Pope Francis marked 12 years as head of the Catholic Church on Thursday, 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, where he was admitted on February 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 Thursday.

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........

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