SPEAKER_02 0:00

Hello, I'm Gina Christian, and you're listening to a special edition of our OSV Newscast. Pope Leo XIV has been diagnosed with lung cancer following a 90-minute surgery on October 13th, during which the lower lobe of the Pope's right lung was removed. Doctors at Rome's Gemelli Hospital said the examination confirmed the diagnosis of lung adenocarcinoma, as suspected by the preoperative tests. The removed tissue will be examined, and the Pope is expected to remain at the hospital for one week of recovery. The Vatican has canceled all of the Pope's scheduled audiences through October 20th. Moments after the announcement of the diagnosis, I spoke with Dr. Nirmo Viramacineni, who's a professor of cardiothoracic surgery at St. Louis University School of Medicine and the medical director for lung cancer screening at SSM Health. While he's not part of the Pope's care team, he shared insights on lung adenocarcinoma and possible outcomes. Let's take a listen to what he had to say. What are we talking about with this diagnosis? Lung adenocarcinoma. What is that?

SPEAKER_01 1:08

So there are multiple types of lung cancer. So the description that you're getting for adenocarcinoma, it depends on, at this point, based on what it looks like under a microscope slide. Okay. So there are multiple forms of lung cancer that exist. There's squamous cell, there's adenocarcinoma, there's large cell neuroendocrine forms, and there's small cell. And each of these is treated a little differently. The first delineation is usually small cell versus non-small cell. So in the non-small cell category is adenocarcinoma. It's one of the two more common types, squamous cell and adenocarcinoma is mostly what I treat and what most surgeons would treat. This is relevant because this kind will determine how we end up following the Pope and whether he needs any additional treatment. So the standard operation, uh so yesterday when we chatted, I gave you the idea of a tree uh representing our lung, and you've got twigs and branches. So what they did was they removed five twigs, half of his right lung. The right lower lobe is the biggest lobe. So it's a very sound oncologic operation. And you might be wondering why take out a whole lobe instead of a segment. Uh, a lot of it depends on location, size of a lesion. There's some oncologic principles at work. In general, this is a uh very sound operation and standard for a number of patients. We we have some bits of information that are missing, for example, uh we don't know radiographically what this looked like. If this was what we call a ground glass opacity, it's a it's a radiographic feature. Those lesions are less likely to spread to lymph nodes, and you can do with less. But a lot of this depends on where it is in a lobe. And yesterday when I was describing this to you, uh I was talking about how you decide how much you have to take, even for a diagnostic biopsy. It all depends on where it is. It fits in the periphery versus more centrally located. But this is a gold standard operation, and as part of it, the surgeon will have taken out a number of lymph nodes that live in the center of the chest. So, in about a week or so, we'll have additional information regarding what the stage of cancer was. So, right now you know it's an adenocarcinoma, and uh within a few days, with more molecular analysis and detailed pathology evaluation, we'll know if it has spread to lymph nodes and what the dimensions of this tumor are. In broad strokes, small early stage tumors, this is probably all the patient, or in this case, the Pope would require, and follow-up would consist of just follow-up CT scans periodically to make sure there's no recurrence. In general, we tend to recommend chemotherapy after an operation in the event any lymph nodes come back as positive for cancer, or if this lesion itself was more than four centimeters in size. Now, it's been reported that this was a nodule, which implies this was fairly small. So I wouldn't expect that. And assuming your PET scans and CT scans really didn't suggest nodal spread or anything else, the risk of a surgeon finding something unexpected after a thoughtful operation, it's maybe on the order of three to four percent that uh you you'd expect to find something like uh lymph node spread. And a meticulous operation, you you would complete the staging.

SPEAKER_02 4:47

Is the game changer here going to be the lymph node biopsy?

SPEAKER_01 4:52

Yes, and as part of an operation, what they will have done is uh inside the chest there's a roadmap of where lymph nodes live, and systematically uh surgeons are expected to go after lymph nodes. There's always the anxiety of what if, because for a person with early stage lung cancer, they're looking at a lifetime of CT scans, periodic checkups. So each one of those causes some anxiety. I would say day at a time, one step at a time, and uh have some faith.

SPEAKER_02 5:25

And that was Dr. Nirmal Viramacaneni, professor of cardiothoracic surgery at St. Louis University School of Medicine, and medical director for lung cancer screening at SSM Health. He shared his general insights on lung adenocarcinoma, the diagnosis announced by doctors at Rome's Gemelli Hospital following Pope Leo's October 13th surgery. Stay with us at OSV News for continuing coverage of the Pope's health, and see the link to our website, osvnews.com, in the show notes. And please join us in prayer for Pope Leo the Fourteenth. I'm Gina Christian. Thanks so much for listening and God bless.