Although melanoma that has spread to the liver and brain is a very serious condition, Jimmy Carter is a good candidate for treatment that combines a targeted form of radiation with an immunotherapy drug that has been shown to help some melanoma patients live many months longer than expected. This is true even though Carter is 91.
Melanoma is the most serious type of skin cancer and carries a high mortality rate when it has metastasized to other parts of the body. It is not known where the original melanoma occurred on Carter, but it is not unusual for the original tumor not to be found. A melanoma usually forms on the skin, but can start in mucous membrane or the eye. As a fair-skinned man who spent a lot of time outdoors farming, Carter was at high-risk for developing skin cancer.
The four small tumors in Carter's brain are being treated with stereotactic radiation therapy. This involves delivering a strong, pinpoint beam of radiation directly to the tumors instead of hitting more areas of the brain, which might be less effective and could cause problems with thinking and memory. He has received the first stereotactic radiation treatment.
A tumor in Carter's liver was removed surgically. However, there are probably other microscopic metastases of melanoma elsewhere in his body. To eliminate these or slow their growth, he will be treated with an intravenous drug called Keytruda (pembrolizumab), which is an immunotherapy drug. The drug essentially removes a cloaking mechanism that allows cancer cells to go undetected by the body's immune system.
Carter has had one treatment with Keytruda and will have three more at 3-week intervals.
Even with these treatments, few doctors will use the word "cure" when it comes to a prognosis of melanoma that has spread. However, treatment with this type of radiation and immunotherapy has been able to provide many patients with a long-lasting remission.