Odds are, Ruth Bader Ginsburg will not survive pancreatic cancer.
The Supreme Court announced that the only female justice had surgery Thursday for the deadly disease, which kills nearly as many Americans as it inflicts.
The news raised the possibility that the liberal jurist might have to curtail her work or even step down before she had planned.
Because after decades of research, scientists have just begun to put a dent in the fourth-deadliest cancer, a rare but aggressive disease that strikes at random.
But the little information the Supreme Court released about Ginsburg's condition suggested she may be better off than most.
The court said the new cancer was discovered during a routine annual exam in late January at the National Institutes of Health in Bethesda, Md. A CAT scan revealed a tumor measuring about 1 centimeter across at the center of the pancreas.
Ginsburg, 75, underwent surgery in New York on Thursday, another good sign.
No more than 5 percent of patients survive after five years. But that rate grows to 20 to 24 percent among those whose cancer is caught early enough for surgery and is followed by chemotherapy.
"There are a lot of things that we do now in medicine that we didn't do a short time ago," said Dr. Alex Rosemurgy, a pancreatic cancer specialist with the University of South Florida and Tampa General Hospital, noting that the first cancer was cured in the 1970s. "It really is a different age."
More than 30,000 Americans get pancreatic cancer each year. The number of those who die of it is almost the same. Risk factors include genetic predisposition and smoking, but neither is a telltale sign of who will get it.
"Unfortunately, when we look at the actual statistics it doesn't look like much has changed over the last 30 to 40 years," said Dr. Mokenge Malafa, who heads the pancreatic tumor program at H. Lee Moffitt Cancer Center and Research Institute in Tampa.
The danger of pancreatic cancer begins with its quiet growth. Symptoms are common maladies like weight loss, back pain and indigestion. They often appear only after the cancer, which affects about one in 75 Americans, has already spread.
Chemotherapy hardly affects it. It's so unresponsive that the FDA approved a drug in hopes it would lengthen lives by a few weeks, Malafa said.
Pancreatic cancer has silenced those who could be its biggest opponents, Malafa said. Survivors of other cancers form powerful advocacy groups to fight for research funding and educate people about the diseases. Pancreatic cancer has so few survivors that only small groups have formed.
Malafa thinks more doctors are growing aware of it and spotting it early, though, as Ginsburg's doctor apparently did.
"I think it's getting a little better, but I think it still needs a lot of help," Malafa said. "Anything to shine light on it is still really needed."
Ginsburg, a justice since 1993 and one of the most liberal members, has been increasingly vocal about the court's more conservative stances, especially after appointments made by President George W. Bush. She has lamented being the only woman on the court since Sandra Day O'Connor retired in 2006.
President Obama expressed hope for her speedy recovery, White House press secretary Robert Gibbs said Thursday, and offered his thoughts and prayers.
Ginsburg, who had colon cancer in 1999, and never missed a day on the bench, isn't the first well-known person to raise the disease's profile. Steve Jobs of Apple Computer survived a less lethal form of the disease after having a tumor removed in 2004. In 2007, Luciano Pavarotti died of it at age 71. Actor Patrick Swayze is also battling the cancer.
Advances against the disease have been incremental. Rosemurgy said the greatest progress has been better surgery. Scientists are also studying viruses that can carry DNA into tumors to change their genetic makeup. Another study is testing whether an immune therapy can block the cancer's return when the tumor contained a specific genetic mutation.
Rosemurgy said curing pancreatic cancer could lead to breakthroughs with other diseases, simply because it is among the hardest to fight.
"If we could solve this riddle, we would unlock a lot of doors," Rosemurgy said.
Information from the Associated Press was used in this report.