VATICAN CITY - Pope Francis marked 12 years as head of the Catholic Church on March 13, celebrating with cake and slowly recovering after a month in hospital, but with his health casting a shadow over his future.

The 88-year-old pontiff was for a time critically ill, battling pneumonia in both lungs at Rome’s Gemelli hospital, to which he was admitted on Feb 14.

The Argentine cleric’s situation has markedly improved since then and he is reported by the Vatican to be stable – and at least well enough to eat cake.

“He celebrated a little bit with the health workers who have been helping him during this time with a cake and candles,” the Vatican press office said late on March 13.

Francis spent the morning following prayers and meditations in the Vatican via videolink, without being seen, alongside his usual treatments and physiotherapy, the Holy See said.

After that, he prayed and continued his breathing exercises, it said.

Other than his cake, no special events were planned for his anniversary, but the Vatican said he was shown hundreds of messages of goodwill sent from schools, religious institutions and young people.

The Vatican press office said it would issue another medical bulletin on the evening of March 14, but might stop sending a daily morning update.

Talk is now turning to when he might go home. But his hospital stay – the longest and most fraught of his papacy – has raised doubts about his ability to lead the world’s nearly 1.4 billion Catholics.

“It takes time for a body of 88 years old affected by bilateral pneumonia to recover, also in terms of energy, of strength,” the press office said.

Slowing down

Francis had before now refused to make any concessions to his age or increasingly fragile health, which forced him to begin using a wheelchair three years ago.

He maintained a packed daily schedule interspersed with frequent overseas trips, notably a 12-day tour of the Asia-Pacific region in September, when he presided over huge open-air masses.

But experts say his recovery could take weeks given his age and recurring health issues, not helped by having part of one lung removed as a young man.

“The rest of his pontificate remains a question mark for the moment, including for Francis himself,” said Father Michel Kubler, a Va...