Medfag update from yesterday:

https://www.nytimes.com/2018/12/21/health/ginsburg-cancer-lung.html

“When you have two lesions in the lung, it usually means it came from someplace else,” said Dr. Raja Flores, chairman of thoracic surgery at the Icahn School of Medicine at Mount Sinai in Manhattan. “It’s probably something that spread from the pancreas to the lungs.”

Again, note that the Dr. is quoting the COURT statement on her prognosis, not from a healthcare professional that is treating her.

https://www.nbcnews.com/news/us-news/fall-broke-ruth-bader-ginsburg-s-ribs-may-have-saved-n951136?cid=sm_npd_nn_fb_ma

"There are cases when someone comes in with belly pain, and then they do a CT scan on the stomach and find a pancreatic growth," said Flores.

Interesting that the entire article was about LUNG cancer, but that they used this as an example of incidental tumor findings. Its almost like they know that is what it IS.

"CT scans specifically for lung cancers, however, are usually reserved for rare high risk cases, such as heavy smokers who've recently quit, so it's unlikely that Ginsburg would haven fallen into that category, said Heymach."

Again, the media is mixing and matching cancers to set up the ideal situation. Primary lung cancers are not typically found until they are too big to cure. They start in the lung and spread from there. Were this a primary lung cancer it WOULD be fortunate to find it so early, but later it clearly says that she has no underlying indications that it would be a primary lung cancer as I said yesterday. This is metastatic.

Going back to look at her fall:

https://www.cnbc.com/2018/11/08/supreme-court-justice-ruth-bader-ginsburg-85-has-broken-her-ribs-in-a-fall.html

“She went home, but after experiencing discomfort overnight, went to George Washington University Hospital early this morning,” the court said in a statement Thursday. “Tests showed that she fractured three ribs on her left side and she was admitted for observation and treatment.”

The rib fractures were on the same side that the lung mets were located and removed. This indicates to me that those ribs were also compromised by mets from the pancreas. If I had to bet I would say it was probably ribs 8,9,10 on the left side, back towards the costovertebral joints.

https://www.npr.org/2018/12/21/679065534/justice-ruth-bader-ginsburg-undergoes-surgery-for-lung-cancer

The cancer was discovered after Ginsburg fell, fracturing several ribs in November. In taking CT scans of her ribs, doctors noticed an abnormality in one lobe of the lung. Subsequent biopsies and other initial tests revealed two non-small cell cancerous lesions, with no lymph node involvement detectable.

This is the first indication that I have seen that the type of cancer was non small cell. These are typically adenocarcinomas and could originate from the pancreas. Same article implies that the surgery was done with a minimally invasive approach–I suspected that would be the case at her age.