Leo XIV: from histology to innovative treatments – the next steps in the Pope’s treatment programme

The operation went well and Pope Leo XIV has begun his rehabilitation by taking his first steps in his room at the Policlinico Gemelli. But this is only the beginning. The next clinical steps in his treatment programme, following surgery for lung adenocarcinoma, are divided into three main phases: immediate post-operative monitoring (24–48 hours), histological examination with tumour staging, and the determination of subsequent treatments.

The first and most critical stage concerns the management of the first 24–48 hours following the operation to remove the lower lobe of the lung. Experts describe this period as the most delicate in terms of ruling out acute complications, monitoring respiratory recovery and managing post-operative pain. However, the medical bulletin has provided initial reassurances on this point: “This morning, the Holy Father underwent the blood tests and chest X-ray scheduled following the operation. The results confirm a smooth post-operative recovery: the values are within the normal range for the type of operation performed”. The Pope has undergone respiratory physiotherapy and has begun walking around his room. He has also resumed a regular diet, having had breakfast and lunch. “His recovery is proceeding as expected,” concludes the bulletin, effectively confirming that his hospital stay is expected to last a week. “Twenty-four hours after his lung surgery, Pope Leo XIV is doing well and is in good spirits,” summarises the director of the Holy See Press Office, Matteo Bruni.

Over the coming days, the medical team led by Dr Luigi Carbone and Prof. Stefano Margaritora will examine the full histological report on the removed tumour and the lymph nodes that were excised. This step is crucial for determining not only the exact staging of the disease (the extent of the tumour) but, above all, the presence of specific molecular alterations or biomarkers. The Vatican has announced that an initial intraoperative histological examination – carried out during the operation – has already been performed, confirming the diagnosis of lung adenocarcinoma, as suspected by the pre-operative tests.

Now, the new test, explains Federico Cappuzzo, director of the Medical Oncology Unit 2 at the Regina Elena National Cancer Institute in Rome, will provide a precise ‘full name’ for the disease: that is, to define the type of lung cancer and its stage, whilst also indicating whether the disease has spread to the lymph nodes in the thoracic area from which samples were taken. Determining the stage of the disease is crucial for assessing whether additional treatments are required. Lung cancer is classified into stages 1 to 4: “For stages 1, 2 and part of stage 3,” continues Cappuzzo, “medical treatments are usually administered either before or after surgery; advanced stage 3 and stage 4 are not operable but require medical treatment.”

We will have to wait a few more days for the results of the histological examination. If the adenocarcinoma is found to be localised and at an early stage, surgery alone may be considered a curative treatment, requiring only periodic check-ups over time. If, however, the tumour is at a more advanced stage or exhibits aggressive characteristics, the use of targeted drug therapies will be considered, which today benefit from the latest advances in thoracic oncology.