Doctors: Several factors to dictate Jimmy Carter cancer treatment

ATLANTA (AP) — Determining what treatment to pursue for former President Jimmy Carter's cancer will depend on several factors, but the first tasks are to determine where it started and whether it is curable, doctors said.

Carter, 90, announced Wednesday that recent liver surgery found cancer that has spread to other parts of his body.

A statement released by the Carter Center indicates that the Nobel peace laureate's cancer is widespread but not where it originated. The liver is often a place where cancer spreads and less commonly is its primary source.

The statement said further information will be provided when more facts are known, "possibly next week."

Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, said determining where the cancer originated can help select the treatment. Sometimes the primary site can't be determined, so genetic analysis of the tumor might be done to see what mutations are driving it and what drugs might target those mutations.

Much in successful cancer treatment depends on the patient's "biological" age versus his actual years, said Dr. Lodovico Balducci, a specialist on treating cancer in the elderly at the Moffitt Cancer Center in Tampa.

"A man 90 years old normally would have a life expectancy of two or three years, but Jimmy Carter is probably much younger than that" in terms of his function, Balducci said. "If he tolerated liver surgery, I imagine he has a relatively good tolerance" to other treatments that might be tried.

The first task is to determine whether the cancer is curable, "which is unlikely with metastatic cancer," or if it is possible to meaningfully prolong the life through surgery or other treatments, Balducci said.

Carter completed a book tour this year to promote his latest work, "A Full Life," which includes his family's history of pancreatic cancer. He wrote in the memoir that his father, brother and two sisters all died of the disease and said the trend "concerned" the former president's doctors.

Carter announced Aug. 3 that he had surgery to remove a small mass from his liver. Carter Center spokeswoman Deanna Congileo earlier this month called the liver surgery "elective."

Good wishes poured in on social media after Carter's announcement. President Barack Obama said he and first lady Michelle Obama wish Carter a fast and full recovery.

Carter defeated Gerald Ford in 1976 with a pledge to always be honest. His second term was doomed by a number of foreign policy conflicts — in particular, the Iran hostage crisis — before losing in a landslide to Ronald Reagan in 1980.

He spent the decades since carving out a reputation for promoting such global issues as health care and democracy. Carter helped defuse nuclear tensions between the Koreas and monitored the first Palestinian elections. In 2002, he won the Nobel Peace Prize.


AP Chief Medical Writer Marilynn Marchione reported from Milwaukee.