Lung cancer remains a leading cause of cancer death in the United States and worldwide. It can develop in people who smoke, former smokers and those who have never smoked. Pulmonary adenocarcinoma is the most common form of lung cancer, and the type most often found in people who have never smoked.
Pulmonary adenocarcinoma has drawn attention following news reports that Pope Leo XIV was recently diagnosed with this type of lung cancer. Doctors discovered the Pope had a lung nodule during a routine medical evaluation. It was removed surgically after it was suspected (and later confirmed) to be cancerous, along with a portion of his lower lung.
Although a lung nodule does not necessarily indicate cancer, finding one may lead to further testing. Understanding how pulmonary adenocarcinoma develops, which factors may increase the risk and how the disease is diagnosed and treated can help patients and their families better understand what a diagnosis means.
What Is Pulmonary Adenocarcinoma and What Are the Symptoms?
Pulmonary adenocarcinoma, also called lung adenocarcinoma, is a type of non-small cell lung cancer (NSCLC). It begins in glandular cells that produce mucus and typically develops in the periphery of the lungs.
In its early stages, pulmonary adenocarcinoma may not cause noticeable symptoms. As the cancer grows, symptoms may develop, including:
- A persistent or worsening cough
- Chest pain
- Shortness of breath
- Coughing up blood
- Fatigue or weakness
- Unexplained weight loss
These symptoms can have many causes, and having one or more does not necessarily mean someone has lung cancer. However, symptoms that persist, worsen or have no clear explanation should be evaluated by a healthcare professional.
Who Is at Risk for Pulmonary Adenocarcinoma?
Smoking is a major risk factor for any type of lung cancer, including pulmonary adenocarcinoma. However, people who have never smoked can also develop the disease. Other factors that may increase the risk of lung cancer include:
- Secondhand smoke: Breathing in smoke from other people’s cigarettes or other tobacco products can increase lung cancer risk, even in people who do not smoke.
- Air pollution: Long-term exposure to polluted air is associated with an increased risk of lung cancer.
- Workplace exposures: Exposure to substances such as asbestos, diesel exhaust and certain chemicals can increase risk.
- Radon exposure: Radon is a naturally occurring, odorless radioactive gas that can enter homes through cracks and openings in the foundation. Prolonged exposure increases lung cancer risk.
- Family history: Having close relatives with lung cancer may increase a person’s risk.
- Genetics: Carrying certain genetic mutations such as TP53, EGFR, ATM and CHEK2 can contribute to the development of lung cancer.
- Sex and ancestry. Among people who have never smoked, pulmonary adenocarcinoma is more common in women and in people of Asian descent.
Understanding personal risk can help patients and their healthcare providers make informed decisions about prevention and screening.
How Is Pulmonary Adenocarcinoma Diagnosed?
Pulmonary adenocarcinoma can be detected through lung cancer screening or when imaging is performed for an unrelated health concern.
If a lung nodule or other suspicious finding is identified, additional testing helps determine whether it is cancer. The diagnostic process may include:
- Imaging: A CT scan or PET-CT can show the size, location and characteristics of a lung nodule or mass. Depending on the findings, doctors may recommend additional imaging or monitoring.
- Biopsy: A tissue sample may be collected to determine whether cancer cells are present. The procedure used depends on the nodule’s location and other clinical factors.
- Molecular testing: If cancer is confirmed, genomic testing may identify genetic changes in the tumor that can help guide treatment decisions.
Not every lung nodule is cancerous or requires biopsy. Next steps depend on its size, appearance, growth over time and the patient’s risk factors.
How Is Pulmonary Adenocarcinoma Treated?
Treatment may involve one approach or a combination of therapies.
Common options include:
- Surgery: When the cancer is confined to the lung and can be removed, surgery may offer the best chance of a cure. Depending on the tumor’s size and location, a surgeon may remove a small section of the lung or an entire lobe.
- Radiation therapy: High-energy radiation destroys cancer cells. It may be used when surgery is not feasible to treat cancer that has spread to other areas, or in combination with other treatments.
- Chemotherapy: These medications kill cancer cells or interfere with their growth and division. Chemotherapy may be given before or after surgery in combination with immunotherapy or used to treat cancer that has spread.
- Targeted therapy: Some pulmonary adenocarcinomas have genetic alterations that promote cancer cell growth. Genomic testing on the tumor can identify these mutations and help doctors determine whether specific oral targeted therapy may be effective.
- Immunotherapy: These medications help the immune system to recognize and attack cancer cells by enhancing the body’s immune response. Depending on the cancer’s stage and characteristics, immunotherapy may be used alone or in combination with other treatments.
What Are the Survival Rates for Pulmonary Adenocarcinoma?
Survival depends on several factors, primarily the stage of the cancer when it is diagnosed and whether it has spread to other parts of the body.
According to the American Cancer Society, five-year relative survival rates for non-small cell lung cancer are:
- Localized: 67 percent when the cancer has not spread beyond the lung
- Regional: 40 percent when the cancer has spread to nearby structures or lymph nodes
- Distant: 12 percent when the cancer has spread to distant parts of the body
Importantly, these figures are based on people diagnosed from 2015 to 2021 and apply to non-small cell lung cancer overall, not pulmonary adenocarcinoma specifically. They are population-level estimates, not predictions of an individual patient’s outcome.
Early detection of pulmonary adenocarcinoma can make a meaningful difference in treatment options and outcomes. People who meet the criteria for lung cancer screening should talk with their healthcare provider about whether screening is appropriate. Anyone experiencing persistent or concerning symptoms should seek medical evaluation rather than wait for a screening appointment.
At Stony Brook Cancer Center, our Lung Cancer and Chest Disease Team provides comprehensive, personalized care for lung cancer and a wide range of lung and chest conditions. Our multidisciplinary team brings together specialists in thoracic surgery, medical oncology, radiation oncology, interventional pulmonology and interventional radiology to coordinate diagnosis, treatment and follow-up care.
From lung cancer screening and early detection to advanced treatments and survivorship support, we combine specialized expertise and collaborative care to help patients navigate every stage of their journey. Learn more or call (631) 638-1000 for an appointment.
