Cancer patients once thought too old to undergo treatment can take new hope from former President Jimmy Carter, who at age 91 is effectively fighting the malignant disease with new two therapies, a top doctor says.

“Usually when I see sick patients as old as this, the thought is to use palliative care [which only alleviates pain] or to call hospice. But we now have to rethink this because Jimmy Carter’s case shows is that there are obviously patients who can tolerate the treatment and survive,” neurosurgeon Dr. Lee Tessler tells Newsmax Health.

On Sunday, the former president shared the good news with his fellow parishioners at his church in Plains, Ga., that he is cancer free. He also said, in a statement posted on the Carter Center website, that new tests had found no signs either of the original cancer or any new ones. He also said he would be continuing treatment.

“This is very good news for Jimmy Carter. It shows that the cancer treatment is working, and that any disease he has, whether in his brain, or elsewhere in his body, is now under control,” says Dr. Tessler, executive director of the Long Island Brain Tumor Center in Lake Success, N.Y.

“It also shows that if the cancer should reoccur, his doctors could use the same type of treatment, and it would likely be effective again.”

Carter had a small cancerous mass removed from his liver in August. Subsequent testing showed that it was a form of melanoma, which had spread to four spots in his brain. He has been in treatment since.

The former president is being treated at Emory University’s Winship Cancer Center in Atlanta with and advanced form of radiation and a new immunologic drug called Kevtruda (pembrolizumab).

The U.S. Food and Drug Administration fast-tracked the approval of Kevtruda last year after studies showed it extended the lives of patients with advanced melanoma. It is also approved for advanced lung cancer.

Immunologic drugs differ from traditional treatment in that they are a “targeted” therapy that bolsters the immune system to fight the cancer, as opposed to the conventional drug treatment for cancer, which is chemotherapy.

Chemotherapy kills cells that are subdividing, including non-cancerous ones as well. But it often debilitating side effects, including nausea, hair loss, and frequent infections.

On the other hand, immunotherapy drugs affect only the cancer cells, and this lessens the side effects. That makes patients like Carter, more likely to be able to continue their usual activities. 

In addition to being treated with the newest type of immunotherapy, Carter is also undergoing the latest form of radiation — stereotactic radiosurgery, which goes by different names, including “Gamma Knife” treatment.

Like conventional chemotherapy, traditional radiation does not distinguish between tumor cells and healthy cells — it kills both. But stereotactic radiosurgery focuses the beams better on the tumor, so it can kill the cancer cells more effectively while sparing the healthy ones.

“Not long ago, we had ways to treat cancer that occurred elsewhere in the body, which we call ‘systemic’ cancer, but once it spread to the brain we had no effective way to treat it. But now all this has changed, and we can both systemic cancer and brain cancer,” Dr. Tessler says.

While Carter’s case doesn’t mean that everyone of such advanced age should undergo such cancer treatment, it does demonstrate that patients should be evaluated on a case-by-case basis, and that age should not be automatically used as a reason to automatically exclude them, Dr. Tessler adds.

“I would rather treat a patient who is 90 and gets sick for the first time than someone who gets sick in their 60s. You always think that the person of 90 is going to do worse, but they’ve got something in them, whether it’s genetics or a certain type of strength, that has enabled them to reach that age,” notes Dr. Tessler.