By Brenda Goodman, MA
WebMD Health News
Reviewed by Brunilda Nazario, MD
Aug. 20, 2015 -- Former President Jimmy Carter outlined Thursday an aggressive course of treatment that he'll follow to attack the melanoma that was discovered in his liver and has spread to his brain.
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In a remarkably candid and detailed press conference, Carter, 90, talked about his plan to fight the cancer, his mood, and how his family and friends have handled the news.
In addition to a radiation treatment to his brain, which he said would have later Thursday, he's receiving a new drug, pembrolizumab (Keytruda), to boost his immune system's ability to fight the disease. He said he'd have four drug treatments at 3-week intervals.
He said he anticipates more cancer will be found.
"It's in the hands of God," Carter said. "I'll be prepared for anything that comes."
"I'm looking forward to a new adventure," said the former president, who has become known for his humanitarian work in the years since leaving the White House.
Carter said he'd received numerous well wishes from across the nation, including from President Barack Obama, former president Bill Clinton and his wife Hillary, and both former Presidents Bush.
Carter said a tumor on his liver was discovered in May, after he cut short a trip to Guyana because he wasn't feeling well. He said he had a "bad cold," but he got a health check that revealed the mass.
Doctors at Atlanta's Emory University Hospital removed the 1-inch mass in his liver in August, taking about one-tenth of his liver, Carter said.
A biopsy revealed that the cancer was melanoma. He says his doctors suspect the cancer started elsewhere in his body and spread to his liver, but they don't know -- and may never find out -- where it originated.
An additional MRI of his head and neck revealed four spots of melanoma on his brain. Once cancer has spread as extensively as his has, it is classified as stage IV.
Asked how he felt when he heard the diagnosis, Carter said, "At first I felt that it was confined to my liver and that the operation had completely removed it, so I felt quite relieved. Then that same afternoon we had an MRI of my head and neck and it showed that it was already in four places in my brain, so I would say that night and the next day until I came back up to Emory, I just thought I had a few weeks left, but I was surprisingly at ease. I've had a wonderful life.
He credited his strong faith and thousands of friends for the sense of calm he felt in facing his diagnosis.
He said he never considered not treating the cancer, and he was in a playful mood as he took questions from reporters.
When CNN's Sanjay Gupta, MD, stepped up to the microphone and introduced himself, Carter said to raucous laughter, "I know. I've been taking all these questions so I could get to you."
Carter said the spots in his brain were "very small" -- about 2 millimeters each in size .
Walter J. Curran, Jr., MD, a radiation oncologist at Emory University and one of Carter's doctors, said the side effects the former president might experience from his treatments -- including achiness in his bones and joints, fatigue, and skin irritation -- would likely allow him to carry on a normal life.
"One of the goals we have with these type of therapies is to make cancers that may not be curable -- make them chronic diseases," Curran said, speaking to reporters.
He said it was hard to say how much time Carter might have left.
"What we're seeking in some types of cancer, which may not be curable, is long-term life with a good quality of life. Any physicians taking care of patients like President Carter, that's their goal as well," he said.
Manmeet Ahluwalia, MD, the director of the Brain Metastasis Research Program at Cleveland Clinic, said that in the past, patients with melanoma that had spread to the brain could expect to live 6 to 12 more months.
"I think these newer therapeutic options are improving outcomes," he said. "And what we're finding out in more recent years is that a select group of patients are living 2 years, 3 years, or even longer when they're being treated with a concoction of these drugs and focused forms of radiation."
Carter said he still plans to teach Sunday school, and he hopes to return to Nepal later this year to build houses for Habitat for Humanity. But he said he'd curb his busy schedule at The Carter Center, the nonprofit public policy center he and his wife Rosalynn founded.
"For a number of years, Rosalynn and I have planned to dramatically reduce our work at the Carter Center but haven't done it yet," he said. "This is a propitious time, I think, for us to carry out our long delayed plans."
He said his grandson Jason Carter, who has been state senator and recently ran for governor in Georgia, would take over as chairman of the Carter Center's board.
"As you might expect, we've all been a little sad," Jason Carter said following his grandfather's press conference.
But, he added, "my grandfather is a remarkable man. This is not a eulogy in any way."
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