Pope Leo XIV’s recent lung cancer diagnosis and surgery are drawing attention to the importance of early detection and the need for people at increased risk to talk with their doctors about screening.

Although the diagnosis has raised concerns about the pontiff’s health, medical experts say there is an important takeaway for the public: Lung cancer does not always cause symptoms in its early stages but finding it before it spreads can significantly improve a person’s chances of successful treatment.

Priya Andanamala, MD, a medical oncologist at the OSF HealthCare Cancer Institute in Peoria, Illinois, specializes in lung cancer. She says the pontiff’s case underscores why people at increased risk should not put off screening.

“As sad as the news is, I think it encourages all of our patients that are under a high-risk category to get that screening because if we are able to identify these lesions at an early stage, we are able to cure most patients. We’re able to cure them with surgery and chemotherapy, immunotherapy and targeted therapy,” Dr. Andanamala stresses.

Pope Leo underwent a lobectomy, a procedure that removes one lobe of the lung. The lungs contain multiple lobes, with three in the right lung and two in the left. The surgery can help doctors determine the type of cancer, assess whether it has spread to nearby lymph nodes and identify characteristics that can guide further treatment.

Dr. Andanamala says the information gathered during surgery and subsequent pathology testing helps doctors determine whether additional treatment may be beneficial.

While the pontiff’s complete pathology findings and cancer stage were not available at publication time, Dr. Andanamala emphasizes earlier-stage lung cancers can often be treated with the goal of curing the disease. The appropriate treatment and prognosis depend on factors including tumor size, lymph node involvement and the cancer’s molecular characteristics.

A personalized approach to care

That molecular profiling allows for what she calls a more personalized approach to cancer care.

“Trying to determine what biomarkers the cancer has and understanding the molecular landscape, there are many different mutations that, thankfully, we have approved targeted therapy for that are highly effective. So, all of these can be found with comprehensive molecular profiling that we run on the surgical specimen.”

That profile can also help determine if a patient is eligible for certain clinical trials.

Rachael Davis, MD, a physician at OSF HealthCare who specializes in lung conditions, says people should also understand that finding a lung nodule does not automatically mean they have cancer.

“In the Midwest, many people have lung nodules that are not cancer.” Dr. Davis explains, “There’s a fungus in our soil called histoplasmosis that predisposes people to lung nodules, so the rates of benign, meaning non-cancerous or not malignant, lung nodules is much higher in the Midwest than in other parts of the country.”

Doctors evaluate nodules based on factors such as size, growth over time, appearance and location. Comparing current scans with older imaging can help determine whether a nodule is concerning and whether it requires monitoring, a biopsy or additional evaluation.

Know if you have risk factors

Smoking remains a major risk factor for lung cancer, but it is not the only one. Radon exposure, workplace exposure to certain chemicals and dusts, secondhand smoke, asbestos and family history can also contribute to risk.

Dr. Davis says people with a strong family history of lung cancer, particularly among relatives who never smoked, should discuss their circumstances with their primary care provider.

“Most cases of lung cancer are completely asymptomatic,” Dr. Davis stresses. “There are no symptoms early, and so if we wait until there's symptoms in a patient, we've waited too long.”

For people who meet established eligibility criteria, annual low-dose CT scans are the standard screening approach. At OSF, Dr. Andanamala says providers are also offering the First Look lung blood test at 49 locations as another way to help reach certain people at risk.

“It is currently not an alternative for a low-dose scan, but if this is something that is easier for patients to come in for, and if we’re identifying something that is concerning, then typically we’re following up with further testing.”

Illinois has considerable room to improve screening participation. According to the American Lung Association, only about 17% of eligible people in Illinois receive lung cancer screening compared with a national rate of approximately 20%.

Screening for early detection can improve treatment outcomes

Screening rates within OSF are higher.

“If the Pope’s case teaches us anything, it’s that we need to get screened for lung cancer. OSF is a national leader in lung cancer screening at 50% systemwide, but there’s still 50% of our qualified patients who are not being screened,” says Ryan Luginbuhl, vice president of the oncology service line at OSF HealthCare.

To date, 275 people have undergone the First Look blood test at OSF, and 133 were referred for further evaluation through a CT scan. To date, 76 people referred, completed scans. Of those, six were referred for more testing, and of them, two are seeing oncologists. One has received a lung cancer diagnosis.

OSF is also one of the largest medical provider in the Midwest offering robotic bronchoscopy. Dr. Davis says the minimally invasive procedure allows for less painful and more accurate lung biopsies.

“We’re able to biopsy multiple lung nodules at the same time during the same procedure and reduce the need for the patient to come back for multiple procedures.”

This next-level approach is also allowing for use of fluorescent dye during surgery to locate and highlight nodules and spare valuable, non-cancerous lung tissue, improving outcomes and patients’ lung capacity.

Pope Leo’s diagnosis serves as a reminder that even people who appear healthy can develop lung cancer. The most important next step is to understand your risk, talk with a primary care provider and determine whether screening is appropriate.

Find out if you are a candidate for lung cancer screening with this short assessment.

Learn more about the full range of services available at OSF Cancer Institute.

Video clips with Dr. Priya Andanamala

Video clips with Dr. Rachael Davis

B-roll-Pope Leo's lung cancer diagnosis

Vitamin D basics

Maddy Draper, APRN, a health care provider at OSF OnCall, says vitamin D is a nutrient our body needs to produce calcium. Calcium helps create strong teeth and bones. So logically, not having enough vitamin D leads to brittle bones (a risk for greater injury after a fall), plus muscle aches and pains. Others with a vitamin D deficiency may not show symptoms. Either way, a provider may order a blood test to confirm the issue and then may advise you to take a supplement. This is usually in pill form and can be prescribed or bought over the counter by itself or as part of a multivitamin.

“Or the provider may just talk about vitamin D-rich foods first before starting a supplement,” Draper says. “High fat fishes, egg yolks, some cheeses and mushrooms.”

Draper adds that pregnant women, babies (especially babies who are breastfed), the elderly and people with darker skin often lack vitamin D.

On the flip side, Draper says it’s rare, but a person can get too much vitamin D. Symptoms include nausea, vomiting and heart palpitations (feeling like your heartbeat is fast, pounding or otherwise irregular). You may also suffer kidney damage.

Summer sun

Here’s advice to commit to memory: Draper says research shows 10 to 15 minutes of sun exposure three times a day can get you a healthy amount of vitamin D.

“You want to protect your skin while doing that,” Draper adds. “Sunscreen and protective clothing like a hat and sunglasses. There’s not any research showing that sunscreen or clothes will prevent you from getting the vitamin D you need.”

Experts say your sunscreen should have a sun protection factor (SPF) of 30 or higher, and you should reapply every two hours. Clothing should be lightweight and light colored (Dark colors absorb more sunlight, leading to quicker heat illness.) Stay hydrated, and watch for redness and blisters from sunburns and suspicious moles that may be skin cancer. See a provider right away if you have issues from getting too much sun.

Another thing to note: Experts say a specialized lamp can help with seasonal affective disorder, a mental health condition often seen in the winter due to decreased daylight. The same logic does not apply for vitamin D. You need natural, not artificial light to get the vitamin D you need.

The bottom line

Draper says most people don’t have to worry about getting too much or too little vitamin D.

“The average person will get it through the sun,” Draper says. “If you live in a cold and dark environment, you’re at higher risk for vitamin D deficiency. People farther away from the equator are higher risk.”

If you have symptoms of too much or too little vitamin D or just have a concern, talk to your primary care provider.

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September is Prostate Cancer Awareness Month. It's a reminder that the disease is manageable when caught early.

Uwais Zaid, MD, a urologist who provides care at OSF HealthCare, is urging men to get screening appointments on their calendar at the right time. That’s critical, he says, because some people who develop prostate cancer will not show symptoms.

“It is something we certainly do take seriously in urology,” Dr. Zaid says.

What is the prostate?

The prostate is a male gland about the size and shape of a walnut. It surrounds the upper part of the urethra, or the tube that carries urine from the bladder. The prostate makes some of the fluid that’s part of semen.

Risk factors

Dr. Zaid says the risk for prostate cancer increases with age.

Other risks: “African American men are at a higher risk,” Dr. Zaid says. “Certain dietary things like too much red meat and greasy, fatty food. And certain type of exposures such as Agent Orange for some of our veterans.”

And like most other ailments, a family history of prostate cancer should put you on higher alert.

Screening: how and when

Dr. Zaid says prostate cancer screening involves two simple tests. One is a blood test that measures the amount of a hormone produced by your prostate called prostate-specific antigen (PSA). An abnormally high reading might warrant further examination by your health care provider.

The other test is a digital rectal exam, where your provider will feel for lumps on the prostate.

Don’t get that confused with a colonoscopy, the more invasive screening that looks for colon cancer, Dr. Zaid says.

“It doesn’t require any special or horrible bowel prep,” Dr. Zaid says of the prostate exam. “It’s about a 20 second thing we do in the clinic that can save your life.”

You should always see your health care provider anytime something seems off with your body. But the American Urological Association has guidelines for when to get a prostate cancer screening.

“For most men, we want them to start screening with an annual PSA [test] at age 54 to 69,” Dr. Zaid explains. “For certain men, you want to start earlier if you have a risk factor.”

After age 69, Dr. Zaid says you should talk to your primary care provider about what screenings are right for you.

What should you not do?

Don’t think this type of cancer is so common that you should just let it run its course. Dr. Zaid says there are aggressive types of prostate cancer that can be deadly.

Also, Dr. Zaid warns of herbal remedies for cancer in general. He says your best bet is to see a doctor.

Treatment

Dr. Zaid says treatment for prostate cancer depends, in part, on how much the cancer has spread.

If it’s contained to the prostate gland, he says radiation (sending radiation waves to destroy the cancer cells) or surgery to partially or fully remove the gland are options.

“If the prostate cancer has escaped the prostate gland, there are a lot of treatment options,” Dr. Zaid explains. “This is actually a very active area [in medicine] with all sorts of research and new medications.”

Hormone therapy may be an option here, the doctor says.

“It’s very manageable,” Dr. Zaid says on treatment of the disease.

Interview clips

Previous coverage

OSF HealthCare library: Prostate cancer

OSF HealthCare Newsroom: Urinary incontinence and the link to prostate cancer

A gradual drop in testosterone is a normal part of aging and most men don’t experience any real symptoms or problems.

Others may not be so fortunate.

They may notice a lack of sex drive, muscles getting thinner and weaker and a loss of body hair over time. Or the shift can be subtle like mood changes, less energy or a lack of concentration.

Shitladas Pamnani, MD, with OSF HealthCare, says men, like women, experience major hormonal changes, especially in their testosterone levels. Some call it “male menopause.”

“Our energy goes down, sex drive goes down, it’s a natural cycle,” says Dr. Pamnani. “Our skin is not the same as we age, and other body organs, including hormone producing glands, are not functioning as well either as testosterone levels naturally decline.” 

Recently, a study published in the journal Annals of Internal Medicine revealed that low testosterone in men can also lead to an increase in mortality risk.

The study was done by researchers at the University of Western Australia and included more than 24,000 subjects. The researchers reported that low baseline levels of testosterone in men are associated with an increased risk of all-cause mortality (death by any cause) and that very low levels are related to a rise in cardiovascular death.

“As we age, studies have found that 50% of men above the age of 80 will have low testosterone,” says Dr. Pamnani.

While age is a major factor in a drop in testosterone levels, illnesses can play a role, too. Type 2 diabetes, obesity and pituitary gland problems can all affect levels, as can treatments such as radiation therapy, chemotherapy and steroid medicines.

Another problem is sleep apnea.

“Obstructive sleep apnea many times goes undiagnosed, which is also linked to decreased testosterone level as well as fatigue,” Dr. Pamnani says. “Those are common symptoms that middle aged men present with and could be explained as simple as sleep apnea, or even anemia or electrolyte deficiency.”

Low testosterone is usually discovered with a blood test, which is usually scheduled in the morning. According to Dr. Pamnani, normal levels range from 300 to 1,000 ng/DL.

If you test for low blood levels of testosterone and have significant symptoms, your medical provider may prescribe supplemental testosterone. This can boost levels and may help with muscles, protect bones, help improve mood as well as sex drive. Supplements come in different forms including shots, gels, patches and tablets. Possible side effects include sleep apnea, enlarged prostate and acne. However, experts say treating normal aging with testosterone therapy is not recommended.

If you don't have a medical condition that's causing your drop in testosterone levels, Dr. Pamnani says making simple healthy lifestyle changes can help maintain proper hormonal balance, such as regular exercise and eating a healthy diet. That’s because low testosterone can also lead to fat gain. If you’re not building muscle with the calories you take in, your body turns those calories into fat.

Bottom line, he adds, is have a conversation with your doctor about any issues that may be concerning to you. It can save your life.

“When it comes to treatment, there are risks and benefits. But you should always talk to your doctor before deciding to take testosterone supplements.”

 

Interview Clips 

In the 2023 State of the Union Address, President Joe Biden renewed a call to cap the price of insulin for people with diabetes.

Five days later, the condition got nationwide attention again when singer Nick Jonas, a type 1 diabetic, starred in a Super Bowl commercial promoting a product that monitors your glucose level.

And a recent report from the U.S. Centers for Disease Control and Prevention predicted a rapid rise in cases of diabetes in young people over the next few decades.

It’s a good thing that influencers and medical professionals continue to preach diabetes awareness, says Uche Allanah, MD, an internal medicine physician with OSF HealthCare. That’s because if undiagnosed or untreated, diabetes can be fatal.

“It’s alarming,” Dr. Allanah says, referring to the number of patients she sees with symptoms or precursors of diabetes.

Prediabetes vs. diabetes

Diabetes is a disorder that affects how your body uses blood sugar, from which our blood cells get energy. Type 1 diabetes is when an autoimmune reaction stops your body from making insulin. Without insulin, blood sugar cannot move out of your bloodstream and into cells. With Type 2, your body still produces insulin but doesn’t use it efficiently. Gestational diabetes occurs in pregnant women. Diabetes symptoms include increased urination, increased thirst, increased hunger and unexplained weight loss.

Dr. Allanah says prediabetes describes when you are at risk for diabetes because your blood sugar is higher than normal. She says a blood test is necessary to diagnose prediabetes because you don’t present with symptoms. In fact, the American Medical Association says of the one in three U.S. adults with prediabetes, more than 80% don’t know they have it.

“It’s important to identify prediabetes because you can stall the development of diabetes and actually prevent a patient from becoming diabetic,” Dr. Allanah says.

Risk factors for prediabetes include obesity, sleep apnea and polycystic ovary syndrome in women. Providers also look at a person’s family history of the disease, and Dr. Allanah says certain groups -- African Americans, Hispanics and Latinos, Asian Americans and American Indians -- are at higher risk.

Dr. Allanah advises everyone to have regular checkups with their primary care provider to keep an eye on the risk factors you can control. Also, practice healthy habits from a young age.

“Eat right. Avoid processed food,” Dr. Allanah advises. “Exercise. A lot of people are sedentary, especially due to the pandemic. People who went to the gym no longer workout. Even now that the stay-at-home orders have been lifted, some people are just not back into their previous lifestyle.”

Dr. Allanah also says a prediabetes or diabetes diagnosis is a lot to handle. Some people may have to learn to safely give themselves shots. Others may have to constantly watch for low blood sugar to avoid fainting. Providers realize this and will be there to answer questions. But Dr. Allanah says it’s not uncommon for someone to see a mental health provider to talk about the emotional toll of the diagnosis.

Learn more

Learn more about diabetes care on the OSF HealthCare website.

Interview clips

Recent reports from the United States Centers for Disease Control and Prevention (CDC) are again raising awareness of hepatitis C.

A 2022 report found “too few people diagnosed with hepatitis C are being treated, despite availability of medications capable of curing this viral infection.” Specifically, the agency estimates fewer than one in three people with health insurance are getting direct-acting antiviral treatment for the infection within a year of diagnosis. A June 2023 study published by the CDC also examined gaps in access to treatment, building on the 2022 findings.

The statistics resonate with Marcie Lindstrom, a gastroenterology advanced practice provider at OSF HealthCare.

“If we go back 10 or 15 years, hepatitis C treatment was really difficult,” Lindstrom notes as a possible reason for the hesitancy. “Treatment lasted a year or a year and a half. It required an injection. People really felt bad during treatment.”

Conversely: “Treatment today is so easy. It’s completed in as little as eight weeks. It’s a pill. No more injections,” Lindstrom says.

The basics

Lindstrom says hepatitis – whether A, B, C, D or E – describes inflammation of the liver. She says hepatitis C is a blood-borne virus, and doctors over the years have settled on some common ways it spreads:

• A blood transfusion prior to 1992. Prior to that time, screening blood donors for diseases was not reliable.
• A tattoo or piercing at a place that’s not regulated
• Men who have unprotected sexual relations with men
• People who use illegal drugs, either through a needle injection or snorting through the nose

“Often people are at parties and sharing a straw or dollar bill to ingest. There are a lot of blood capillaries inside the nose. Those can break open,” and blood can spread, Lindstrom says.

Lindstrom calls hepatitis C a silent ailment due to a lack of symptoms.

“Many people can have hepatitis C for decades before they become aware of it,” she says.

Even worse, when a person does have symptoms, they may be vague and tough to distinguish from everyday problems. Fatigue and body aches are common complaints.

Often, Lindstrom says a provider discovers hepatitis C after a person comes in for some routine bloodwork. The bloodwork may come back showing elevated liver enzymes, and a test specifically for hepatitis – also a simple blood test – would then be done.

But if you have any hepatitis C risk factors, you should talk to your health care provider about when you need to be screened. A provider may recommend a screening once a year. And generally, federal guidelines say all adults should be screened for hepatitis C once in their life, and all pregnant women should be tested during each pregnancy. Ask your provider about it when you’re younger rather than older, Lindstrom pleads.

Why it’s important

Untreated hepatitis C can lead to liver scarring known as cirrhosis. That means fewer cells doing their daily functions, which, in turn, can lead to liver failure, liver cancer and even death.

“That’s why treatment is important. We don’t want people to progress to getting cirrhosis,” Lindstrom says. “If they take their eight to 12 weeks of treatment and don’t have a lot of scarring, we have a high success rate in clearing the virus – 98 to 100%.”

Learn more

Read more about gastroenterology care on the OSF HealthCare website.

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You see the phrase as you browse the grocery aisle: helps lower cholesterol.

But have you looked into what that means for you? And more importantly, is this something my children need to worry about?

The answer to the second question is yes, says Tricia Herman, a cardiac rehabilitation registered nurse at OSF HealthCare in Danville, Illinois. And it’s a perfect time to change lifestyles to avoid cholesterol problems as we enter a holiday eating season where you may be chowing down on unhealthy food.

What is cholesterol?

Herman says cholesterol is a fatty, waxy substance that’s responsible for building cells in our body. It also helps produce hormones and vitamin D.

“When we have our cholesterol checked, it’s not just total cholesterol that we’re really looking at. We’re looking at three different levels,” Herman says.

“The bad cholesterol is LDL [low-density lipoprotein]. You can consider it lousy. The good cholesterol is HDL [high-density lipoprotein]. And triglycerides is another level that we take a look at.”

LDL values should be less than 100 milligrams per deciliter. HDL should be greater than 60 milligrams per deciliter. And triglycerides should be less than 150 milligrams per deciliter.

Be proactive at all ages

The average person doesn’t need to memorize those numbers. Herman recommends that when you get your yearly physical, get a blood test to measure cholesterol as well. You’ll need to fast for 12 hours before the test, so Herman says to do it first thing in the morning if possible.

After the results come in, your health care provider will come up with a course of action, if necessary. That may involve follow up lab work or medicine.

What you should think about daily: a healthy lifestyle.

For kids, try for 60 minutes of exercise per day. That could be as simple as walking, Herman says.

And cut down on less healthy food choices like fried or fatty foods, sweets and red meat.

Or as Herman puts it: don’t brake and hit the drive thru because it’s the quick and easy option. Keep your foot on the gas.

“Eating habits are the hardest thing for a lot of people,” Herman says. “It’s the way we were brought up. What was served at our table when we were younger become habits we grow up with.”

Instead, try lean meats like fish or poultry. Bake, grill or broil your meat instead of frying it. Use whole grain bread instead of white bread.

“Create a meal plan for your child that has lots of fruits and vegetables,” Herman says. “Don’t have them eat on the go. Have them sit down and eat so it’s more meaningful and thoughtful.”

The consequences

High cholesterol leads to plaque building in arteries of the heart, brain or legs.

“You’re at risk for stroke if it’s happening in your brain or even in your carotid arteries [in your neck],” Herman says. “You’re at risk for heart disease if it’s happening in your heart. And peripheral artery disease if it happens in your legs.”

Herman notes that high cholesterol often doesn’t come with symptoms until it’s too late. So talk to your primary care provider if you have concerns.

Interview Clips

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What you can eat can help improve your cholesterol

The good and bad about cholesterol