ROME -- Pope Leo XIV resumed his regular diet, began walking and underwent respiratory exercises on Wednesday as he recovered from surgery to remove a cancerous mass from his lung, the Vatican said. Questions remained about whether the cancer had spread, while Peru’s president suggested Leo might have to alter his planned visit to Latin America next month. Dr. Luigi Carbone and Dr. Stefano Margaritora, a thoracic surgeon, said blood tests and a chest X-ray showed the recovery of the 71-year-old Pope was proceeding normally. “The Holy Father underwent respiratory physiotherapy and has begun walking in his room. He resumed his regular diet and had breakfast and lunch,” they reported. “Recovery is proceeding as planned.” Tuesday’s surgery confirmed that Leo has lung adenocarcinoma, the most common type of lung cancer. Surgeons removed the lower lobe of his right lung. The right lung has three lobes and the left has two. After one lobe is removed, the remaining lung tissue can gradually compensate, especially in otherwise healthy, physically active people. Leo is known for his interest in sports, including weekly tennis games and swimming. Experts said some of Leo’s lymph nodes would also have been removed and tested to determine whether the cancer had spread. Those results have not so far been made public. If the cancer has spread, tests will determine what kind of therapy to pursue, said Dr. Stephen Liu, a lung cancer expert at Georgetown’s Lombardi Comprehensive Cancer Center. Options include chemotherapy, a combination of chemotherapy and immunotherapy or targeted therapy, which involves pills for specific cancers. Liu, who is not involved in the Pope’s care, said adenocarcinoma is the most common type of lung cancer, and also has the most favourable prognosis. “While we know the diagnosis, we now need to know the stage,” Liu said. “We now need to know how big it is, how many spots in the lung are involved. Is it just one nodule, or more than one, and the lymph nodes, are they cancerous?” Dr. PierCarlo Gentile, head of radiation oncology at the San Pietro Fatebenefratelli Hospital in Rome, said the kind of video-assisted minimally invasive chest surgery the Pope underwent could allow him to be back on his feet within 48 to 72 hours. Recovery from the surgery itself takes 15 to 20 days. Post-op complications, including infections, are rare, he said. Doubts over Latin America trip The Vatican has so far announced no changes to Leo’s planned trip to Uruguay, Argentina and Peru on Nov. 6-17. But Peruvian President Keiko Fujimori said Wednesday that his diagnosis and recovery could affect the visit, even as she expressed hope it would go ahead. Leo spent two decades as a missionary in Peru, holds Peruvian citizenship and is beloved by his flock there. “We understand that this recovery will take several weeks, longer than expected,” Fujimori told reporters. “We also understand that there could be some changes to the schedule of his visit.” The ambitious itinerary for the longest trip of his papacy covers just over 31,000 kilometres (19,000 miles), with a dozen flights and two helicopter rides across the three countries, as well as a significant change in altitude in Peru. Fujimori said millions of Peruvians were praying for the pontiff’s recovery and awaiting further announcements from the Vatican. “We hope his recovery will be swift and that his visit can go ahead, but we will also understand if that is not possible,” she said. “What matters most is that His Holiness regains his health.” Oncology surgeons often advise patients not to fly for three weeks after surgery. “If it is Stage 1, he can complete these trips. If more treatment is needed, I would likely advise against the trips,” said Liu. Doctors took tissue samples before surgery The pontiff has offered a rare degree of transparency about the first publicly disclosed major health problem of his 17-month papacy. He revealed the discovery of a nodule, or growth, on his lung during his Sunday noon prayer, announcing it on live television almost as an aside at the end of his blessing. But Leo did not disclose everything he knew Sunday. Tuesday’s medical bulletin said preoperative tests had led doctors to suspect cancer, which surgery confirmed. Leo did not use the word cancer in his announcement, though he described the nodule as being at an “early stage.” The Vatican has now said that those tests included a robotic bronchoscopic biopsy, meaning doctors had already taken tissue samples to assess whether the mass was cancerous. The procedure requires general anesthesia and must be performed in a hospital equipped with one of the advanced machines, said Dr. Lorenzo Spaggiari, chief thoracic surgeon at the European Institute of Oncology in Milan. He said Gemelli hospital had had one for about a year. The Vatican did not say when Leo underwent the diagnostic tests, which also included a chest CT scan with contrast and a PET scan. Pope breaks with a tradition of secrecy surrounding health issues The Vatican has long been secretive about the health of popes and tightly controlled any such information -- a practice encapsulated in the popular Italian saying, " The pope is fine until he’s dead." St. John XXIII died in 1963, nearly a year after doctors diagnosed stomach cancer that was kept hidden at the time. St. John Paul II died in 2005 after suffering for years from the obvious effects of Parkinson’s disease that the Vatican only confirmed after he died. Pope Francis seemed more up front about his health problems, giving an Argentine doctor a tell-all interview for a book about his physical and mental health. But in the end Francis, too, tightly controlled the information that was released in his dying months. As a result, Leo’s decision to announce himself that he had a nodule and was undergoing surgery was significant. “That was truly a revolution. It was like he was reading a medical bulletin himself,” said Giovanni Maria Vian, a church historian and the former editor-in-chief of the Vatican newspaper L’Osservatore Romano. Vian, who was part of the Vatican communications team from 2007 to 2018, said the Vatican’s obsession with secrecy about the Pope’s health was due to both practical and cultural considerations. He noted the Vatican is a 2,000-year-old institution that is culturally European -- and Europeans tend to be more guarded about health problems than people in the United States. “In theory, the Pope has absolute power, so you can understand that there are many people who would aspire to that absolute power,” he said. Secrecy about a pope’s health, therefore “is a legitimate defense of both the Pope in question and the institution itself.” ------ By Nicole Winfield And Colleen Barry Barry reported from Milan. Associated Press video producer Paolo Santalucia in Rome and Associated Press writer Lauran Neergaard in Washington contributed to this report. Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.
