吉斯伯格大法官进行胰腺癌手术

导读：吉斯伯格大法官进行胰腺癌手术

　　华盛顿&mdashmdash;最高法院大法官鲁斯·班德·吉斯伯格周四做了胰腺癌手术。吉斯伯格是最高法院唯一的女性大法官。该手术增加了主导最高法院的持自由立场的法官之一，不得不缩短任期甚或在她做出计划前辞职的可能。

75岁的吉斯伯格自1993年起担任大法官。最近几年来，尤其是在布什总统任命之后，她持续地提高了针对最高法院更为保守的姿态的反对声。

最高法院说医生似乎发现吉斯伯格的癌症尚在早期，但尽管如此，胰腺癌通常有生命危险。

1999年吉斯伯格通过放射疗法和化疗做了结肠癌手术，从没缺席最高法院的岗位。统计显示，这次手术可能是一场更为艰巨的战斗。

给吉斯伯格做手术的是纽约州纪念斯隆-凯特琳癌症中心。根据最高法院的消息，她的主治大夫默里·布伦南说，她将住院7到10天。最高法院法官们的下次私下集会将在2月20日举行，此后法官们则在2月23日结束冬季休假回到法官席。

白宫新闻发言人罗伯特·吉布斯周四说，巴拉克·奥巴马总统已向吉斯伯格表达了早日康复的祝愿，并献出了他的建议和祈祷。

如果吉斯伯格或者其他法官离开最高法院，奥巴马将有机会任命其继任者。他选来替代吉斯伯格的人选，可能将像她一样具有持自由立场，即便不是如此，也能保持最高法院原来5对4的保守立场。

吉斯伯格是美国史上仅有的第二位女性大法官。另一位是2006年退休的桑德拉·戴·奥康纳，吉斯伯格曾为作为最高法院唯一的女性而悲叹。

2007年春，吉斯伯格通过两封因她决定在法庭上宣读而更为著名的言辞尖刻的异议，表达了她对最高法院日甚一日的保守倾向的失望。

通过反对一项主张在全国范围内禁止堕胎程序的裁定，亦即被反对者称为“怀孕后期堕胎”的程序，基斯伯格说该裁定“除了努力削弱一项被最高法院反复宣示的权利，以及对增加妇女生命的核心性的理解外，不会有任何意义。”

此后不久，最高法院拒绝了莉莉·莱德贝特的歧视诉讼。莱德贝特是一位长期任职于古德伊尔公司的高管人员，她每年领到的薪水比他的男同事少了数千美元。吉斯伯格说，“在我们看来，最高法院对足以使妇女成为待遇歧视的受害者的阴险方式并未理解，亦不感兴趣。”

她敦促国会修改法律，以便准许像莱德贝特这样的诉讼。恰恰在上周，奥巴马签署了该修正案，使之成为法律。

吉斯伯格生于纽约市。她爱好戏剧，在法庭上的神态酷似她理想中与之对应的安东尼·斯卡利亚。这两位法官曾一起休假，她办公室里摆着她俩在一头大象上照片。她们还年复一年地享用由配偶们精心准备的晚餐，共同度过新年夜。

在比尔·克林顿总统任命吉斯伯格之前，她曾是华盛顿特区的一个联邦上诉法院法官。而在更早的时候，她则以律师的身份服务于美国民权联盟，并促使6件案子上诉于最高法院。

据最高法院说，上月在马里兰州毕士大的国家健康研究所进行的一次常规的年度体检中，发现了吉斯伯格患新的癌症。通过CAT扫描，在胰脏中心发现了一个1厘米见方的肿瘤。

最高法院并未对该手术或者她的治疗进程提供更多的细节。

胰腺癌是最容易致死的癌症之一。对最近一年的38000个病例的调查发现，能够存活五年的病人总共只有不到5%。

就像吉斯伯格那样，少于十分之一的病例发现于早期，此时癌细胞尚未扩散到腹部以及更远处。这是因为较之含糊的消化不良，早期的胰腺癌很少显示出征兆。

即便在早期就发现，胰腺癌手术依然非常艰巨。医生们通常会切除部分胰脏、胃或者肠。手术后紧接着的便是放射疗法和化疗。

吉斯伯格的预后取决于很多因素，包括尽管很小的肿瘤是否已经开始扩散到淋巴节，以及该肿瘤究竟属于什么类型。尽管小部分病人拥有乔治城大学校医院医生约翰·马歇尔称为“更安静的肿瘤”，但绝大部分肿瘤都十分活跃。

马歇尔警告，“我们希望能在早期发现，以便能够进行手术，并有一个潜在的治愈的机会。但这是一个大手术，而且这种病往往在很早的时候就开始扩散。”

即便那些少数适合手术的病人，也很少能够通过手术痊愈。所以只能使那些早期病人中大约五分之一能够活够五年的化疗，是延长生命的标准疗法。

试图寻找更好疗法的研究正在进行中。其中例如探索是否有一种包含着某种特别的基因突变的能够阻止肿瘤恢复的免疫疗法。

吉斯伯格的医生布伦南在胰腺癌和胃癌方面是一个主流的专家，已经帮助数千患有肉瘤或者软组织肿瘤的病人们，建立了一个计算机程序和数据库，以便有助于在检测后至少12年内预测他们存活的几率。

布伦南在1985年~2006年6月担任是斯隆-凯特琳中心外科主任，亦曾担任美国外科手术协会会长。

Justice Giurg has pancreatic cancer surgery

WASHINGTON dash; Supreme Court Justice Ruth Bader Giurg had surgery Thursday for pancreatic cancer, raising the poibility that one of the ideologically divided court‘s leading liberals — and its only woman — might have to curtail her work or even step down before she had plaed.

Giurg, 75, has been a justice since 1993. She has been increasingly vocal in recent years about the court‘s more coervative stances, eecially after the aointments made by President George W. Bush.

Pancreatic cancer is often deadly, although the court said doctors aarently found Giurg‘s growth at an early stage.

In 1999, she had colon cancer surgery, underwent radiation and chemotherapy, and never mied a day on the bench. Statistics suggest this could be a tougher fight.

Giurg underwent the surgery at the Memorial Sloan-Kettering Cancer Center in New York. She will remain in the hoital for seven to 10 days, said her surgeon, Dr. Murray Brean, according to the court. The justices hold their next private conference on Feb. 20 and return to the bench from their winter break on Feb. 23.

President Barack Obama expreed hope for her eedy recovery, White House pre secretary Robert Gi said Thursday, and offered his thoughts and prayers.

If Giurg or another justice leaves the court, it falls to Obama to pick a succeor. Anyone he might choose to replace her probably would be as liberal as she, if not more so, keeping in place the 5-4 coervative tilt of the court.

Giurg is only the second female justice in the nation‘s history. The other was Sandra Day O‘Coor, who retired in 2006, and Giurg has lamented being the only woman on the court.

In the ring of 2007, she vented her frustration with the court‘s increasingly coervative tone by writing two sharp dients that were made even more notable by her decision to read from them in the courtroom.

Objecting to a decision that upheld a nationwide ban on an abortion procedure that oonents call partial-birth abortion, Giurg said the ruling "caot be understood as anything other than an effort to chip away at a right declared again and again by this court — and with increasing compreheion of its centrality to women‘s lives."

A short while later, the court threw out a discrimination suit by Lilly Ledbetter, a longtime Goodyear supervisor who was paid thousands of dollars a year le than her male peers. "In our view, this court does not comprehend, or is indifferent to, the iidious way in which women can be victims of pay discrimination," Giurg said.

She urged Congre to change the law to allow lawsuits like Ledbetter‘s. Just last week, Obama signed the change into law.

Giurg was born in New York City. She‘s a lover of opera and is perha personally closest on the court to her ideological oosite, Antonin Scalia. The justices have vacationed together — a photo in her office shows the two atop an elephant — and routinely mark New Year‘s Eve with an elaborate meal prepared by their ouses.

Giurg was a federal aeals court judge in Washington before President Bill Clinton aointed her. She served as a lawyer for the American Civil Liberties Union before that and argued six cases before the high court.

The new cancer was discovered during a routine, aual exam late last month at the National Ititutes of Health in Bethesda, Md. A CAT scan revealed a tumor measuring about 1 centimeter acro at the center of the pancreas, the court said.

The court offered few details about the operation or her anticipated course of treatment.

Pancreatic cancer is one of the most deadly cancers. Nearly 38,000 cases a year are diagnosed and overall le than 5 percent of patients survive five years.

The reason: Fewer than one in 10 cases are diagnosed at an early stage — like Giurg‘s aears to be — before the cancer has begun reading through the abdomen and beyond. That‘s because early pancreatic cancer produces few symptoms other than vague indigestion.

Even when caught early, surgery for pancreatic cancer is arduous. Doctors typically remove parts of the pancreas, stomach and intestines. Radiation and chemotherapy are common after surgery.

Giurg‘s prognosis depends on a number of factors, including whether the tumor, deite its small size, had begun reading to the lymph nodes, and what ecific type it was. Most are aggreive, although a small proportion of patients have what Dr. John Marshall, a pancreatic cancer ecialist at Georgetown University Hoital, calls "quieter ones."

"We want to be in that early group so we can have the surgery and have a potential chance at cure, but it is a big operation and a disease that does tend to read even very early," he cautioned.

Even those few patients who qualify for surgery seldom are cured by it. So chemotherapy is standard to extend survival, which is still only about 20 percent at five years for people diagnosed in early stages.

Studies are under way to try to find better therapies. Among them: testing if an immune therapy can block the return of tumors that contain a ecific genetic mutation.

Brean, her doctor, is a leading ecialist on pancreatic and stomach cancers and has helped to build a computer program and database of thousands of patients with sarcomas, or soft-tiue tumors, that help to predict their survival chances for at least 12 years after diagnosis.

Brean was chairman of Sloan-Kettering‘s surgery department from 1985 until June 2006 and is past president of the American Surgical Aociation.