Casino titan Sheldon Adelson is undergoing treatment for cancer, raising questions about the future of his Las Vegas Sands casino empire.

On Thursday, the Nevada Independent quoted a Sands attorney saying Adelson was in “dire” health. The quote was made during a Clark County District Court hearing in the latest go-round of Hong Kong businessman Richard Suen’s 15-year quest to get Sands to pay him the millions he claims to be owed for helping Sands secure a Macau casino license.

Adelson didn’t participate in Sands’ Q4 earnings call on January 23, as Sands president Rob Goldstein claimed Adelson was “a little bit under the weather.” On Monday, Sands’ attorneys told the court that Adelson had “not participated in the company proceedings in terms of being physically present” at the company’s Las Vegas HQ since around last Christmas.

Sands spokesman Ron Reese later issued a statement saying Adelson was “still dealing with certain side effects from medication he is taking for the treatment of non-Hodgkin’s lymphoma.” However, Reese added that, while the treatment had “restricted [Adelson’s] availability to travel or keep regular office hours,” Adelson was still capable of “fulfilling his duties as [Sands] chairman and CEO.”