Justice's Surgeons Find Malignant Tumor

Ginsburg Goes Home After Procedure To Remove Spleen, Growth in Pancreas

Supreme Court Justice Ruth Bader Ginsburg was released from Memorial Sloan-Kettering Cancer Center yesterday, a week after surgery to remove a tumor in her pancreas, the court announced.

Ginsburg, 75, is recuperating at home after the procedure, which involved the removal of her spleen and a small malignant tumor determined to be Stage 1 cancer, a court spokeswoman said.

A routine examination in late January revealed a 1-centimeter lesion in the center of the justice's pancreas. Shortly thereafter, Ginsburg checked herself into Memorial Sloan-Kettering in New York for treatment by renowned surgeon Murray F. Brennan.

The first tumor uncovered by a January CT scan proved to be benign, but in the course of the Feb. 5 surgery, Brennan identified a "previously undetected single, even smaller tumor" that tests showed to be malignant, according to the statement from the court.

Physicians told the court that Ginsburg's cancer had not spread to the lymph nodes or elsewhere in the body. Stage 1 cancer is the earliest form of the disease.

The latest information about Ginsburg's case is very promising, said Patrick G. Jackson, chief of gastrointestinal surgery at Georgetown University Hospital.

"It's as good news as she could possibly get," Jackson said. "Given all patients with pancreatic cancer, that best survival rates are in the lowest stage," which offers about a 25 to 35 percent chance of surviving five years, he said.

The reason the survival rate is not higher is that pancreatic cancer tends to be very aggressive, and even the smallest tumors often have already spread elsewhere in the body. As a result, such patients almost always undergo follow-up chemotherapy, although the cancer frequently does not respond to the treatment.

"You're just trying to treat the disease that is probably microscopic and already present in the liver or in the lungs, where it might have spread to," Jackson said.

Medical experts said that Ginsburg was lucky that the scan detected the benign tumor, which led to the surgery and the discovery of the smaller malignancy.

"It was just fortuitous that she had the other benign thing that forced them to do this operation and find the even smaller but present pancreatic cancer, because pancreatic cancer is difficult to identify until it grows larger," he said.

The operation performed on Ginsburg is called a distal pancreatectomy and splenectomy. Doctors removed her spleen, because the surgery to remove part of the pancreas and nearby lymph nodes required the removal of the artery supplying blood to the spleen.

The surgery was far less extensive than another procedure, known as the Whipple, which is sometimes necessary when a tumor is found in another part of the pancreas.

Ginsburg, who did not miss a single day of court proceedings when she underwent treatment for colon cancer 10 years ago, previously said that she intended to return to the bench in time for three days of oral arguments Feb. 23.

Lawyers who closely follow the court said that Ginsburg adopted an open approach to her illness, releasing an unusual amount of information to the public about her condition, compared with other justices who have suffered health scares.

Word of her illness last week resurrected debate that began during the presidential campaign about the types of jurists President Obama would choose for prestigious court appointments.

Women's rights advocates have pressed the administration to name more female judges to the bench and to the high court, in particular, since the 2006 retirement of Justice Sandra Day O'Connor left Ginsburg the lone female justice on the nine-member court.

Ginsburg is considered a reliable liberal voice on a court that is divided among four liberals and four conservatives, with one justice in the middle.