The topic of lung cancer has once again raised its ugly head with the news that Pope Leo was operated on for an adenocarcinoma of the lung. Of course, many question now arise about this type of cancer and what it means for the long-term outlook for the Pope. I have spoken about lung cancer many times in this column but given the current concern about the Pope I feel a brief review is warranted.
Adenocarcinoma is the most common type of lung cancer found. The management of this cancer is now driven by molecular testing and gene expression. The best treatment is surgical removal. This is what the Pope had done. However, before this happened, I am sure he had other studies to determine if surgery was the best option since survival still depends on the extent of disease or more correctly said, the stage of the cancer. Stages are determined by the anatomic extent of the disease going from very localized to widely spread. The stages are determined by various tests including lymph node biopsy, PET scanning, and lab studies.
There are four stages to consider with adenocarcinoma of the lung. Survival in Stage I (the best) at three years is 84%, Stage II 65.9%, Stage III 49.5%, and Stage IV 21.3%. Survival has improved due to better staging techniques, so patients are not subjected to surgeries that would not be helpful, and there are now more effective biologic and chemotherapeutic options. We wish the Pope well.
