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Wishing Justice Ginsburg a Speedy Recovery:
The AP is reporting that Justice Ginsburg had surgery today for pancreatic cancer:
  Supreme Court Justice Ruth Bader Ginsburg has undergone surgery for pancreatic cancer, apparently at an early stage.
  The court said the 75-year-old Ginsburg had the surgery Thursday at the Memorial Sloan-Kettering Cancer Center in New York.
I'm very glad it was caught an an early stage, apparently after a routine exam. (Read more details on that in the story -- click on the link to see them.) Best wishes for a speedy recovery. Thanks to David Chesler for the heads-up.
EricPWJohnson (mail):
Best Wishes Justice Ginsberg
2.5.2009 1:35pm
EricPWJohnson (mail):
That would be Ginsburg - sorry
2.5.2009 1:35pm
Ariel:
Best wishes to Justice Ginsburg, the Justice on the left with the most integrity.
2.5.2009 1:55pm
Brad Patrick (mail):
Let the rampant speculation about retirement and appointments begin! I hope Justice Gisburg has a speedy recovery, and chooses to retire and emulate her colleague Justice O'Connor as an active, vibrant retired Justice.
2.5.2009 1:59pm
Edmund Unneland (mail) (www):
She's my home girl on the Court (we're both from Brooklyn). All the best to one of the few people in Washington who knows that an Egg Cream has neither.
2.5.2009 2:00pm
GD:
Pancreatic is not good.
2.5.2009 2:08pm
TerrencePhilip:
She has always been a very patient, precise Justice, down to business but courteous with people appearing before her, and a great American success story. Here's hoping her recovery goes great.
2.5.2009 2:08pm
Archon (mail):
Unfortunately pancreatic cancer is a death sentence. The survival numbers are not good - only 5 percent after 12 months. Researchers don't even bother tracking rates after 18 months.

Maybe she will get lucky with an experimental treatment, but realistically speaking we will most likely see a retirement in June if not earlier.
2.5.2009 2:14pm
GSC:
I too send my warmest thoughts for her recovery. Sadly, 95% of individuals with pancreatic cancer don't make it past 6 months. It is an awful disease, and unless she is very lucky and has the rarer form of the condition, this will sadly be her final term on the Court.
2.5.2009 2:16pm
Sarcastro (www):
[They caught it crazy early, though which could skew the odds at least a bit.

I understand that at least it is often not painful.]
2.5.2009 2:18pm
Michael Masinter (mail):
The NCI PDQ reports a five year survival rate of 18-24% for localized tumors of 2cm or less; Justice Ginsburg had a 1cm tumor. I hope she returns to the bench in good health.
2.5.2009 2:27pm
xx:
Hasn't she already survived one bout? Bodes well, I hope.
2.5.2009 2:28pm
Happyshooter:
I am sorry for her, that is one of the worst ways to go.
2.5.2009 2:32pm
Dave N (mail):
My best wishes for Justice Ginsburg's speedy recovery. I would not wish pancreatic cancer on anyone this side of Osama Bin Ladin.
2.5.2009 2:36pm
A Law Dawg:
My grandmother was diagnosed with Pancreatic when I was 13. She was given 6 months to live, then 6 more months to live, then 6 more, etc. It took almost 2 years for her to waste away, slowly, painfully, and across the hallway from my bedroom.

Though I generally disagree with Justice Ginsburg on many of the major politically divisive cases, I truly hope that she has dodged a bullet with this early catch.
2.5.2009 2:37pm
Steve Job's pancreas:
Hopefully it's a rare form of the cancer - Steve Jobs survived his bout with a rare form of pancreatic cancer.

"the Justice on the left with the most integrity."

Quite. I'd rather have two Justice Ginsburgs than one Kennedy, and I'm no liberal...
2.5.2009 2:43pm
Steve:
Prayers and best wishes for Justice Ginsburg.
2.5.2009 2:43pm
Connecticut Lawyer (mail):
It's an awful disease, very painful, almost always fatal. I pray that she doesn't suffer.
2.5.2009 2:53pm
hawkins:
Here I was thinking all Justices had sufficient integrity...
2.5.2009 3:02pm
Jeff Lebowski (mail):
Best wishes to Justice Ginsburg, and her family and friends.

According to this link at NPR, she had colon cancer about 10 years ago. She had radiation treatment, and would probably not be able to have radiation again. The article goes on to say that pancreatic cancer generally doesn't respond to chemo.



h/t Protein Wisdom
2.5.2009 3:11pm
Jeff Lebowski (mail):
Let's try this again....

2.5.2009 3:13pm
Jeff Lebowski (mail):
OK, can't seem to link. It's at NPR.

Sorry for the triple post.
2.5.2009 3:14pm
ohwilleke:
While pancreatic cancer has a high mortality rate, it isn't necessarily insurmountable.

My father was diagnosed with it more than five years ago, and now has essentially no cancer markers or traces of it, despite the fact that the first doctor who looked opened him up, said there was nothing he could do, and closed him up again.

Equally important, the main reason that mortality for pancreatic cancer is so high is that it is usually asymptomatic until discovered at a very advanced stage. Ginsberg's colon cancer in 1999 probably means that she, unlike most people, was receiving monthly or quarterly cancern marker screens which would have caught this otherwise asymptomatic condition very early. This increases her prospects immeasurably.

At any rate, I certainly wish her the greatest health and best available care.
2.5.2009 3:24pm
Just an Observer:
Tom Goldstein writing at SCOTUSblog: Call Off The RBG Retirement Watch, Before It Starts
2.5.2009 4:00pm
Richard Aubrey (mail):
My doc says pancreatic cancer is nature's way of humbling the art of medicine.
2.5.2009 4:13pm
neurodoc:
Sarcastro: [They caught it crazy early, though which could skew the odds at least a bit.

I understand that at least it is often not painful.]
Unfortunately, even your bracketed posts are usually wrong, and this one about it often not being painful is no exception. If I had my druthers, this is not what I would chose to die from.

Steve Jobs of Apple seems to have beaten the odds on survival, at least for now, but reportedly he had a very unusual kind of pancreatic cancer.

Now, I don't see discussion above about the prospects of Justice Ginsburg returning to the bench. If she tries to, though, the question may be asked whether she ought to be doing it, with discussion of others who have tried to soldier on in the face of grave illness. Rehnquist come first to mind, then Douglas, and perhaps others. (With Douglas, of course, he wasn't mentally up to it and that made it all very awkward.)
2.5.2009 4:14pm
Lucius Cornelius:
I wish Justice Ginsburg a speedy recovery and a long, healthy life. Major surgery on someone her age is difficult to bounce back from, but not impossible.
2.5.2009 4:33pm
Henry679 (mail):
Assuming she can beat this, the issue becomes what is best for her, and the nation, while trying to do so. Perhaps the knowledge that Obama will appoint someone likely to emulate her ideologically might make it easier for her to leave, if that is advisable (which I think highly likely).

Best wishes to you, Justice Ginsburg.
2.5.2009 4:50pm
The Cabbage (mail):
She's tougher than Patrick Swayze, and he seems to have beaten it.

No one puts Bader in a corner!
2.5.2009 4:58pm
CDR D (mail):
My mother died of pancreatic cancer in 1996. She was only 72, and died on Mother's Day that year. She had no idea what was wrong with her until the final month.

Two of my close friends also passed from that disease.

I wish the best for Justice Ginsburg.
2.5.2009 6:59pm
neurodoc:
Just heard on the evening news that Justice Ginsburg's tumor was discovered unexpectedly on an abdominal CT, which I imagine was done as part of routine follow-up to the colon cancer she had 10 years ago. Perhaps it is in her favor that it was not the case that she presented with symptomatic complaints and the CT scan that discovered the tumor done on account of those symptoms. (I'm not at all expert in these matters, so can't offer any statistics. But probably relatively few cases of pancreatic cancer are discovered when they are small and not yet causing any symptoms, so wonder if there are solid statistics to go by in her case.)

While it seems logical that early detection of cancers, e.g., cancer of the lung, and hence earlier treatment, would mean substantially greater survival rates, that may not be so. It may be that what is most significant is the biology of the individual's tumor, that is the aggressiveness of the tumor in them, and those who will do the best were those who were likely to do the best whether diagnosed "early" or not, and those who will do worst would not have had all that much greater a chance had they had their tumor been seen/imaged earlier.
2.5.2009 7:35pm
PersonFromPorlock:

While it seems logical that early detection of cancers, e.g., cancer of the lung, and hence earlier treatment, would mean substantially greater survival rates, that may not be so.

So long as survival rates are determined by what percentage of patients are alive x years after discovery of the cancer, earlier discovery will always result in a higher survival rate even if treatment is completely ineffective.
2.5.2009 8:46pm
Thoughtful (mail):
As a radiologist whose father died of pancreatic cancer at an early age, this report caught my eye. It IS, as neurodoc indicates, pertinent that this was an incidental finding in a patient with no symptoms of pancreatic cancer. One of the reasons for the dismal prognosis of pancreatic cancer is that it is often widespread and commonly inoperable (for cure) when it becomes symptomatic.

The earliest case I caught was a 1 cm pancreatic cancer in a patient getting a routine CT because he had consented to give a kidney to a relative. There was no evidence of spread beyond the pancreatic capsule, no regional enlarged lymph nodes, no evidence of metastatic disease to the liver, no evidence of direct spread into adjacent organs. Nonetheless, the patient did not survive a year. Early microscopic (sub-imaging) spread of disease makes this an especially difficult cancer to affect in terms of longevity.
2.5.2009 10:47pm
MHodak (mail):
This news jolted me. I'm no fan of Ginsburg, but I am very sad for her, and would be very happy to hear of her recovery from this. But I don't expect it.
2.5.2009 11:23pm
LM (mail):
Prayers.
2.5.2009 11:50pm
theobromophile (www):
Many hopes for a solid recovery for Justice Ginsburg. What a horrible thing to have happen.

One of my friends got pancreatic cancer in college; it was discovered after a year of complaints of (and tests for) abdominal pain. He passed away 15 months later, after having gone into remission about nine months after his diagnosis.

While he rarely said anything to us about the pain he was in, he did discuss it - in great detail - with the doctors at Dana-Farber and Harvard med school, in an attempt to improve pain management for other cancer patients. I can only presume that he was in horrific pain to have said anything, let alone gone through the effort to educate medical professionals.

The doctors on here obviously know way more about this than I do, but I heard that older people can sometimes fare better with cancer, because it spreads more slowly through the body. (Everything slows down as you age; my understanding is that cancer is no exception.) May it be so with Justice Ginsburg.
2.6.2009 2:14am
neurodoc:
PersonFromPurlock: So long as survival rates are determined by what percentage of patients are alive x years after discovery of the cancer, earlier discovery will always result in a higher survival rate even if treatment is completely ineffective.


Early Lung Cancer Detection Does Not Increase Survival

Popular wisdom says the earlier a cancer is detected, the more successful the treatment and the better the chances of survival. But this does not seem to hold true for at least one kind of lung cancer, according to new research.

The surprise finding of the study, which appears in the June issue of the journal Chest, was that there was no correlation between tumor size and survival. It remains to be seen whether detecting smaller nodules with newer [more sensitive] technologies such as computed tomography (CT) scans will alter the natural history of the disease,? said lead investigator Edward F. Patz, M.D., of the department of radiology at Duke University Medical Center in Durham, N.C.

Patz and colleagues studied 510 consecutive patients...
2.6.2009 3:46pm

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