As in Jimmy Carter’s case, cancer can spread from skin to brain

Up to 10% of patients diagnosed with the skin cancer called melanoma can suffer from the same kind of brain tumors that former President Jimmy Carter is now being treated for.

So says Dr. John Boockvar, a neurosurgeon at Lenox Hill Hospital, noting that the brain is a common place for the deadly cancer to spread.

Carter’s melanoma likely started as a lesion on his skin that must have been missed, says another expert, Dr. Anna Pavlick, the co-director of the melanoma program at NYU Perlmutter Cancer Center.

Former President Jimmy Carter has a good chance of getting cancer-free, some doctors say

“The melanoma that gets inside the body is melanoma that started in the skin,” she says, explaining that once the lethal cancer digs into the body, it passes through the lymph nodes or blood stream and makes its way to internal organs.

Such is what happened with Carter. In addition to his brain, the former President’s cancer also spread to his liver.

What’s frustrating is that sometimes doctors never end up pinpointing the mark that led to the cancer’s spread, the experts say.

Pavlick is optimistic that Carter can still recover.

“I am exceedingly hopeful he will be in the group that responds (to treatment) and this will not be a problem for him long term,” she says.

Her confidence comes from Carter’s two-pronged approach to beating the cancer: radiation and immunotherapy.

Radiation — which he was scheduled to begin Thursday — will target the four small tumors on his brain, while immunotherapy drugs will boost his immune system, which fights illness in the body.

“The immune system is like a police force: It looks for bad guys, finds them, traps them and takes them to jail,” Boockvar says. “Cancer cells evade this police force, (but) we have new drugs that help boost the police force.”

The immunotherapy drug, administered via an IV, will not only target cancer cells still lurking after Carter’s May liver surgery, but also any cancer cells that doctors haven’t discovered yet.

Immunotherapy is a relatively new approach to cancer treatment and physicians find it very promising.

“If this was five years ago, we probably would have told him ‘you've got six months to live,’” Pavlick said. “Now, with effective therapies, there’s a good possibility we may get him disease-free in a very short period.”

More good news: According to both doctors, despite suffering from tumors in his brain, Carter shouldn’t experience any cognitive changes.

“A lot of times these are so small and end up on the frontal lobes, of which we use very little,” says Boockvar. “You (can) have these and be completely asymptomatic.”

The radiation he’ll likely receive will target just his tumors — not his whole brain — so he’ll come out of that unscathed, too.

“We try not to give people whole-brain radiation (because those) patients get cognitive changes,” Pavlick said.