Ruth Bader Ginsburg undergoes lobectomy for lung cancer

CharminTide

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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.
 
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TIDE-HSV

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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...
 

NationalTitles18

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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.
 

CharminTide

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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.
 

Crimson1967

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




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Crimson1967

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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 don’t like Trump but I don’t wish him to die.

People that say things like that are truly sick.


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selmaborntidefan

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




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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).
 

selmaborntidefan

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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.
 

selmaborntidefan

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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....:)
 

Crimson1967

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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).
I had someone on my feed make a snarky remark when Scalia died. This same person also said he was a little put off when people rejoiced when Bin Laden was killed.

I always thought it was special that Scalia and Ginsburg were close friends.


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selmaborntidefan

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I had someone on my feed make a snarky remark when Scalia died. This same person also said he was a little put off when people rejoiced when Bin Laden was killed.

I always thought it was special that Scalia and Ginsburg were close friends.


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I think what's bad is that relationships have become so politicized that that surprises folks (and yes, it was cool).

On Election Day 1988, I walked around my college campus wearing my red jacket with blue Bush/Quayle 88 stickers and Elect Trent Lott stickers. My best friend was a black man who was walking around dressed much better than I with a black/white Dukakis leaflet easily readable above his pocket.

My advisor said that watching the two of us walk down the hall together calmly conversing and not raising voices was one of the best things he'd seen. (Keep in mind the school was still segregated when that advisor began).
 

selmaborntidefan

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And then I read this kind of uncompassionate tripe:

Justice Ginsburg is very ill. Another Justice appointment inevitable and soon. Bad news for the left.


That's from Bill O'Reilly.
 

BamaJama17

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I about halfway think Ginsburg and Scalia might have been more than just friends....Anyways if RBG does in fact dIE during Trumps tenure, I can’t even begin I imagine the (pathetic) resistance the left will put up against her replacement.
 

DzynKingRTR

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I about halfway think Ginsburg and Scalia might have been more than just friends....Anyways if RBG does in fact dIE during Trumps tenure, I can’t even begin I imagine the (pathetic) resistance the left will put up against her replacement.
They will probably find out when he was 11 years old, he pulled the pigtails of a girl and pushed her down. They will note his history of abuse of women and we will have to endure months and months of trials and media stories. He will not be confirmed. The next guy we will discover he passed gas and pulled the covers over his wife's head when he was 20.

As far as Ginsburg goes, I wish her well. I do feel that a supreme court justice should not be a lifetime appointment. At some point you are just too old to do the job. I am old enough to remember when Thurgood Marshall retired. When asked why he was retiring, his reply was "I am old".
 

2003TIDE

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I can’t even begin I imagine the (pathetic) resistance the left will put up against her replacement.
Probably won't be as pathetic as McConnell not allowing Obama to fill the vacant seat during his last term.

As far as Ginsburg goes, I wish her well. I do feel that a supreme court justice should not be a lifetime appointment. At some point you are just too old to do the job. I am old enough to remember when Thurgood Marshall retired. When asked why he was retiring, his reply was "I am old".
Maybe she would have retired long ago if she saw that Congress would do their jobs..
 
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