The 87-year-old Supreme Court justice began a course of gemcitabine, a type of chemotherapy, in May after immunotherapy didn't work.

By Korin Miller
July 17, 2020
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Supreme Court Justice Ruth Bader Ginsburg revealed on Friday that she is currently undergoing chemotherapy after a recurrence of her cancer. Ginsburg was taken to the hospital on Tuesday for a possible infection, sparking concerns about her health.

“On May 19, I began a course of chemotherapy (gemcitabine) to treat a recurrence of cancer,” Ginsburg, 87, said in a press release on Friday. Justice Ginsburg shared that a “periodic scan” in February, followed by a biopsy, showed lesions on her liver. “My recent hospitalizations to remove gallstones and treat an infection were unrelated to this recurrence,” she said.

It was implied that Justice Ginsburg had known about her cancer recurrence for a while, and wanted to avoid revealing her status until she had a treatment plan in place. “Immunotherapy first essayed proved unsuccessful. The chemotherapy course, however, is yielding positive results,” she wrote. “Satisfied that my treatment course is now clear, I am providing this information.” Her latest scan on July 7 “indicated significant reduction of the liver lesions and no new disease.” She said she is “tolerating chemotherapy well and am encouraged by the success of my current treatment.”

Justice Ginsburg, who was first appointed to the US Supreme Court in 1993, is, unfortunately, no stranger to cancer. In 1999, she underwent surgery for colon cancer, followed by another surgery for early-stage pancreatic cancer in 2009, The New York Times reports. She's also undergone surgery for lung cancer and radiation treatment for pancreatic cancer in recent years.

Though Justice Ginsburg's most recent diagnosis revealed lesions on her liver, it's still unclear what type of cancer she has, and what stage it's in—the "recurrence" portion of her statement suggests it's not a new diagnosis, however, and instead is a recurrence of one of her former cancers.

What is cancer recurrence?

According to the American Cancer Society (ACS), a cancer recurrence happens when cancer is found after treatment, and after a period of time when the cancer could not be detected.

There are also different types of cancer recurrence, per the ACS, Those include:

  • Local recurrence, when the cancer comes back in the same place it started.
  • Regional recurrence, when the cancer comes back in the lymph nodes near the place it first started.
  • Distant recurrence, when the cancer comes back in another part of the body, someplace distance from where it started (often the lungs, liver, bone, or brain).

While cancer can recur in a different body part, it's important to remember that it's still technically a cancer of where it first originated. That means, if a person initially has pancreatic cancer, and it goes away, then recurs in another part of the body like the liver, it's still a pancreatic cancer recurrence, and will be treated as pancreatic cancer.

OK, and what is RBG's new treatment, gemcitabine?

Justice Ginsburg specifically name-checked this form of chemotherapy. It’s in a class of medications called antimetabolites and works by slowing or stopping the growth of cancer cells in your body, according to the U.S. National Library of Medicine MedlinePlus resource. Gemcitabine is an injectable medication that’s delivered via IV over the course of 30 minutes by a doctor or nurse. It’s used slightly differently, depending on the type of cancer a person has, and may even be used with other medications. The length of treatment with gemcitabine depends on the other types of drugs a patient is taking and how well their body responds to the medication, per MedlinePlus

Like other forms of chemotherapy, gemcitabine can cause unpleasant side effects, including:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Loss of appetite
  • Sores in the mouth and throat
  • Hair loss
  • Headache
  • Sore or painful muscles
  • Pain, burning, or tingling in the hands or feet
  • Swelling, pain, redness, or burning at the injection site

Ultimately, a person may feel quite ill on gemcitabine, Jamie Alan, PhD, assistant professor of pharmacology and toxicology at Michigan State University, tells Health. However, she adds, "there are things you can do to decrease nausea, increase white blood counts, and increase appetite."

Ginsburg said in her statement that she plans to continue to have bi-weekly chemotherapy “to keep my cancer at bay” and that she’s still able to have an active daily routine. “Throughout, I have kept up with opinion writing and all other Court work,” she said.

And then, she ended on this classic RBG note: “I have often said I would remain a member of the Court as long as I can do the job full steam. I remain fully able to do that.”

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