Contrary to some media accounts, Jimmy Carter was not “cured” of his cancer by a new wonder drug. The former president’s metastatic melanoma, diagnosed in the summer of 2015, is in remission after a multi-treatment approach. The medical community does not consider him “cured” and believes use of the word regarding his status is misleading.
Dr. Jorge Perez of Sierra Nevada Cancer Center points out the distinction in terminology. “President Carter’s cancer is no longer detectable by MRI scan. This is great news, but it does not indicate his cancer is cured; his cancer is in remission,” Dr. Perez continues. “To be consider ‘cured,’ a patient must be cancer-free for five years. As he is 91, in all likelihood, when President Carter dies, it will be from some other cause.”
Carter first revealed in August 2015 that he had been diagnosed with metastatic melanoma (making him one of an estimated 74,000 Americans who will be diagnosed with melanoma this year, according to the National Institute of Health.) Doctors found a small tumor on his liver that was later found to have spread to four spots on his brain. The important part of his diagnosis is how early it was made in his cancer progression – most likely this was the most significant factor affecting Carter’s response to treatment.
Following his diagnosis, Carter underwent surgery to remove the lesion in his liver, received brain irradiation and received a newly approved immunologic drug called Keytruda. Each of these therapies played a role in his current remission status, but we don’t – and can’t – know which one played the most important role.
Surgical removal of a cancerous tumor or lesion (or portion of ) is a common treatment option for many cancers. As Carter had a lesion on his liver, it was a logical decision to remove that localized lesion to prevent spreading.
The immunotherapy drug Keytruda has received the most media interest. Back in July 2015, Oncology Stat reported on the evolving role of immunotherapy in cancer treatment. Immunotherapy works by stimulating a person’s own immune system to attack cancer cells. Ketryuda was fast-tracked and approved by the FDA in 2014 for the treatment of melanoma. While approved for use, it is important to note there are still many questions regarding its efficacy. The clinical trial leading to its approval involved just 173 subjects – a very small sample. Follow-up was just 6 to 36 weeks post treatment – a very short period of time. In the end, 21 percent of patients had an ongoing positive response where their tumors partially or completely shrank. This is promising, yes, but not a slam dunk.
The stereotactic radiation therapy Carter received provided concentrated radiation to his brain lesions using highly accurate beams that target cancerous lesions without affecting nearby tissue and with limited side effects. Some would argue that this treatment was the one most likely to have sent his cancer into remission.