Facts must be de­ter­mined for Carter care, say doc­tors


De­ter­min­ing what treat­ment to pur­sue for for­mer U.S. 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.

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