Justice Ginsburg Treated For Pancreatic Cancer

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U.S. Supreme Court Justice Ruth Bader Ginsburg was hospitalized on Thursday and treated for pancreatic cancer. Ginsburg, 75, has told friends she intends to be back on the bench when the court reconvenes Feb. 23. Nevertheless, there's speculation about whom President Obama would chose to replace her should she step down.

RENEE MONTAGNE, host:

This is MORNING EDITION from NPR News. I'm Renee Montagne.

LINDA WERTHEIMER, host:

And I'm Linda Wertheimer.

The possibility of change on the Supreme Court always echoes through Washington. And so it was yesterday, when news came that Justice Ruth Bader Ginsburg, the only woman on the court, had surgery to remove a cancerous tumor from her pancreas.

At the White House, President Obama said his thoughts and prayers are with Ginsburg, and outside the White House, there was immediate speculation about a possible replacement for Ginsburg should she step down.

NPR legal affairs correspondent Nina Totenberg reports.

NINA TOTENBERG: Justice Ginsburg, who has served on the court since 1993, was treated for colon cancer 10 years ago. So this is her second cancer, and a much more serious one. Though pancreatic cancer is relatively rare, it is the fourth leading cause of cancer-related death in the United States. The five-year survival rate is only 5 percent.

Doctors say the poor prognosis rate is due in significant part to the fact that cancers of the pancreas are discovered late. In fact, most pancreatic cancers are discovered so late that they are inoperable.

Justice Ginsburg's cancer was discovered early, in the course of a routine annual screening. But the medical literature says that even in this circumstance, her chances of a five-year survival range from 10 to 30 percent, depending, in part, on what stage her cancer is and whether it has spread. It usually takes a couple of days to do that sort of pathology report.

The tiny, 75-year-old justice is known for her toughness, and she's told friends she intends to be back on the bench when the court reconvenes in three weeks. She's never missed a day of court because of any illness, even during her treatment for colon cancer, when she had surgery, radiation and chemotherapy treatments.

But doctors say the surgery she underwent yesterday is a bigger blow to the system, and that there are frequent complications afterwards. Should Ginsburg not want to attend the next court session February 23rd, she can still participate in deciding the cases by listening to the tape of the oral arguments.

News of Ginsburg's cancer swept political and legal Washington yesterday like a quiet tsunami. One conservative group even sent out a press alert entitled, "Justice Ginsburg Prayers and Prognosis," with survival statistics attached. White House sources say that prior to yesterday's news, the president's top legal aides had begun compiling lists of potential Supreme Court nominees in the event of a retirement later this year.

Previously, most speculation had centered upon the possibility that 88-year-old Justice John Paul Stevens or 69-year-old David Souter would retire, but even then, the White House focus was mainly on women. Now, you can be sure the list will be all female. In a country that is majority women, it would be politically unthinkable to have an all-male court, not to mention that 56 percent of the Obama vote came from women.

A call to leading constitutional scholars and Supreme Court advocates yields a remarkably similar list of female contenders. The most-often mentioned are Diane Wood of the Seventh Circuit of Appeals in Chicago, who knew President Obama when they both taught at the University of Chicago Law School; Sonia Sotomayor, a judge on the Second Circuit Court of Appeals in New York, who has the added advantage of a Puerto Rican heritage; and Harvard Law School Dean Elena Kagan, who's already been nominated by President Obama to be solicitor general, the government's advocate in the Supreme Court.

Also mentioned with some frequency are two political figures: Michigan Governor Jennifer Granholm, who served previously as her state's attorney general, and Department of Homeland Security Secretary Janet Napolitano, who served previously as Arizona's governor, attorney general, and as the United States attorney there.

Even if Justice Ginsburg were to retire, her replacement would not in any grand sense change the ideological balance of the court. Ginsburg is a moderate liberal. President Obama would undoubtedly replace her with a liberal. But on the close cases, the conservatives usually prevail on this court by a 5-4 vote.

Nina Totenberg, NPR News, Washington.

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Justice Ginsburg Undergoes Cancer Surgery

About Pancreatic Cancer

Only 5 percent of people diagnosed are alive five years later. Read more about the disease.

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At A Glance: Ruth Bader Ginsburg

  • Born March 15, 1933, in Brooklyn, N.Y.
  • In 1954, graduates from Cornell University and marries Martin Ginsburg. (They have two children, Jane and James.)
  • In 1956, enrolls in Harvard Law School, one of nine women in a class of more than 500.
  • In 1958, transfers to Columbia University Law School, where she ties for first place in her class.
  • In 1963, joins the faculty of Rutgers University Law School. During the 1960s, she assists the New Jersey affiliate of the American Civil Liberties Union in litigating sex discrimination cases.
  • In 1972, the ACLU selects Ginsburg to head its Women's Rights Project; the same year, she becomes the first tenured female professor at Columbia University Law School.
  • Between 1972 and 1978, she wins five out of six cases involving sexual inequality that she argues before the U.S. Supreme Court.
  • In 1980, President Carter names Ginsburg to the U.S. Court of Appeals for the District of Columbia.
  • On Aug. 10, 1993, becomes the second female justice on the Supreme Court after being nominated by President Clinton.
  • As a relatively new justice in 1996, she writes the court's 7-to-1 opinion declaring that the Virginia Military Institute can no longer remain an all-male institution.
  • In 1999, Ginsburg undergoes surgery for colon cancer, as well as chemotherapy and radiation treatment..
  • In 2007, writes dissenting opinions in two prominent cases: one in which the Supreme Court limited the time frame for bringing pay discrimination cases; and the other in which the majority upheld a federal ban on partial-birth abortions.
  • In 2009, she has surgery to remove a cancerous tumor from her pancreas.

Sources: Supreme Court biography; NPR staff reports; Supreme Court Historial Society; The Associated Press

Supreme Court Justice Ruth Bader Ginsburg, the only woman currently serving on the nation's highest court, underwent surgery Thursday for removal of a cancerous tumor from her pancreas.

Ginsburg, 75, is being treated at Memorial Sloan-Kettering Cancer Center in New York.

Ginsburg has served on the court since 1993.

She was treated for colon cancer 10 years ago.

Ginsburg's pancreatic cancer was discovered early, in the course of a routine annual screening, but medical literature says even in this circumstance — when the cancer is detected early enough for surgery — a patient's five-year survival chances range from 10 to 30 percent.

Overall, only 5 percent of people who are diagnosed with pancreatic cancer survive for five years.

Doctors say the relatively bleak survival rate associated with pancreatic cancer is due in significant part to the fact that cancers of the pancreas are often discovered late, when the cancer is very advanced.

A release from the court says Ginsburg's surgeon, Dr. Murray Brennan, expects her to stay in the hospital for seven to 10 days.

"Justice Ginsburg had no symptoms prior to the incidental discovery of the lesion during a routine annual check-up in late January at the National Institutes of Health in Bethesda, Md. A computerized Axial Tomography (CAT) Scan revealed a small tumor, approximately 1 (centimeter) across, in the center of the pancreas," the statement said.

On Thursday afternoon, White House spokesman Robert Gibbs said the president has not yet spoken to Ginsburg. "(President Obama's) thoughts and prayers are with her and her family right now, and we hope for and wish her a speedy recovery right now," Gibbs said.

Because Ginsburg previously underwent radiation treatment after her colon surgery, she likely will not be able to have radiation treatment a second time, doctors say. Chemotherapy has not proved to be curative for pancreatic cancer, according to medical literature.

The justice is known for her toughness, and she has told friends she intends to be back on the bench when the court reconvenes in three weeks. She has never missed a day of court because of any illness. But doctors say the surgery she underwent Thursday is a blow to the system that takes time to recover from and there are often complications.

White House sources say that the president's top legal aides have already begun compiling lists of potential replacements in the event that any of the justices retire this year. And even before the news broke about Ginsburg, speculation focused heavily on potential female candidates. Now, it's likely the list will be all female.

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