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Ruth Bader Ginsburg underwent treatment for tumor on her pancreas

Justice Ruth Bader Ginsburg completed radiation treatment on Aug. 23 for a malignant tumor found on her pancreas. (Video: Reuters)

Justice Ruth Bader Ginsburg confronted another bout with cancer this month and on Friday completed radiation treatment for a malignant tumor found on her pancreas, the Supreme Court disclosed.

It was the second treatment for cancer in nine months for the court’s oldest member and leader of its liberal wing. The 86-year-old had a lobe of her left lung removed in December, and in the past was treated both for colon and pancreatic cancer.

The court said the three-week treatment for her current condition began earlier this month at Memorial Sloan Kettering Cancer Center in New York, and no additional treatment is planned.

“The tumor was treated definitively and there is no evidence of disease elsewhere in the body,” the court’s spokeswoman said in a statement. “Justice Ginsburg will continue to have periodic blood tests and scans. No further treatment is needed at this time.”

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Experts on pancreatic cancer said there was no indication Ginsburg’s ability to serve on the court will be affected, but cautioned it was difficult to make predictions about her prognosis based on the scant details provided by the court.

Louis Weiner, director of the Georgetown Lombardi Comprehensive Cancer Center, whose research focuses on pancreatic treatment models, said “there is reason to be optimistic that she will do well and will be able to continue work.”

Weiner said “high-dose, localized radiology to a particular part of the body will eradicate pancreatic cancer cells. The radiology typically works very successfully.”

A less-optimistic view of the use of radiation is that it is for “tumor control rather than cure,” said Diane Simeone, director of the Pancreatic Cancer Center at NYU Langone Health’s Perlmutter Cancer Center and a specialist in pancreatic cancer. “It’s a little bit uncommon to just do radiation only,” she said. “It’s often used for disease control. It’s not often a curative approach.”

Ginsburg seems to have tolerated the outpatient treatment well; she was at work at the Supreme Court on Friday afternoon after receiving her final treatment in New York during the morning.

She has maintained an active schedule of speaking engagements throughout the treatment, and last week attended an off-Broadway production of “Fiddler on the Roof.” Photographs of her meeting actor Kate McKinnon, who portrays Ginsburg on “Saturday Night Live,” lit up social media.

Ginsburg is one of the oldest justices to serve on the Supreme Court, and her health is a constant matter of concern and speculation for both liberals and conservatives. Her inability to serve would provide President Trump with a chance to nominate a third conservative to the high court and shift it further to the right.

Ginsburg said in speeches and in an interview last month that her health was fine, and she would continue to serve as long as she felt up to the job.

“I was okay last term; I expect to be okay next term, and after that we’ll just have to see,” Ginsburg said July 24 at an appearance in Washington. According to the court’s statement, that event was after an abnormality was detected in a routine blood test, but before a biopsy confirmed a “localized malignant tumor.”

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The court’s statement said Ginsburg started a three-week course of stereotactic ablative radiation therapy — a highly focused radiation treatment that concentrates an intense dose of radiation on a tumor, while limiting the dose to the surrounding organs — on Aug. 5. A bile duct stent was placed as part of the treatment.

Ginsburg canceled an annual summer visit to Santa Fe, N.M., where she attends an opera performance each night, “but has otherwise maintained an active schedule,” the statement said.

Ginsburg has been open about her past episodes with cancer.

The discovery of cancer in December was most serious. For the first time since she joined the court in 1993, she missed a two-week round of oral arguments at the court. Her absence prompted some on right-wing social media to insist she was incapacitated, or even dead.

However, she returned to the court, and she even wrote the majority decision in one of the cases argued when she was gone.

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Ginsburg was treated for colorectal cancer in 1999, and pancreatic cancer was discovered at a very early stage 10 years later. She scheduled treatment for both during the court’s off days.

Pancreatic cancer is particularly dangerous, but Ginsburg in an interview with NPR last month made light of predictions about her fate at the time.

“There was a senator, I think it was after my pancreatic cancer, who announced, with great glee, that I was going to be dead within six months,” she recalled in the interview. “That senator, whose name I have forgotten, is now himself dead, and I am very much alive.”

The senator was Jim Bunning (R-Ky.), who later apologized for his remarks.

Weiner said Ginsburg’s previous cancers made it more likely that an additional tumor would be found at an early, treatable stage.

“Localized measures have an excellent chance of being useful” when a tumor is detected early, Weiner said.

The five-year survival rate for pancreatic cancer is quite low when compared with other forms of the disease, though people with localized tumors do better, according to the American Cancer Society. Ginsburg has already survived for 10 years after one bout with the disease. The survival rates are also skewed by the fact that pancreatic cancer is often not detected until it has spread significantly.

In light of Ginsburg’s cancer history, Simeone speculated that she might have a subtype of the disease that is less aggressive and grows more slowly. However, she said she could not be sure without knowing more about Ginsburg’s lung and colon cancers.

Nadia Laack, chair of radiation oncology at the Mayo Clinic in Rochester, Minn., said she suspected that Ginsburg’s tumor is a new cancer, rather than a recurrence. “Normally, pancreatic cancer recurs fairly quickly, generally in the next two years,” she said.

Three justices older than Ginsburg have served in the court’s history: Oliver Wendell Holmes, John Paul Stevens and Roger B. Taney. Stevens, who served with Ginsburg and who died in July, was 90 when he retired in 2010, and Holmes served until he was almost 91.

Ginsburg was under pressure from some on the left to retire when President Barack Obama could have nominated her successor, but she was not ready to go. When Justice Antonin Scalia died of a heart attack in 2016, the Republican-controlled Senate refused to hold a hearing on Obama’s choice to replace Scalia, Judge Merrick Garland.

Trump then chose Neil M. Gorsuch for the position. Last year, he picked Brett M. Kavanaugh to replace Justice Anthony M. Kennedy, who retired.

Ginsburg is expected to resume her normal schedule, including a teaching and speaking appearance Monday in Buffalo, and an appearance at the end of the month at the National Book Festival.