As cancer treatment begins, Carter to scale back on work

ATLANTA (AP) -- Former President Jimmy Carter is stepping back from most of his humanitarian work and surrounding himself with family as doctors target the skin cancer that showed up in his liver and brain.

Four generations of Carters are gathering in his tiny hometown of Plains, Georgia, to celebrate his wife Rosalynn's 88th birthday. He plans to teach Sunday School at his church, as he often does. And on Oct. 1, Carter will turn 91.

The former president was relentlessly upbeat Thursday, making jokes and flashing his wide smile during a detailed, 45-minute news conference about his melanoma diagnosis and treatment. He said he feels "ready for a new adventure" and said his life's work is not yet done.

"Within the bounds of my physical and mental capability I'll continue to do it," Carter said. "But I'm going to have to give the treatment regimen top priority."

His spirits seemed to dampen only when he expressed doubt about being able to participate in a home-building mission in Nepal this November with Habitat for Humanity. The trip would have been the 33rd such mission for Carter and his wife, Rosalynn. Instead, he said, family members may have to take his place.

Carter received targeted radiation therapy Thursday, aimed at four small tumors in his brain.

The day before, he received his first dose of a recently approved drug to help his immune system seek out and destroy cancer cells that may develop anywhere else in his body. He will have that treatment three more times at three-week intervals, and there could be other radiation treatments, if needed.

Doctors also removed a small tumor from his liver on Aug. 3.

He said Thursday that he felt little pain or weakness and had slept well after receiving his first intravenous dose of pembrolizumab, which is sold as Keytruda after being approved by the FDA for melanoma patients last fall.

Jason Carter, his grandson, said the extended Carter family already had plans to gather in Plains for Christmas this year. In the meantime, Jason Carter said he expects his grandfather to spend time with his wife and do a lot of fishing.

"For the longest time, I think a lot of people have looked at him as someone who's just going to go on forever," Jason Carter said. "There's this old gospel song we were just talking about that says `I'm going to stay on the battlefield,' and that's always the way that he's approached his life."

As much as he's able, Carter said he'll keep lecturing at Emory University, raising money for the Carter Center's $600 million foundation, and meeting with experts on guinea worm and other diseases the center is working to eradicate.

"We understand that he has to focus on his treatment, and that's what we want him to do," the center's CEO Mary Ann Peters said. "The best thing we can do is continue to do our job so that when we report to him, we're not creating any problems."

Carter's team includes Dr. Walter Curran, Jr., who runs Emory's Winship Cancer Institute. Treatments for melanoma have improved tremendously recently, and Carter's prospects are good even at the age of 90, Curran said. But he cautioned against the idea that Carter can be "cured."

"We're not looking for a cure in patients who have a disease like melanoma that has spread," Curran said. "The goal is control and to have a good quality of life."

Doctors told Carter they had completely removed cancer from his liver, but then an MRI exam showed the spots on his brain. Carter said he went home that night thinking he had only a few weeks to live, but found himself feeling "surprisingly at ease."

"I've had a wonderful life," Carter reflected. "I've had thousands of friends, I've had an exciting, adventurous and gratifying existence. So I was surprisingly at ease, much more so than my wife was."

Carter didn't discuss his long-term prognosis.

He said the path toward his cancer diagnosis began in late May, when he departed an election monitoring trip to Guyana early because of a bad cold. Doctors found a spot on his liver during a follow-up exam, but he wanted to complete a book tour before the surgery, and only told others about the diagnosis once it was certain.

Carter served in submarines in the Navy and spent years as a peanut farmer before running for office, becoming a state senator and Georgia governor. His "plainspoken" nature helped Democrats retake the White House in 1976. On Thursday, he said he remains proud of what he accomplished as president, but more gratified by the humanitarian work he's done since, which earned him a Nobel Peace Prize in 2002.

"When he first got the news that there was melanoma in his brain, he was worried that he wasn't going to get to finish the book he was reading," Jason Carter said. "But now he is clearly, having spoken with the doctors, he understands that there's a period of time and he's going to be able to go catch some fish, and hopefully catch more of his grandkids' baseball games."

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