well as a history of certain lung diseases. People with significant exposures or a strong family history of lung cancer should discuss their individual risk with a health care professional. In these cases, a CT scan would be an individualized decision rather than standard guideline-based screening.