Thread by @athein1

RBG update

1/ RBG just got admitted to JHU this am. Last year, I predicted that she would probably have to leave USSC by the end of this summer. That time is drawing near and she has so far defied all but most optimstic expectations

supremecourt.gov/publicinfo/pre…

2/ given her dire diagnosis of locally advanced and possibly metastatic pancreatic adenocarcinoma. The following is what we know from the limited info available publicly and I'd try to make a best guess on her prognosis...

3/ In 2009, she had cancer in distal part of her pancreas that got resected and cured.
In August 2019, they found another cancer in the remaining portion of her pancreas (head/proximal part) for which she received stereotactic radio-ablation ONLY,

4/ without chemo or surgery (that we know of), and also she got a biliary stent. Based on this very limited info, it can be deduced that 1) she has at a minimum unresectable or Locally Advanced pancreatic cancer (LAPC), 2) she may or may not have distant metastases

5/ (in Jan 2019, they found 2 small malignant lung nodules that could have been metastases from that pancreatic cancer), and 3) she got the biliary stent as a palliative/quality of life improvement measure. Now, with that diagnosis, and knowing that she got no chemo

6/ after radioablation which only served as tumor debulking (if they are not witholding chemo info), we can expect her pancreatic cancer (most likely adenocarcinoma; they would have already mentioned the cell type if she had a "better" neuroendocrine type) to be regrowing

7/ at the margins of the radioablation. This regrowth had led to her Nov 2019 hospitalization with sepsis (fever and chills after "stomach bug") most likely caused by obstruction of her biliary stent. So, they presumably cleaned up the stent then.

8/ Although they were not announcing, I suspect they would have put her on some regimen of chemo. That probably allowed her to battle on up to this point. However, time is not on her side, unfortunately. This most recent hospitalization today with fever and chills ...

9/ indicates that the tumor has regrwon and is causing impingement on her stent again, obstructing it. As this malignant tumor grows and regrows further, it would invade adjacent organs such as duodenum, mesenteric neurovasculature (which are probably already involved), ...

10/ stomach, liver and peritoneal cavity. The median survival for patients with unresectable pancreatic cancer without chemo is probably less than 6 months.

Hence, given all that she had gone through, I don't expect her to return to the bench in October. I wish her the best.