WASHINGTON — Supreme Court Justice Ruth Bader Ginsburg underwent surgery to remove malignant lung nodules, and the threat of a government shutdown looms over Capitol Hill with Democrats and President Trump playing chicken over funding for a border wall.
Justice Ginsburg Treated for Lung Cancer
Supreme Court Justice Ruth Bader Ginsburg had two malignant lung nodules removed on Friday, the court announced.
“Justice Ruth Bader Ginsburg underwent a pulmonary lobectomy today at Memorial Sloan Kettering Cancer Center in New York City,” the court said in a press release. “Two nodules in the lower lobe of her left lung were discovered incidentally during tests performed at George Washington University Hospital to diagnose and treat rib fractures sustained in a fall on November 7.”
“According to the thoracic surgeon, Valerie Rusch, MD, both nodules removed during surgery were found to be malignant on initial pathology evaluation,” the release continued. “Post-surgery, there was no evidence of any remaining disease. Scans performed before surgery indicated no evidence of disease elsewhere in the body. Currently, no further treatment is planned. Justice Ginsburg is resting comfortably and is expected to remain in the hospital for a few days.”
This is the 85-year-old Ginsburg’s third cancer diagnosis and her second “incidentaloma.” In 1999, doctors discovered she had stage II colon cancer while treating her for an unrelated abdominal infection; she had her sigmoid colon removed. “The justice is very lucky to have had this picked up incidentally,” said Harmon Eyre, MD, chief medical officer for the American Cancer Society at the time, in an article in the New York Times. “If it had been left alone, it would have advanced to another stage.”
The federal government partially ceased operations after both chambers of Congress and President Trump failed to agree on a funding bill before a midnight deadline on Friday.
Most of the government healthcare functions will continue unaffected. Because emergency funding provisions were included in a bill passed by Congress earlier this year, the Department of Health and Human Services itself may continue operations; but the FDA was excluded from that funding and could place as much as 40% of its staff on furlough, according to the Politico Pulse newsletter.
Pulse noted that the FDA has certain protocols in place to prioritize emergency concerns such as an outbreak of a foodborne illness, but the agency would plan to scale back its regulatory oversight and inspection processes.
Surgeon General Calls for New E-Cig Restrictions
The U.S. Surgeon General on Tuesday declared electronic cigarette use among America’s youth “an epidemic” and called for new restrictions on the products.
The action comes a day after release of a Monitoring the Future report, which confirmed that teen vaping nearly doubled in 2018, with one in five high school seniors reporting current use of e-cigarettes. More than 3.6 million teens in the U.S. reported that they regularly used the vaping products.
Recommendations in an advisory by Surgeon General Jerome Adams, MD, include banning vaping from establishments now covered by indoor smoke-free air policies, further restricting youth access to e-cigarettes in retail establishments, implementing new price policies, and banning marketing to youth.
“The recent surge in e-cigarette use among youth, which has been fueled by new types of e-cigarettes that have recently entered the market, is cause for great concern,” he said. “We must take action now to protect the health of our nation’s young people.”
HHS Recommends Co-Prescribing Naloxone With Opioids
Naloxone should be prescribed together with opioids for patients considered at risk for overdosing, such as when they receive very high opioid doses, the Department of Health and Human Services (HHS) said.
“Given the scope of the opioid crisis, it’s critically important that healthcare providers and patients discuss the risks of opioids and how naloxone should be used in the event of an overdose,” said Adm. Brett Giroir, MD, assistant secretary for health and senior advisor for opioid policy at HHS, in a statement. “We have begun to see some encouraging signs in our response to the opioid crisis, but we know that more work is required to fully reverse the decades-long epidemic. Co-prescribing naloxone when a patient is considered to be at high risk of an overdose, is an essential element of our national effort to reduce overdose deaths and should be practiced widely.”
The guidance released Wednesday for healthcare providers and patients reinforces and expands on earlier guidance from the CDC, the statement noted. It recommends that clinicians prescribe or co-prescribe naloxone “to individuals at risk for opioid overdose, including, but not limited to: individuals who are on relatively high doses of opioids, take other medications which enhance opioid complications, or have underlying health conditions. By co-prescribing, or prescribing naloxone to at-risk individuals, patients and their loved ones could be better equipped for possible complications of overdose, including slowed or stopped breathing.”
Olaparib Gets First-Line Ovarian Cancer Maintenance Indication
The FDA approved the PARP inhibitor olaparib (Lynparza) on Wednesday for first-line maintenance therapy in advanced, BRCA-mutated ovarian cancer.
The approval applies to patients with germline or somatic mutations and who respond (complete or partial) to first-line platinum-based chemotherapy. At the same time, the FDA approved the BRACAnalysis CDx as a companion diagnostic test to select patients with germline BRCA mutations for maintenance treatment with olaparib.
The new indication for olaparib followed a report from the randomized, multicenter, placebo-controlled SOLO-1 trial, which showed a 70% reduction in the hazard for disease progression or death in patients randomized to 2 years of olaparib maintenance therapy. Patients in the olaparib arm of the trial had a 3-year progression-free survival (PFS) of 60.4% as compared with 26.9% in placebo-treated patients. Median PFS had yet to be reached in the olaparib group as compared with a median of 13.8 months in the placebo group.
“We feel the SOLO-1 trial has demonstrated an unprecedented improvement in progression-free survival in patients who have a BRCA mutation and advanced ovarian cancer when olaparib is incorporated following platinum-based chemotherapy,” principal investigator Kathleen Moore, MD, of the Stephenson Oklahoma Cancer Center in Oklahoma City, said at the 2018 European Society for Medical Oncology congress in Munich. “It appears that the benefit of olaparib maintenance is extended beyond the 2-year time point during which patients were receiving treatment.”
Congress is on recess. Enjoy your holidays.