Chicago experts explain what a lung nodule like Pope Leo XIV's may mean

The Vatican announced this weekend that Pope Leo XIV will undergo surgery this week after a nodular lesion was found in his lung, but experts say such a discovery does not necessarily mean cancer.

The South Side Chicago native Leo, 71, said Sunday that doctors recently discovered the nodular lesion during medical checks. He said it was found in an early stage and was "circumscribed."

"The doctors believe it's best to take action, so, following their advice, I've decided to have surgery to remove it," Leo said in remarks during his Sunday noon blessing. "Thank you for your spiritual support, and I entrust myself to your prayers."

At Holy Name Cathedral on Sunday, congregants prayed for the pope, and his message about the operation was addressed first-thing in services.

Meanwhile, Chicago-area doctors and experts explained the diagnosis and what can be expected. Dr. Nicole Geissen, a thoracic surgeon at Rush University Medical Center, explained the definition of a nodule. 

"A nodule is a term that we use to describe any spot that's found on the lung in imaging, usually when it's less than 3 centimeters in size," Geissen said, "and for reference, that's about the size of a bottle cap." 

Dr. Justin Karush of Northwestern Medicine explained why lung nodules warrant operations.

"Lung nodules, generally speaking, are common. They are far and away not most often to be malignant," Karush said. "But sometimes we remove them based on suspicion." 

Both Geissen and Karush said such nodules do not necessarily indicate cancer.

"Honestly, there's a variety of possibilities," said Karush. "You know, people get long nodules for a variety of reasons. We inhale certain things. We get infections in our lungs." 

Geissen also explained what it may mean given that Pope Leo's nodule was caught early, and he is moving to surgery quickly.

"What it says to me is that there's a characteristic of the spot that maybe is a little more concerning, that warrants further investigation," she said, "so not necessarily that someone's highly concerned for cancer, but there's something about this spot that they want to do more investigation." 

But Karush said jumping to conclusions would be premature.

"We don't have enough information to guess exactly what it is going on," he said.

However, the odds that a lung nodule is cancerous are low.

"Most of these, about 95/100, are not cancerous or benign in nature," Geissen said.

Karush added, "When we do find small early-stage suspicious lesions, we do as surgeons have a lot of options in terms of what we can do for patients."

Blase Cardinal Cupich, the archbishop of Chicago, released a statement Sunday inviting everyone to join in prayer for the pope:

"Pope Leo announced today that at the advice of doctors he will undergo surgery in the coming days to remove a small, localized nodule at an early stage in his lung. Please join me and the people of the Holy Father's home diocese in praying for his swift and complete recovery.

"May the Holy Spirit guide the hands of the surgeons and may the Blessed Mother hold Pope Leo in the days ahead as he returns to full health."

The pope has no other documented health problems and is known to be physically active — swimming and playing tennis weekly.  He said in his Sunday remarks that he still plans to make a trip to South America next month. 

The Chicago experts said recovery from something like the pope's condition can be quick.

"The report was that he was going to be out of contact for a week or so," said Geissen. "Most of our patients are feeling good the same day and tell us they are back to normal at about that week mark, and I think that's a realistic expectation."

Meanwhile, medical institutions are being more proactive in screening for and detecting lung abnormalities.

"We are trying to broaden the net of who should qualify for a screen to pick up early-stage lung cancers. At Northwestern, we're studying that because we found that even the wide net that we have doesn't capture all the lung cancers that we diagnose," said Karush. "So at Northwestern, we have a lung health center where we're offering screening to patients who do not have that history, who weren't smokers their entire lives. And so we're identifying more and more lung cancers and more risk factors for lung cancers so we truly know who deserves a screen."

The Lung Health Center at Northwestern was founded after a study that only 35% of 1,000 consecutive lung cancer patients would have qualified for screening under the current U.S. Preventive Services Task Force guidelines.

Northwestern Medicine researchers now recommend expanding universal age-based screening for lung cancer to ages 40 to 85. They say this would detect 94% of lung cancers and prevent more than 26,000 deaths a year.

Patients interested in scheduling a screening with the Northwestern Medicine Lung Health Center can call 312.695.1800 or email lunghealthcenter@nm.org.

Karush said if the pope were being treated in Chicago, he would undergo an ambulatory precision lung-sparing, or A-PLUS, procedure. These involve a cancer screening test, followed by a surgical procedure involving robotic scopes.

A spokesperson for the Vatican said the surgery will happen in the first days of the week.