Pope plans gradual return to duties after cancer surgery

Pope Leo has thanked thousands of faithful in St Peter's Square for their prayers while he was in hospital for an operation to remove a malignant tumour, and said he plans to gradually return to his usual duties.

The crowd erupted in cheers when the pontiff showed himself in the window overlooking the square, where a week ago on the same occasion of the traditional Angelus blessing he revealed that a nodule had been located on his lung, and that it would be surgically removed.

"Now that this delicate phase is behind me, I will gradually resume my activities, always with God's help and your prayers," Leo said, his voice sounding strong four days after the lower lobe of his right lung was removed.

The pontiff said the experience of the last week "has made me feel especially close to those facing illness and infirmity."

He told the faithful that he had "truly felt your support", and expressed "particular gratitude to the doctors, nurses and all the staff at Gemelli hospital" where he was treated.

The pope paused for a moment and waved to the crowd before retreating into his apartment in the Apostolic Palace.

The 71-year-old pontiff had the lower lobe of his right lung removed on Tuesday in the first major health event of his 17-month pontificate.

The surgery confirmed he had adenocarcinoma, the most common type of lung cancer.

He told a reporter in English that he was doing "much better" as he drove away from Rome's Gemelli hospital to return to the Vatican, after a shorter hospital stay than had initially been anticipated.

"I don't believe it, because he was just operated on the other day," Cosimo Mastrocinque, a retired factory worker visiting the Vatican from the southern region of Puglia, said.

"It is a miracle that he recovered already."

Leo's next major engagement is an ambitious 6-17 November trip to Uruguay, Argentina and Peru, including a dozen flights and two helicopter rides to high altitudes.

His surgeon, Dr Stefano Margaritora, told Vatican News that "there are no clinical reasons why it should not take place."

"The Holy Father has put his heart and soul into his recovery," Dr Margaritora told Vatican News, adding that he expected the pope to recover fully from surgery "in another 10 days or so."

Histological testing of the tumour and related lymph nodes was under way. The results, along with details of the tumour's molecular and genetic make-up, will help doctors determine whether the pope needs additional treatment.

Options include chemotherapy, a combination of chemotherapy and immunotherapy, or targeted oral therapy based on the tumour's genetic characteristics.