Dr. Marc Siegel: Justice Ginsburg overcomes cancer … and critics

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When Supreme Court Justice Ruth Bader Ginsburg fell and fractured three ribs back in November, part of her medical workup was a CT scan of the chest. This test revealed two lung nodules in the left lower lobe of the 85-year-old’s lung. The lobe was removed at Sloan Kettering Memorial hospital in New York this past week and the nodules were found to be malignant. The good news is that the cancer was completely removed, and there was no reported spread to either lymph nodes or anywhere else in her body.

This is encouraging news, yet it unfortunately doesn’t stop pundits from wildly pontificating that her professional end is near, that the powerful legendary justice will be forced to retire soon, and that another conservative judge on the Court is just over the horizon.

I believe, as I wrote in my book “The Inner Pulse,” that Justice Ginsburg is aided by a strong will to live and an inner strength which helps her overcome the odds. This is her third cancer since 1999, when she beat colon cancer. Ten years ago, she was operated on for early stage pancreatic cancer, a disease which is frequently fatal. Her tumor was in the center of the pancreas so she didn’t require the more extensive Whipple procedure.

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We don’t yet know what the source of the cancer is in the justice’s lungs, but the final pathology this week should reveal it. Ten years is a long timeframe for metastases to occur, but this is still possible, especially if the pancreatic cancer was slow-growing in the first place. A more likely possibility, in my opinion, is that there were either two primary lung cancers or one primary that has spread to a second site. Either way, finding the cancer this early, before it has apparently spread beyond the lungs or even to lymph nodes within the lungs, is a good sign.

In other words, Justice Ginsburg’s Supreme Court hourglass seems to have some sand left in it. But try telling that to the political vultures, who would just as soon ignore the inspirational lesson of Justice Ginsburg overcoming one health obstacle after another, returning time and again to the court without missing a day. I expect to see her there in January 2019, too.

Three separate cancers over time brings up the question of a genetic predisposition. As we gain a greater understanding of human genetics, we will uncover more and more cancer genes, and we will learn to map your cancer risk and mine. It is possible that Justice Ginsburg has a genetic predisposition to forming cancers.

Her age may be a factor as well. Cancer is based on mutations, when one or more genes in a cell mutates and begins producing abnormal proteins. Simply put, the older you are, the more mutations, and the greater the cancer risk. When cells become cancerous, they also become one hundred times more likely to undergo further mutations than regular cells.

This change enables cancer to elude a body’s immune response, and renders cancer treatments less and less effective over time – even immunotherapy, which targets abnormal proteins on the surface of the cancer cell.

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Environmental exposures, including dietary indiscretions, are other important risk factors.

But whatever Justice Ginsburg’s personal risks may be, one thing is for sure: she has been saved so far by great medicine, early detection, a healthy lifestyle filled with a rigorous exercise routine, and an indomitable spirit.

It isn’t possible to quantify the role that spiritual healing plays in disease, but more than thirty years of medical experience tells me not to count Justice Ginsburg out just yet. Not even close.