Understanding Justice Ginsburg’s Pancreatic Cancer

Feb 2009 from the Wall Street Journal.

This morning U.S. Supreme Court Justice Ruth Bader Ginsburg had surgery for pancreatic cancer, the court said today.


The operation took place at Memorial Sloan-Kettering Cancer Center in New York. The attending surgeon, Murray Brennan, said Ginsburg will likely stay in the hospital for a week to 10 days, according to the court.


Ginsburg, 75 years old, had no symptoms before a CT scan found a small tumor — about one centimeter across — in the center of her pancreas during a routine annual check-up at the National Institutes of Health late last month. Ginsburg was treated for colon cancer in 1999.

Pancreatic cancer can be a particularly deadly form of the disease. The American Cancer Society  predicted about 37,680 Americans would be diagnosed with it in 2008, and 34,290 would die of it.
Brennan, who was chairman of surgery at Sloan-Kettering from 1985 until 2006, is an expert in pancreatic cancer and has held leadership roles in several national medical organizations. A Sloan-Kettering spokeswoman declined to make him available to discuss Justice Ginsburg’s case.





J. Randolph Hecht, a gastroenterologist and medical oncologist at the UCLA Jonsson Comprehensive Cancer Center, tells the Health Blog that most patients are already inoperable when pancreatic cancer is found.

For those whose tumor is still small enough for surgery, there are a couple of “binary” possibilities, he says. The surgery could cure Ginsburg. Or the tumor could return, which, if it happens, usually occurs between one and three years afterward. Once pancreatic cancer recurs, the patient usually dies within a year.
For most patients, the cancer does come back, Hecht says. But based on the limited information the Supreme Court put out, Hecht says her situation sounds good and “she has a reasonable chance for cure.” Patients in whom the cancer is found before symptoms begin typically do best, he explains.
Most pancreatic cancer cases are a form called adenocarcinoma. Unfortunately, Hecht adds, “this is the most deadly of all the major malignancies.”

Apple CEO Steve Jobs had a rarer type of pancreatic cancer, called an islet cell neuroendocrine tumor, which was removed surgically in 2004. If caught early that cancer often responds well to treatment.

Update: The fact that Justice Ginsburg had surgery is a relatively good sign, says Gauri Varadhachary, a pancreatic cancer expert at the University of Texas M.D. Anderson Cancer Center. Most patients have progressed to an inoperable stage of the disease by the time pancreatic cancer is diagnosed. Varadhachary isn’t involved in Justice Ginsburg’s care.

http://blogs.wsj.com/health/2009/02/05/understanding-justice-ginsburgs-pancreatic-cancer/