The Worrisome Word in Ruth Bader Ginsburg’s Cancer Diagnosis

On Friday, surgeons in New York removed the lower lobe of Justice Ruth Bader Ginsburg’s left lung. According to a statement from the Supreme Court, two nodules—which had been discovered in a CT scan after Ginsburg broke three ribs last month—were determined to be malignant.

Images before the surgery showed no evidence of cancer elsewhere in her body, and doctors at Memorial Sloan Kettering Cancer Center reported that there was “no evidence of any remaining disease” after the procedure. According to the statement, no further treatment is planned.

What does this mean?

First, there’s a mandatory caveat in any such circumstance: A prognosis is impossible even for Ginsburg’s doctors to predict perfectly, and very limited information has been made public. Nevertheless, Ginsburg is a public figure whose health status is of particular consequence to American citizens, and readers of the Supreme Court’s statement are likely to draw conclusions. It is possible to add some context to the statement and to determine that this is neither a clean bill of health nor a clear sign of imminent peril.

After the news, I tweeted: “If you’re 85 and you break a rib and get a CT, the radiologist will very likely find pulmonary nodules. Most aren’t removed. Since hers are now out and there’s apparently no evidence of metastatic disease, the primary issue is recovery from the procedure.”

Most readers took this as good news. Though I didn’t mean to imply that she’s cleared. It’s true that nodules are very common—and a nodule is different from a mass, the distinction being the size. A nodule is, by definition, fewer than 3 centimeters (around an inch) in diameter. These two nodules are now gone, and there are apparently no others remaining.

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