VATICAN CITY – Pope Leo XIV was expected to enter a Rome hospital Tuesday for surgery to remove a lung nodule, a procedure that doctors say will establish whether the lesion is cancerous and whether further treatment will be required.
Leo has provided an unusual degree of public detail about the first major health issue disclosed during his 17-month pontificate. During his Sunday noon prayer, he announced that doctors had found a small, localized nodule and that it would be removed.
The Vatican said the pope was scheduled to be admitted to Rome’s Gemelli hospital late Tuesday morning. It did not immediately announce when the operation would take place.
The procedure is generally carried out under general anesthesia and is expected to require a weeklong hospital stay. The Vatican has canceled all of Leo’s audiences through Oct. 20.
“These are things that can be treated very well, if the words he used reflect the clinical situation,” said Dr. Lorenzo Spaggiari, director of thoracic surgery at the European Institute of Oncology, or EIO, in Milan. Spaggiari is not involved in the pope’s treatment but is familiar with the medical team at Gemelli.
Robotic technology could allow doctors to perform a biopsy before surgery
Spaggiari said he expected Gemelli specialists to conduct a biopsy to determine whether the nodule is lung cancer, followed by removal of the section or lobe containing it.
Both procedures could potentially be carried out with robotic equipment during the same session and under one anesthetic, with separate specialist teams handling each stage, Spaggiari said.
Spaggiari said a sophisticated robotic bronchoscopy system known as ION can biopsy nodules measuring as little as 3 millimeters, or roughly one-tenth of an inch. Gemelli and the EIO both have the technology, which has been available in Italy for only two years.
Gemelli also has robotic surgical equipment that could allow doctors to remove the nodule through “a minimally invasive technique,” he said.
The approach requires four small incisions in the chest, through which surgeons insert instruments connected to the so-called da Vinci robot. The surgeon controls the robotic arms while viewing the operating area on a high-definition, three-dimensional screen.
“It’s a very well-established technology. This is something we have been doing for 20 years,” he said.
It remained unclear which technique would be used in Leo’s case. Gemelli has documented completing robotic procedures for both diagnosis and surgery in less than four hours.
Spaggiari described the risk associated with the biopsy as “virtually zero.” For otherwise healthy patients with good heart and lung function, the mortality risk from the surgery is also very low, estimated at 0.6% to 0.8%, he said.
Further tests will show whether additional treatment is needed
During the operation, doctors would remove lymph nodes draining the affected lung segment or lobe along with the nodule and surrounding tissue. “If all those lymph nodes turn out to be negative, so stage one, then the outlook is very good,” Spaggiari said, adding that no further treatment would be necessary in that case.
The Vatican has said the nodule was found during routine medical checks. Spaggiari said the pope likely underwent additional examinations before doctors recommended surgery.
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“I think he has had a bit of luck. They found something that was asymptomatic — a lung nodule, possibly a tumor. He might call it something else; we call it luck,” he said.
Recovery could determine whether November trip to South America goes ahead
The European Institute of Oncology advises patients to avoid flying for three weeks after this type of surgery. That timeline would leave Leo just enough time to make his planned Nov. 6-17 visit to Peru, Argentina and Uruguay, depending on how his recovery progresses.
“I think the Holy Father is in excellent hands at Gemelli,” Spaggiari said. “They have everything needed to keep the Holy Father alive for a long time.”
An unusually open approach to papal health
Leo’s surgery marks the first major health event of his pontificate. It was significant because the pope himself revealed the news, in perhaps the most public way possible: at the end of his Sunday noon blessing, with thousands of people in St. Peter’s Square.
The Vatican has for centuries zealously guarded the pope’s health and has often sent out confusing information, or none at all, about papal illnesses. Pope Francis tried to change that by being upfront about his frailties and musing on his eventual death. But even during his pontificate, information was tightly controlled.
Leo’s decision and reveal suggested an unusual level of transparency by the American pope.
“I really appreciated yesterday at the end of the Angelus, he himself said, ‘This is what’s going on — very transparent — and ask for prayers,’” said Quebec Cardinal Gérald Cyprien Lacroix at the Vatican Monday.
A lung nodule is a small abnormal area measuring less than 3 centimeters (1.2 inches) that sometimes appears on a CT scan of the chest or abdomen. Often, the scans are done to investigate trauma or a lung infection, unrelated to a lung cancer screening. A nodule can be benign or malignant, and oftentimes surgical removal is recommended both to establish whether it is cancer and to treat a malignancy while it is still localized.
Oncologists say even if the nodule turns out to be cancerous, Leo’s prognosis is “excellent” since it will have been removed at an early stage.
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Barry reported from Milan.
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