Supreme Court Justice Ginsburg Faces Tough Battle Against Pancreatic Cancer

ByABC News
February 6, 2009, 1:01 PM

Feb. 7 -- FRIDAY, Feb. 6 (HealthDay News) -- U.S. Supreme Court Justice Ruth Bader Ginsburg will face tough challenges following her surgery on Thursday for early-stage pancreatic cancer, experts say.

At this point, it's not clear exactly what type of pancreatic cancer Ginsburg has, but the odds suggest pancreatic adenocarcinoma, which accounts for about 85 percent of all cases and is a far deadlier malignancy than neuroendocrine pancreatic cancer.

"The difference [in survival rates] is staggering," said Dr. Aaron Sasson, chief of gastrointestinal surgical oncology at the University of Nebraska Medical Center in Omaha. "The odds are that it's pancreatic adenocarcinoma, but there's a chance that it could be a neuroendocrine tumor."

A 2-centimeter neuroendocrine tumor, once removed surgically, could be considered cured, Sasson said. Ginsburg's tumor was reported to be 1 centimeter across.

Roughly 5 percent of people diagnosed with the more common form of pancreatic cancer will survive five years from diagnosis, according to the American Cancer Society.

Reports surfacing in the media, along with statements from the Supreme Court, suggest that the justice has an early-stage malignancy.

"She was able to have surgery, and only people who are early-stage cases are amenable to surgery, so that's probably true," said Dr. Allyson J. Ocean, an assistant professor of medicine at the Jay Monahan Center for Gastrointestinal Health at New York Presbyterian Hospital/Weill Cornell Medical Center in New York City.

Even after surgery in the more hopeful cases, however, the cancer has a high recurrence rate, and Ginsburg will likely undergo chemotherapy and radiation.

There again, though, the outlook is grim. "Pancreatic cancer usually responds poorly to our available therapies," Ocean said.

Ginsburg, 75, underwent surgery at Memorial Sloan-Kettering Cancer Center in New York City. Given the length of the hospital stay (seven to 10 days) and the location of the tumor, she probably underwent a distal pancreatectomy (removal of the end of the pancreas) and likely had her spleen removed as well, Sasson said.