Ruth Bader Ginsburg undergoes lobectomy for lung cancer
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  1. #1
    BamaNation Hall of Fame CharminTide's Avatar
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    Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Ruth Bader Ginsburg Underwent Cancer Surgery

    Justice Ruth Bader Ginsburg underwent surgery on Friday to remove two malignant nodules from her left lung, according to Kathleen Arberg, a Supreme Court spokeswoman. The nodules were discovered during tests following a fall in November in which Justice Ginsburg fractured her ribs.

    The surgery, called a pulmonary lobectomy, took place at Memorial Sloan Kettering Cancer Center in New York City.

    According to the thoracic surgeon, Dr. Valerie W. Rusch, the nodules removed during surgery were found to be malignant on initial pathology evaluation, Ms. Arberg said in a statement.

    After the surgery, she added, “there was no evidence of any remaining disease” and “scans performed before surgery indicated no evidence of disease elsewhere in the body.”
    Alright, I'm going to parse some wording here. I obviously have no knowledge of this case beyond what's in this press release, but two things stick out to me:

    1) There were two nodules.
    2) Initial evaluation (i.e. frozen section) was done on both nodules, and both were malignant.
    3) She underwent lobectomy (meaning both nodules were in the same lung).

    Anyone who's not familiar with the TNM staging system can google it. It's basically a way doctors can measure the size and extent of tumors in order to formulate a prognosis.

    I'm assuming that the two malignant nodules are separated in the resected lobe, and are histologically the same tumor. The second is my biggest assumption. She could have two separate cancers arising independently, but that's statistically less likely given the spatial relationship. It's uncommon to have two cancers at the same time, and even less common for them to occur right next to each other unless there's some outside factor (e.g. carcinogen exposure, radiation field, etc.). So the two cancers are most likely related, but not necessarily.

    Based on this, she likely has pT3N0M0 cancer. There's a lot of doctor-talk in there, but the basic gist is that the second nodule implies metastatic spread to a different part of the lung. That puts her at increased risk for metastatic spread elsewhere in the body, although there is apparently no evidence of that yet. They won't give her chemo unless they have evidence that it has, so she'll be monitored very closely. The 5-year survival for pT3 lung cancer is ~55-60%.

    Edit: Actually, another assumption I'm making is that these are both primary to the lung. If they're not, the prognosis is worse.
    Last edited by CharminTide; December 21st, 2018 at 01:04 PM.

  2. #2
    Senior Administrator TIDE-HSV's Avatar
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    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Quote Originally Posted by CharminTide View Post
    Ruth Bader Ginsburg Underwent Cancer Surgery



    Alright, I'm going to parse some wording here. I obviously have no knowledge of this case beyond what's in this press release, but two things stick out to me:

    1) There were two nodules.
    2) Initial evaluation (i.e. frozen section) was done on both nodules, and both were malignant.
    3) She underwent lobectomy (meaning both nodules were in the same lung).

    Anyone who's not familiar with the TNM staging system can google it. It's basically a way doctors can measure the size and extent of tumors in order to formulate a prognosis.

    I'm assuming that the two malignant nodules are separated in the resected lobe, and are histologically the same tumor. The second is my biggest assumption. She could have two separate cancers arising independently, but that's statistically less likely given the spatial relationship. It's uncommon to have two cancers at the same time, and even less common for them to occur right next to each other unless there's some outside factor (e.g. carcinogen exposure, radiation field, etc.). So the two cancers are most likely related, but not necessarily.

    Based on this, she likely has pT3N0M0 cancer. There's a lot of doctor-talk in there, but the basic gist is that the second nodule implies metastatic spread to a different part of the lung. That puts her at increased risk for metastatic spread elsewhere in the body, although there is apparently no evidence of that yet. They won't give her chemo unless they have evidence that it has, so she'll be monitored very closely. The 5-year survival for pT3 lung cancer is ~55-60%.

    Edit: Actually, another assumption I'm making is that these are both primary to the lung. If they're not, the prognosis is worse.
    She seems to be saying there's no evidence of metastasis. However, one has to remember her pas scrape with encapsulated pancreatic cancer...
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  3. #3
    Super Moderator NationalTitles17's Avatar
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    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Quote Originally Posted by CharminTide View Post
    Ruth Bader Ginsburg Underwent Cancer Surgery



    Alright, I'm going to parse some wording here. I obviously have no knowledge of this case beyond what's in this press release, but two things stick out to me:

    1) There were two nodules.
    2) Initial evaluation (i.e. frozen section) was done on both nodules, and both were malignant.
    3) She underwent lobectomy (meaning both nodules were in the same lung).

    Anyone who's not familiar with the TNM staging system can google it. It's basically a way doctors can measure the size and extent of tumors in order to formulate a prognosis.

    I'm assuming that the two malignant nodules are separated in the resected lobe, and are histologically the same tumor. The second is my biggest assumption. She could have two separate cancers arising independently, but that's statistically less likely given the spatial relationship. It's uncommon to have two cancers at the same time, and even less common for them to occur right next to each other unless there's some outside factor (e.g. carcinogen exposure, radiation field, etc.). So the two cancers are most likely related, but not necessarily.

    Based on this, she likely has pT3N0M0 cancer. There's a lot of doctor-talk in there, but the basic gist is that the second nodule implies metastatic spread to a different part of the lung. That puts her at increased risk for metastatic spread elsewhere in the body, although there is apparently no evidence of that yet. They won't give her chemo unless they have evidence that it has, so she'll be monitored very closely. The 5-year survival for pT3 lung cancer is ~55-60%.

    Edit: Actually, another assumption I'm making is that these are both primary to the lung. If they're not, the prognosis is worse.
    Relatively safe assumption, though, as I don't recall hearing about previous abdominal or pelvic surgeries (colon or ovaries, I'm thinking of primarily). Of course, there could be something of which we have no knowledge so the caveats are warranted.

    Cancer is a terrible disease. I've had too many diagnosed lately, professionally and personally. A few years ago my aunt died of AML and her brother now has it, both in late 60's or early 70's. Some concern in the family now about that.
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    BamaNation Hall of Fame CharminTide's Avatar
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    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Quote Originally Posted by TIDE-HSV View Post
    She seems to be saying there's no evidence of metastasis. However, one has to remember her pas scrape with encapsulated pancreatic cancer...
    Agreed, the fact that they don't see a large primary tumor somewhere else means it's probably a primary lung cancer. But like you say, with her history I couldn't be completely sure unless the slides were in front of me. Most of that hot take is based on what's statistically most likely; the range of possibilities is obviously wider.

    Frankly, I'm a little surprised that they confirmed there were two malignant nodules in the resection, because that allows anyone with some knowledge of surgical oncology to make this kind of inference.

  5. #5
    Super Moderator NationalTitles17's Avatar
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    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Quote Originally Posted by TIDE-HSV View Post
    She seems to be saying there's no evidence of metastasis. However, one has to remember her pas scrape with encapsulated pancreatic cancer...
    Must have missed that. Had to go back again and read down the page.
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  6. #6
    BamaNation Hall of Fame Crimson1967's Avatar
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    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    I saw a comment on a Facebook post about this where someone said they hope she dies.




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  7. #7

    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Quote Originally Posted by CharminTide View Post
    Thank you for the medical explanation - I'm fairly ignorant about a lot of things, and cancer is certainly one of them.

    What I do know is that I've had several friends and acquaintances pass from lung cancer over the years and it's horrific.
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  8. #8

    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Quote Originally Posted by Crimson1967 View Post
    I saw a comment on a Facebook post about this where someone said they hope she dies.
    I don't agree with some of her views, but what kind of evil does a person have to harbor in their heart to wish that on someone? Goodness...
    Oderint dum metuant - Lucius Accius

  9. #9
    BamaNation Hall of Fame Crimson1967's Avatar
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    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Quote Originally Posted by crimsonaudio View Post
    I don't agree with some of her views, but what kind of evil does a person have to harbor in their heart to wish that on someone? Goodness...
    I donít like Trump but I donít wish him to die.

    People that say things like that are truly sick.


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  10. #10
    Suspended Bazza's Avatar
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    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Quote Originally Posted by crimsonaudio View Post
    I don't agree with some of her views, but what kind of evil does a person have to harbor in their heart to wish that on someone? Goodness...
    I see this kind of stupidity every day, unfortunately.

    Idiots.....

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    BamaNation Hall of Fame selmaborntidefan's Avatar
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    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Quote Originally Posted by Crimson1967 View Post
    I saw a comment on a Facebook post about this where someone said they hope she dies.




    Sent from my iPhone using Tapatalk
    That's stupid and cruel and wrong.

    (But lest we think that's "only" a right-wing thing, mine was littered with glee when Scalia actually did die - well that and a bunch of conspiracy theories about Scalia being whacked).
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    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Quote Originally Posted by Crimson1967 View Post
    I don’t like Trump but I don’t wish him to die.

    People that say things like that are truly sick.


    Sent from my iPhone using Tapatalk
    I hold Trump and Hillary both in utter contempt, but I wouldn't wish that on either one of them.

    Something about praying for people, one of those many "do" commands that a lot of people forget when politics displaces their religion as an idol.
    My New Year's resolution for 2019 is this year I'm not going to drink anymore. I'm not going to drink any less, either.

    I was married for 25 years, but if I'd killed her on the honeymoon, I'd have been out in less than 20.

    Butch Jones has richly earned his title, The Archbishop of Talentbury

    After reading all the horrible things drinking will do to you....I gave up reading.

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    BamaNation Hall of Fame selmaborntidefan's Avatar
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    Re: Ruth Bader Ginsburg undergoes lobectomy for lung cancer

    Quote Originally Posted by CharminTide View Post
    Agreed, the fact that they don't see a large primary tumor somewhere else means it's probably a primary lung cancer. But like you say, with her history I couldn't be completely sure unless the slides were in front of me. Most of that hot take is based on what's statistically most likely; the range of possibilities is obviously wider.

    Frankly, I'm a little surprised that they confirmed there were two malignant nodules in the resection, because that allows anyone with some knowledge of surgical oncology to make this kind of inference.
    I feel like I'm back in Pathology class, heh heh.

    Or for that matter just doing slides earlier this week....
    My New Year's resolution for 2019 is this year I'm not going to drink anymore. I'm not going to drink any less, either.

    I was married for 25 years, but if I'd killed her on the honeymoon, I'd have been out in less than 20.

    Butch Jones has richly earned his title, The Archbishop of Talentbury

    After reading all the horrible things drinking will do to you....I gave up reading.

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