President Jimmy Carter learned earlier this year that he has a small mass on his liver and decided to have it removed on Aug. 3. It turned out, however, that the cancer was melanoma and it has spread to his brain.
The 39th president related that he thought he only had a few weeks to live when after his diagnosis of advanced melanoma, a cancer that begins in the melanocytes, the cells responsible for producing the pigment that gives the skin its color.
Stage IV melanoma means that the cancer has already spread to other areas of the body. MRI showed that Carter has four spots of melanoma in his brains with the small spots measuring about 2 millimeters.
Carter, however, is set to benefit from new treatments designed to fight the cancer including a newly approved drug from Merck and a highly targeted form of radiation treatment.
The immunotherapy drug Pembrolizumab, known by its brand name Keytruda, was green lighted by the U.S. Food and Drug Administration in September last year as treatment for melanoma that cannot be removed by surgery or a cancer that has already metastasized.
The drug generally has very low incidence of side effects such as fatigue and rash that experts said it should not impair Carter's quality of life at all.
Carter already received the first infusion of pembrolizumab, which works by disabling a protein that prevents the immune system from detecting and attacking cancer cells. He was set to undergo radiation treatment on Thursday afternoon.
Stereotactic radiation therapy allows doctors to deliver a strong radiation beam directly to the four melanoma spots on Carter's brain instead of applying radiation to his entire brain, which may not only be less effective but could also result in significant cognitive impairment.
"Focused radiation as compared to general radiation has shown some success," said Manmeet Ahluwalia, director of Brain Metastasis Research Program at Cleveland Clinic. "That they are really small makes it more likely that these lesions can be controlled."
The former president said that he was "surprisingly at ease" and that he trusts in the treatment prescribed to him by his doctors. Experts believe the new treatments could give hope to other melanoma patients.
"When patients have metastatic melanoma in the brain and liver, that is historically associated with very poor prognosis," said surgical oncologist Jeffrey Gershenwald, from MD Anderson Cancer Center in Houston. "The fight is still early but clearly the advances in the last four years are tremendous, so we're offering new hope to patients like President Carter."
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