Catholic healthcare providers, grateful that the pope is recovering well and should need no further treatment, also hope that his ordeal will help promote lung cancer awareness and the importance of early detection. Lung cancer is the leading cause of cancer death in the United States and worldwide, claiming more lives each year than breast, prostate and colon cancer combined.
November is Lung Cancer Awareness Month.
Only about 26% of lung cancers are diagnosed at a localized, early stage, when the disease is most treatable, according to the American Lung Association. If it's caught before it spreads, the odds of surviving five or more years improve to more than 60%.
"Screening is important," said Dr. Brian Louie, a thoracic surgeon at Providence Swedish, part of Providence St. Joseph Health, in Seattle. "Having conversations with your care team, your primary care physician, are critical for these sorts of things because if we catch them earlier, (our) job is much easier than if patients show up with symptoms."
Pope Leo is not known to have ever been a smoker, and his pulmonary adenocarcinoma, the most common type of non-small-cell lung cancer, is increasingly being detected in people who have no history of smoking. The pope's tumor was discovered accidentally during a routine abdominal exam.
Among those recently diagnosed with lung cancer, in "never smokers," or people who have never smoked who have a recent diagnosis of lung cancer, the majority are women. The patients aren't necessarily older: Of affected people ages 20 to 49, about 28% are women who haven't smoked and 19% are men who haven't smoked, according to the American Cancer Society.
Screenings and follow-up
Dr. Sid Devarakonda, the director of thoracic medical oncology at Providence Swedish, said his youngest patient is 21 years old. And while insurance covers scans for lung cancer screening for certain patients who may have smoked for a certain number of years, it's difficult to know when and who else to scan, especially since nonsmokers also get cancer and some don't show symptoms at all, he said. Risk factors for never-smoker lung cancer may include exposure to secondhand smoke, occupational exposures, exposures to radon and/or air pollution, and genetics. However, how these factors should be used to guide screening for lung cancer in never-smokers is not clear.
"The pope's lung cancer can help raise awareness and reduce the stigma that it is a smoker's disease," Devarakonda said.
"The biggest risk factor for never-smoked lung cancer is having lungs, and that's all of us, right?" he said.
Screening challenges
Dr. Sy Sarkar, an interventional pulmonologist at Mercy Medical Center in Baltimore, emphasized that despite strong evidence supporting lung cancer screening, participation remains low. National estimates suggest that fewer than one in four eligible Americans undergo recommended screening. Sarkar said physicians and health systems must do more to identify eligible patients, discuss their risk factors, and facilitate access to low-dose CT screening. Equally important, he emphasized, is ensuring that patients with abnormal findings receive appropriate follow-up.
Many pulmonary nodules are discovered incidentally when patients undergo chest CT scans for unrelated medical reasons, rather than through formal lung cancer screening programs. Although most pulmonary nodules are benign, some may represent early lung cancer. Sarkar noted that one of the greatest challenges is ensuring that these findings are appropriately evaluated and that patients are not lost to follow-up.
"A significant part of my role as an interventional pulmonologist is evaluating these incidentally discovered lung nodules and determining which patients need surveillance and which require further diagnostic testing," Sarkar explained. "Not every nodule needs a biopsy, but identifying the ones that may represent an early lung cancer is critical. Early detection can make a tremendous difference in patient outcomes."
Sarkar referenced the landmark National Lung Screening Trial, which demonstrated that screening with low-dose CT reduced lung cancer mortality by approximately 20% compared with chest radiography.
"The difference in survival between early stage and advanced lung cancer is substantial," Sarkar said. "When we identify lung cancer at an early stage, patients have significantly more treatment options and a much greater opportunity for long-term survival."
Advances in interventional pulmonology have expanded the ability to evaluate suspicious pulmonary nodules through minimally invasive procedures.
Techniques such as navigational and robotic-assisted bronchoscopy allow specialists to reach and biopsy selected small nodules located deep within the lungs, potentially establishing a diagnosis while the cancer is still at a treatable stage.
Sarkar pointed out that a bronchoscopy is not a screening test, but rather a diagnostic tool. Last year, Our Lady of Lourdes Regional Medical Center in Lafayette, Louisiana, a member of FMOL Health, introduced bronchoscopies as part of a lung cancer screening program, as did Holy Cross Health in Fort Lauderdale, Florida, a member of Trinity Health. Early this year, Ascension Via Christi's Lung Nodule Clinic in Wichita, Kansas, announced it had completed 1,000 procedures to detect early lung cancers.
Hospitals and health systems across the country are increasingly developing comprehensive lung nodule programs that combine screening, incidental nodule detection, advanced diagnostic procedures, and coordinated follow-up.
Spreading awareness
Sarkar said the recent attention surrounding Pope Francis' lung health has prompted patients to ask whether they, too, should be concerned about findings on their chest imaging.
"Patients have asked me whether their situation is similar to what they've heard about the pope," Sarkar said. "These conversations provide an opportunity to explain why appropriate evaluation and follow-up are so important."
He emphasized that awareness should extend beyond prominent public figures.
"Lung cancer is not just a concern for celebrities or high-profile individuals. It affects everyday people, and many patients have no symptoms when an early cancer is discovered," Sarkar said. "The message is that we need to identify those at risk, screen eligible patients, and make sure suspicious findings are never overlooked. Early detection, appropriate diagnosis, and timely treatment can save lives."