Miraculously- President Jimmy Carter, 99, Still ‘Hanging in There’ More Than a Year Into Hospice Care and Having Cast His Vote in Statewide Election

A Resilient President and Cancer Survivor Defying the Odds In Hospice Care

• Former President Jimmy Carter, 99, thrives 15 months after entering hospice care. He recently voted in an election and credited his longevity to his faith.
• The main difference between palliative care and hospice care is that during hospice care, no efforts are made to cure the illness, while palliative care may also provide treatment “intended to cure” the illness.
• The former president is also a cancer survivor whose metastatic melanoma was previously treated with Keytruda, a type of immunotherapy drug called a checkpoint inhibitor.
• Immunotherapy drugs have made a significant impact on advancements in cancer treatment. They work by activating immune cells against cancerous cells, using the body’s own ability to fight off the cells. Immunotherapy drugs are used for many different types of cancer, including melanoma, bladder cancer, colorectal cancer, lung cancer, blood cancer, pancreatic cancer, and breast cancer.

Former President Jimmy Carter, 99, still exercises his civic duty and credits his devout faith for his long life, which lasted more than a year after he entered hospice care. “He may be immortal. We have not seen evidence to the contrary,” Jimmy Carter’s grandson Jason told the Atlanta Journal-Constitution in an interview.

Carter entered hospice care in February 2023. The oldest living president has since defied the odds, having survived metastatic melanoma – a type of skin cancer – surpassing doctors’ expectations and outliving his beloved wife of 77 years, Rosalyn, who died last year at 96. According to the Washington Post, Carter’s family was told once he began hospice care in February, he would not live beyond a week. Jason says his resilient grandfather voted in Georgia’s most recent election. “It’s important to him,” Jason said.

Jason added that he had told the former president that people asked him how he was doing. Carter replied to his grandson, “I don’t know myself,” with a laugh. Carter credits his longevity to his faith in God. “He’s hanging in there, and he knows he’s not in charge,” Jason said.

Expert Resources on Melanoma

• A Biopsy of Your Mole Doesn’t Mean You Have Melanoma
• A Melanoma Vaccine for Metastatic Patients
• Am I at High Risk for Melanoma?
• An Immunotherapy Success Story: Mary Elizabeth Williams Lived Through Metastatic Melanoma
• Be Aware of the Side Effects of Targeted Therapy for Melanoma

Carter’s Remarkable Journey

Jimmy Carter served as President of the United States from 1977 to 1981. The former peanut farmer, Georgia Governor, and Navy servicemember faced several challenges domestically and abroad, including an energy crisis and mounting issues in the Middle East. The Iranian hostage crisis influenced his defeat of President Ronald Reagan. During the crisis, Carter tried to secure the safe return of hostages. Jimmy Carter is the longest-lived American president, and his legacy has become more adored in the five decades since he left the White House. He has long advocated for democracy, public health, and human rights and was awarded a Nobel Peace Prize. However, amid those accolades, Carter also successfully overcame health challenges that helped grant him the blessing of celebrating 77 years of marriage to the former first lady.

Well into his golden years, Carter entered hospice care early last year. “Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life,” the National Institute of Health (NIH) explains . Hospice care provides comfort care but does not attempt to cure the illness. Families facing potential hospice care should talk to their care team early enough before pursuing hospice care to take advantage of its comforts. “Starting hospice early may be able to provide months of meaningful care and quality time with loved ones,” the NIH says. During palliative care, the patient is provided specialized medical care to manage symptoms associated with their medical condition. This form of care may also offer treatment “intended to cure” the illness instead of hospice care, which does not. WATCH: Palliative care improves your overall treatment by focusing on comfort. “It’s not the same thing as hospice. It’s really important to recognize that palliative care , whether provided by your oncologist or by a specialty palliative care team, is an important adjunct to your oncologic care,” Dr. Lisa Diver, a gynecologic oncologist and Medical Director at ImmunoGen tells SurvivorNet. “It doesn’t mean that your doctor is going to stop treatment or even wants to talk about that, but simply that he or she thinks it’s important to support all aspects of your health. That could be pain control, [relief for] nausea or constipation, or mental health care. All these other symptoms that commonly arise and are intertwined inextricably with your cancer care,” Dr. Diver added. While the scope of President Carter’s health when he began hospice care is unclear, he’s had several health scares over the years. Carter underwent elective surgery at Emory University Hospital in Atlanta, Georgia, “to remove a small mass in his liver” in August 2015. The operation was successful, but it also revealed he had cancer that had spread or metastasized to other parts of his body. He received care for his metastatic melanoma at Emory’s Winship Cancer Institute. WATCH: Understanding Your Melanoma Diagnosis. Melanoma starts in the same cells that give your skin, hair, and eyes their color. Only in melanoma do the cells change in a way that allows them to spread to other organs. While it’s mostly found on areas of your skin exposed to the sun, it can also develop in areas that rarely receive sun rays. These areas may include the palms of your hands, soles of your feet, your eyes, inside your mouth, and under your nails. “At the time, Carter thought he might have only weeks to live, but Winship doctors quickly developed a treatment plan for him, beginning with stereotactic radiation to control metastatic tumors in his brain and a new immunotherapy drug that worked systemically,” a statement from the Cancer Institute reads. During a press conference before his first radiation treatment , the former president clarified that his melanoma had spread to his liver and brain and would have four rounds of the immunotherapy drug pembrolizumab(brand name Keytruda) at three-week intervals. Immunotherapy drugs work by activating immune cells against cancerous cells using the body’s ability to fight off the cells. WATCH: What Do Checkpoint Inhibitors Do for Cancer Treatment? Carter’s drug Keytruda is a type of immunotherapy called a checkpoint inhibitor , which works by interfering with signaling pathways between T cells and cancer cells and prevents cancer cells from hiding from the body’s T cells. “I’ve had melanoma patients early on who, many years ago, wouldn’t have had a chance,” Dr. Scott Strome explains to SurvivorNet. The former president reportedly announced to his church in March 2016 that doctors stopped his treatment after seeing no more signs of tumors. Then, in 2019, Carter had surgery to relieve pressure on his brain caused by bleeding from his multiple falls at home. In recent months, Carter has made rare public appearances but was present at Rosalyn’s funeral service. He was also spotted riding in an SUV at a parade in his hometown of Plains, Georgia. When spotted, the resilient former president still has a smile on his face.

Questions for Your Doctor

If you are in the middle of your cancer journey or caring for a loved one who is asking questions about late-stage care, the following questions can help you begin your conversation.

• How will I know if I need palliative care to aid my cancer treatment?
• How does palliative care differ from the care I'm getting now?
• Who provides palliative care?
• Will my insurance cover palliative care?
• Is there a moment when palliative care becomes hospice care?