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The Supreme Court has announced that Justice Ruth Bader Ginsburg has been treated for pancreatic cancer.

The 86-year-old completed a three-week course of outpatient radiation therapy in New York.

This is her fourth bout with cancer. She was diagnosed with colon cancer in 1999 and treated for early stage pancreatic cancer in 2009. Last year, she underwent surgery to remove two cancerous nodes from her lung. This time, the abnormality was detected during a routine blood test in July.

“A routine test may show that enzymes in the liver are off,” said Dr. Mokenge Malafa, a pancreatic surgeon at Moffitt Cancer Center. “Since she’s been treated for other cancers before, doctors may have been monitoring her blood for tumor markers, which are proteins that tumors usually produce, and if those proteins start to elevate, that could prompt investigation.”

Malafa says because of this routine test, it is likely Ginsburg’s cancer was caught early and with a better prognosis. For most, pancreatic cancer is detected at a later stage when the disease has already spread, making it difficult to cure. Pancreatic cancer has about an 8% five-year survival rate.

“Almost half of patients present with metastatic disease and are beyond our ability to cure them,” said Malafa. “Only about a quarter of patients present with early disease that can be treated successfully, and even in those patients, the success rate is only 30%. There is a high priority around the country and a lot of research is being done to improve survival.” 

It is estimated pancreatic cancer will become the second-leading cause of cancer-related death in the United States behind lung cancer by 2020.

Symptoms of the disease include jaundice, unexplained weight loss and abdominal pain.

The Supreme Court says Ginsburg’s tumor was treated definitively and there is no evidence of disease. She will continue to have routine blood tests and scans.