Supreme Court Justice Ruth Bader Ginsburg, who battled colon cancer a decade ago, is being treated at a New York hospital for pancreatic cancer that doctors apparently diagnosed in its early stages.
Ginsburg, 75, underwent surgery Thursday. Her illness raises the possibility that one of the ideologically divided court's leading liberals — and its only woman — might have to curtail her work or even step down before she had planned. Pancreatic cancer is often deadly.
Ginsburg, appointed to the nation's highest court in 1993 by President Bill Clinton, has been increasingly vocal in recent years about the court's more conservative stances, especially after the appointments made by President George W. Bush.
In 1999, she had colon cancer surgery, underwent radiation and chemotherapy, and never missed a day on the bench. Statistics suggest this could be a tougher fight.
She will remain in the Memorial Sloan-Kettering Cancer Center in New York for seven to 10 days, said her surgeon, Dr. Murray Brennan, according to the court. The justices hold their next private conference on Feb. 20 and return to the bench from their winter break on Feb. 23.
President Barack Obama expressed hope for her speedy recovery, White House press secretary Robert Gibbs said, and offered his thoughts and prayers.
If Ginsburg or another justice leaves the court, it falls to Obama to pick a successor. Anyone he might choose to replace her probably would be as liberal as she, if not more so, keeping in place the 5-4 conservative tilt of the court.
Ginsburg is only the second female justice in the nation's history. The other was Sandra Day O'Connor, who retired in 2006, and Ginsburg has lamented being the only woman on the court.
In the spring of 2007, she vented her frustration with the court's increasingly conservative tone by writing two sharp dissents that were made even more notable by her decision to read from them in the courtroom.
Objecting to a decision that upheld a nationwide ban on an abortion procedure that opponents call partial-birth abortion, Ginsburg said the ruling "cannot be understood as anything other than an effort to chip away at a right declared again and again by this court — and with increasing comprehension of its centrality to women's lives."
A short while later, the court threw out a discrimination suit by Lilly Ledbetter, a longtime Goodyear supervisor who was paid thousands of dollars a year less than her male peers. "In our view, this court does not comprehend, or is indifferent to, the insidious way in which women can be victims of pay discrimination," Ginsburg said.
She urged Congress to change the law to allow lawsuits like Ledbetter's. Just last week, Obama signed the change into law.
Ginsburg was born in New York City. She's a lover of opera and is perhaps personally closest on the court to her ideological opposite, Antonin Scalia. The justices have vacationed together — a photo in her office shows the two atop an elephant — and routinely mark New Year's Eve with an elaborate meal prepared by their spouses.
Ginsburg was a federal appeals court judge in Washington before Clinton appointed her. She served as a lawyer for the American Civil Liberties Union before that and argued six cases before the high court.
The new cancer was discovered during a routine, annual exam late last month at the National Institutes of Health in Bethesda, Md. A CAT scan revealed a tumor measuring about 1 centimeter across at the center of the pancreas, the court said.
The court offered few details about the operation or her anticipated course of treatment.
Pancreatic cancer is one of the most deadly cancers. Nearly 38,000 cases a year are diagnosed and overall less than 5 percent of patients survive five years.
The reason: Fewer than one in 10 cases are diagnosed at an early stage — like Ginsburg's appears to be — before the cancer has begun spreading through the abdomen and beyond. That's because early pancreatic cancer produces few symptoms other than vague indigestion.
Even when caught early, surgery for pancreatic cancer is arduous. Doctors typically remove parts of the pancreas, stomach and intestines. Radiation and chemotherapy are common after surgery.
Ginsburg's prognosis depends on a number of factors, including whether the tumor, despite its small size, had begun spreading to the lymph nodes, and what specific type it was. Most are aggressive, although a small proportion of patients have what Dr. John Marshall, a pancreatic cancer specialist at Georgetown University Hospital, calls "quieter ones."
"We want to be in that early group so we can have the surgery and have a potential chance at cure, but it is a big operation and a disease that does tend to spread even very early," he cautioned.