What is going on with Supreme Court Justice Ruth Bader Ginsburg’s health after her FOURTH cancer diagnosis?
Dr. Kevin Wacasey – an ER doctor with 25 years’ experience – weighs in on the possible health implications of Ruth Bader Ginsburg’s diagnosis and treatment.
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https://www.cnbc.com/2019/08/26/heres-what-we-know-about-ruth-bader-ginsburgs-latest-cancer-scare.html
Here’s what we know about Ginsburg’s cancer.
What kind of cancer was it?
Likely pancreatic cancer, but not definitively. If it was pancreatic cancer, it is not clear which kind.
In a statement, the Supreme Court said Ginsburg was treated for a “tumor on her pancreas,” though it did not specify which kind of cells were involved. A biopsy performed in July confirmed that the tumor was malignant and “localized,” meaning it had not spread to other parts of her body.
Ginsburg has previously been treated for colon and pancreatic cancer, as well as for cancerous growths found on her lungs. Colon and lung cancers can metastasize to the pancreas, but it is rare.
The fact that the tumor was localized makes it more likely that Ginsburg had pancreatic cancer, according to Raja Flores, a leading cancer surgeon and the chairman for the department of thoracic surgery at the Mount Sinai Medical Center in New York.
Still, Flores said, “there are a lot of unknowns here.”
How bad is it?
That depends on which kind of cancer it is, which the Supreme Court isn’t disclosing. (The Supreme Court did not respond to a request for more details, including this one.)
There are two main types of pancreatic cancer: Adenocarcinoma and neuroendocrine carcinoma. According to the Pancreatic Cancer Action Network, about 90% of pancreatic cancers fall into the first category, which has a lower survival rate.
According to the American Cancer Society, the five-year survival rate for localized adenocarcinoma is about 34%. In comparison, the five-year survival rate for localized neuroendocrine carcinoma is about 94%.
There is reason to believe that Ginsburg has the less common, more survivable form of cancer. That is because Ginsburg was treated for pancreatic cancer 10 years ago, and is still alive. That makes it likely that Ginsburg had neuroendocrine carcinoma, and that it came back, Mount Sinai’s Flores said.
“My sense, because she is alive a decade later, leads me to believe it was more likely a neuroendocrine carcinoma,” Flores said.
But another question mark is the absence of a surgical procedure.
In December, surgeons removed two cancerous nodules from Ginsburg’s left lung. In contrast, the recent treatment involved radiation therapy.
Radiation is more common for adenocarcinoma than for neuroendocrine carcinoma, according to Joe Hines, the director of UCLA’s Agi Hirshberg Center for Pancreatic Disease.
“I want to be really careful, it’s impossible for me to say exactly,” he said. But, for neuroendocrine carcinoma, “treatment has generally been surgical.”
The treatment Ginsburg received is known as stereotactive ablative radiation therapy. The treatment is generally used for small tumors and is advertised as an effective and convenient procedure typically done on an outpatient basis. Side effects of the radiation include tiredness.
The December surgery, Flores told CNBC at the time, would not have been done if doctors did not believe it would be possible to cure Ginsburg of the disease.