ATLANTA — Cancer in his brain is forcing Jimmy Carter to slow down, but the 90-year-old Nobel Peace Prize winner is insisting on keeping up with some of the humanitarian work that has sustained him since leaving the White House as a one-term president 35 years ago.
Hours before receiving radiation targeted at four spots of melanoma in his brain on Thursday, the former president warned his staff and a roomful of reporters that he has no intention of missing The Carter Center's next progress reports on the eradication of elephantiasis and Guinea worm disease.
Carter acknowledged Thursday that skin cancer is forcing him to cut back "fairly dramatically" on his usual routine. His regimen includes intravenous drug treatments every three weeks, and the possibility of more targeted radiation if the melanoma shows up elsewhere in his body.
But he insisted that his work isn't done yet — and pointed to The Carter Center's dramatic inroads against diseases in Africa, Asia and Latin America as an example. Guinea worm — a parasite that lives in untreated water and grows inside the human body — afflicted 3.5 million people but seemed beyond the reach of global health initiatives.
The Carter Center says its public health work helped reduce Guinea worm disease to a mere 126 cases worldwide last year.
"I would like the last Guinea worm to die before I do," Carter said.
That's no surprise to Jim Niquette, who spent nine years working on the disease in Nigeria, Ghana and Southern Sudan with the center, and accompanied Carter on three working trips in the field. Niquette founded and now runs WATER (Water in Africa Through Everyday Responsiveness), a nonprofit focused on improving access to clean water.
"He gets his strength from the future world," said Niquette. "My guess is, his frame of reference is, as long as he's on this Earth, he's supposed to do as much as he possibly can."
Gerald Rafshoon, who ran Carter's political advertising campaigns, said a president's legacy is determined by "what he can accomplish for the future." Carter has kept that mentality ever since, despite his disappointment at losing to Ronald Reagan in 1980, he said.
White House aides would "joke about asking: 'What are your priorities?' and he would give you a list of 6 or 7 things for that day," Rafshoon said. "But he wanted to accomplish everything. You knew if he was working you hard, he was working even harder."
Carter stressed that he will closely follow the recommendations of "the best cancer-treaters in the world," even as he keeps lecturing at Emory University, attending meetings and fundraising for The Carter Center, and enjoying his extended family -- four children, 12 grandchildren and 10 great-grandchildren.
Dr. Walter Curran, Jr., leader of Emory's Winship Cancer Institute and part of Carter's medical team, said with melanoma patients like Carter, doctors aren't seeking to "cure" cancer but rather to control it and provide a good quality of life.
Asked if he finds it difficult to step back, Carter immediately responded that he "really wanted to go" to Nepal this November to build houses with Habitat for Humanity. Carter said he and his wife, Rosalynn, have helped the organization build on 32 previous missions.
Curran said he would defer to his patient's better understanding of the trip's demands. Carter explained that flying to Katmandu and then the even more distant Habitat site near the Indian border could delay his final dose by five weeks. Reluctantly, he acknowledged that his family might make the trip to Nepal without him.
"For a number of years, Rosa and I have planned on dramatically reducing our work at The Carter Center but haven't done it yet," he said, prompting a round of laughter from the center's employees watching from an upstairs balcony.
"We thought about this when I was 80," Carter said. "We thought about it again when I was 85; we thought about it again when I was 90. So this is a propitious time I think for us to carry out our long-delayed plans."
Kathleen Foody can be followed at http://twitter.com/katiefoody