Rehnquist has thyroid cancer

Illness returns attention to high court nominees

October 26, 2004|By Gail Gibson and Jonathan Bor | Gail Gibson and Jonathan Bor,SUN NATIONAL STAFF

The future face of the Supreme Court, a muted issue throughout the heated presidential race, gained urgency yesterday with the unexpected announcement that Chief Justice William H. Rehnquist has thyroid cancer and underwent surgery over the weekend in connection with the illness.

Rehnquist, who at 80 is the second-oldest person to preside over the high court, was admitted Friday to the National Naval Medical Center in Bethesda, where doctors performed a tracheotomy Saturday, the court said in a brief statement.

The court is not in session this week, but the statement said Rehnquist was expected to be on the bench when court reconvenes Monday.

No other details were provided about Rehnquist's condition or treatment, which experts said made it difficult to assess his prognosis. But some doctors said the fact that he required a tracheotomy, which is rarely performed in cases of thyroid cancer, does not bode well and suggests that he may be suffering from an aggressive form of the disease.

That uncertainty and the timing of the hospitalization - a little more than a week before Election Day - brought new attention to the question of possible Supreme Court appointments in a presidential race that has been consumed with the war in Iraq, terrorism and the economy.

Court observers have predicted that the next president could have the chance to nominate at least one Supreme Court justice and possibly as many as four. The court's current lineup has not changed in a decade, since Justice Stephen G. Breyer joined in August 1994. And Justice Clarence Thomas, at 56, is the only member who is younger than 65.

"The timing is extraordinary," said Michael J. Gerhardt, a law professor at the College of William & Mary in Virginia. "This election is chock-full of issues, and people maybe weren't that focused on the Supreme Court. But this news is just a dramatic reminder of the likelihood of a vacancy on the court."

Rehnquist, a conservative who joined the court as an associate justice in 1972 and was elevated to chief justice in 1986, has been at the center of speculation in recent years about likely departures from the court.

He has had a series of health problems, including chronic back problems and knee surgery in 2002. The court is shrouded in secrecy - with the justices carefully guarding information about their private lives - and yesterday's four-sentence statement gave little information about Rehnquist's overall health and no clues about his plans.

About 22,000 cases of thyroid cancer, which is relatively uncommon and usually treatable, are diagnosed in the United States each year, according to the American Cancer Society. Most of the 1,400 deaths each year are caused by a rare type of thyroid cancer, called anaplastic cancer, which accounts for only 5 percent of all cases but is always fatal.

Dr. Rodney Taylor, a head and neck surgeon at the University of Maryland Medical Center, said in an interview that a tracheotomy sometimes follows surgery to remove a patient's thyroid - the butterfly-shaped gland behind the Adam's apple that regulates cellular activity.

In those cases, Taylor said, surgeons may have inadvertently injured nerves controlling the vocal cords during the first surgery. Paralyzed vocal cords interfere with breathing so surgeons performing a tracheotomy insert a tube into the windpipe to surmount this problem.

But the statement from the court said nothing about thyroid surgery - either before or after the tracheotomy. If, indeed, surgeons have elected not to remove the thyroid, that might suggest that the thyroid is beyond treatment and the tumor has invaded or is causing pressure on the trachea.

"There's only one type of thyroid cancer where I would not make an attempt to remove the gland and only do a tracheotomy - anaplastic thyroid cancer, which is universally fatal," Taylor said. "It is one of the most aggressive forms of cancer known to man."

David N. Atkinson, a law and political science professor at the University of Missouri, Kansas City and the author of Leaving the Bench: Supreme Court Justices at the End, has long faulted justices for failing to disclose information about their health and for resisting retirement.

"They want their privacy, but they involve themselves in such momentous decisions, we have a right to know what their condition is," Atkinson said. The plain fact, he noted, is that when justices remain on the court beyond their mid-70s, it increases the possibility of a sudden, unplanned departure due to severe illness or death.

"These kinds of events are just inevitable, and it puts the whole country in a tailspin," Atkinson said. "Whoever is president, if you have a chief justiceship open up immediately [after the election], the country is going to go through a real issue."

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