When former President Jimmy Carter first learned at the age of 90 that his melanoma cancer had spread to his brain, he thought his death was imminent.
He even said pretty much that to relatives and friends. But his doctors quickly corrected him, telling him that he could live many more years and that he was in good overall health.
After the consult, Carter felt much more optimistic about his future. His docs gave him a thorough description of his treatment and gave him a tutorial on Keytruda, the immunotherapy that works with your immune system to help fight multiple types of cancer.
From that point on Carter would share his immunotherapy experience with others. It proved to be a huge boost for the drug, and for Jimmy. It clearly gave the former President a new and powerful way to make a positive difference in the world even at his advanced age.
A Champion for Cancer Patients and Doctors
Carter’s life journey has inspired many people, including me. Back in December I underwent an immunotherapy treatment myself called CAR T. I did not know if I would survive. There was no guarantee.
I was pretty scared, but also determined. I had beaten stage IV cancer twice before and I had read up as best I could on immunotherapy. I knew that if a man in his 90’s could beat cancer, so can I.
I have always thought of Jimmy Carter as a man with a sweet side but also tough as nails. I thought a lot about him during my worst days in treatment when I could literally not even remember my own last name. Cognitive issues, major ones, often come with CAR T immunotherapy.
But hey, Carter showed so much courage while going through his cancer journey. And he was 90 years old! I needed to chill. And for the most part I did.
Carter has always been a hero to me dating back to when I was a kid and he was in the White House. There is an innate kindness and strength in this man.
As an effective peace broker. As a builder of homes in poor parts of the world. And much more. But he has probably gotten the best reviews of his life for the way he has dealt with his cancer and for his generous work with cancer patients.
Spreading the Good Word of Immunotherapy
Dr. Gregory Daniels, a medical oncologist and professor of medicine at UC San Diego, treats people with melanoma and is very familiar with Keytruda.
Daniels told me last year that Carter’s decision to be treated with an immunotherapy caused a positive nationwide ripple effect. Daniels noted that as immunotherapy began showing positive results, more patients began asking about it, especially older patients. And that was largely because of Carter’s nudging.
Virtually every oncologist I’ve spoken to about Carter has mentioned his positive comments about Keytruda and immunotherapy in general. His subsequent talks were an enormous boost for cancer patients. He made it real and not so frightening.
Keytruda now treats such cancers as Skin Cancer; Head and neck cancer; Breast Cancer; Lung Cancer; Bladder Cancer; Kidney Cancer; Colorectal cancer; Biliary Tract Cancer; Bile Duct Cancer; Gallbladder Cancer; Classic Hodgkin’s lymphoma and many more. It is certainly a “wonder drug”.
Carter’s Life Coming to an End
It’s hard to think this is true. He seems invincible. Jimmy Carter has lived for almost a decade since his diagnosis. He is almost 100 years old. And he is still with us.
But this past week, his oldest grandson announced that his grandfather is “coming to the end” after spending more than a year in hospice care.
Jason Carter, who also runs the Carter Center Board of Trustees, announced last week, “He really is, I think, coming to the end that, that — as I’ve said before, there’s a part of this faith journey that is so important to him. And there’s a part of that faith journey that you only can live at the very end, and I think he has been there in that space.”
The Human Immune System
Carter was of course a deeply religious man. But he was also a friend to science. He would also preach to anyone who would listen about the several new types of immunotherapy that are used to treat cancer, including immune checkpoint inhibitors, T-cell transfer therapy, monoclonal antibodies, treatment vaccines, and more.
Immunotherapy of course enables the body’s own immune system to find and attack cancer cells. This is different from traditional chemotherapy, which typically works by attacking cancer cells directly.
There are side effects, and scientists are continuing to make these treatments as safe and effective as possible.
The Defense Against Disease and Infections
As Jimmy knows, the immune system is the body’s natural defense against disease and infections. The immune system uses T cells — white blood cells that target substances they don’t recognize — to detect and kill other cells in the body, like cancer cells. Cancer cells and T cells can connect in the body through the PD-1/PD-L1 pathway.
The PD-1/PD-L1 pathway helps balance the immune system’s response to cancer — it’s similar to having a gas and brake pedal on the immune system. Immune checkpoints prevent the immune system from attacking cells randomly in the body.
Cancer cells can hide from this pathway by having a protein called PD-L1 on their surfaces. PD-L1 is a protein on the cancer cell that connects with the PD-1 protein on the T-cell.
When these two proteins bind together, the T cell isn’t able to destroy the cancer cell. This is like applying the brakes on the immune system. This means the cancer can continue to grow and spread in the body.
Immunotherapies like pembrolizumab aim to stop this connection — and press the immune system’s gas pedal.
Jimmy Carter Has Led by Example
President Carter has led his life by example. He is a rare breed. He publicly and selflessly announced that he would be taking Keytruda for treatment of his metastatic melanoma and described how it worked. He wanted others to pursue and support these treatments.
This helped to increase solidarity around this promising future that immunotherapy held in store for patients. I’m sure that President Carter feels a strong sense of ownership for the remarkable growth of these new, remarkable, lifegiving treatments.
And I hope he also knows that there are many, many people out here in the world who are happy to know that you touched our lives.
