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Video on the Full Spectrum Approach to Dog Cancer Care

by Dog Cancer Vet Team · 0 comments

This video on the full spectrum approach to dog cancer care is one of over 40 videos that you can find on our Dog Cancer Vet YouTube channel.

Here is the transcript of the video:

Transcript of: The Full Spectrum Approach to Dog Cancer Care

James Jacobson: One of the most interesting things that you present in the book The Dog Cancer Survival Guide is this approach that you call the “full spectrum approach”. Dr. Dressler, what is the full spectrum approach and how do we use it?

Dr. Demian Dressler: The full spectrum approach is embodied by avoiding personal bias. These means that we do not want to exclude things that may help our dogs, because we don’t like where the information came from. Here’s how it works. As a conventional veterinarian, I graduated from Cornell Veterinary School and I learned conventional veterinary medicine. As time went on, I began to explore other areas, because some of the diseases that we deal with are a little bit frustrating. So, I began to delve in to more diet and more nutriceutical such as plant derived compounds that have beneficial medical effects in the body and mind body connection all these things. Now, many conventional vets will say “no, no… That’s not good,” because, it’s “alternative”. Now the flip side happens as well. We have veterinarian who considered themselves as alternative vets, and they say no, no conventional veterinary medicine antibiotic surgery, these types of things that’s no good either. Now, in order for us to deal with the disease, we’re really struggling both in human and in veterinary medicine. We do not have a cure for cancer unlike some other veterinary or medical issues. We need to look very, very objectively at all of the available tools we have and select from those intelligently and disregard our own personal biases as far as the color of the wrapping paper that the particular tool comes in.

James Jacobson: It makes sense. Dr. Ettinger, what’s your approach in terms of looking out it from a broad perspective like that?

Dr. Susan Ettinger: I think, it’s just important to learn about everything and consider all the options, and I think Dr. Dressler’s completely right and we both went to Cornell together and as you go out into the real world, you learned that there is more options out there and not everything is completely pharmaceuticals, and I think there’s a lot more spiritual connection and a lot of other things to consider.

James Jacobson: So, Dr. Dressler, when you talk about full spectrum, you’re not talking about holistic veterinary treatment per say.

Dr. Demian Dressler: Not at all. No, I don’t want to say ok we’re only going practice “holistic”, we’re only going to focus on diet we’re only going to focus on plant derived compounds, we’re only going to use acupuncture, and we’re not going to use all of the tools that we know have their place. This is why it is called full spectrum. This full spectrum approach is all about as objectively as possible avoiding hype, avoiding bias, assessing each tool independently and seeing well. Does this have merit in combating a disease that we struggle with? So, we’re looking for always new options, cause we want to improve survival times, get more life and make that life as good as it possibly could be.

James Jacobson: What is a very exciting approach and it certainly is throughout the book The Dog Cancer Survival Guide. Thank you both for joining us today Dr. Dressler in Hawaii and Dr. Ettinger in New York. Thanks!

Dr. Demian Dressler & Dr. Susan Ettinger: Thank you.

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Chemotherapy for Osteosarcoma

by Dr. Susan Ettinger · 3 comments

In my last two posts about osteosarcoma (OSA), we discussed treatments that address the tumor affecting the bone. We discussed amputation, Stereotactic RadioSurgery (SRS) like Cyberknife, palliative radiation, and limb-spare surgery.

While these treatments are important for the malignant tumor destroying the bone, metastasis (cancer spread) is inevitable.  So even if the primary tumor is successfully removed with surgery or killed with SRS, these tiny metastases (which are often undetectable at first) will grow and eventually kill dogs with OSA. This makes systemic treatments aimed at controlling micrometastasis a critical part of conventional care.

Chemotherapy Delays Metastasis

I know what you are thinking: chemo for your dog sounds scary and crazy. But overall chemo in dogs is very well tolerated, with minimal side effects. It’s one of the things I like about my job! Hospitalization from chemo-induced side effects is rare. I have a whole series of blogs dedicated to chemotherapy and its side effects, so if you haven’t read them, check them out. The pet Guardians of my patients are always amazed how healthy and happy their pets are during and after chemo.

I bring this up again because chemotherapy is very effective for OSA to delay metastasis. When compared to treating with amputation alone, chemo more than doubles median survival times:

  • Survival times for OSA cases with amputation and no other treatment have a median survival time of four to five months, with 90-100% dying by one year, and only 2% still alive at two years.
  • Median survival times for OSA cases with amputation and chemotherapy increase to ten to twelve months, with 20-25% of dogs are still alive at two years.

For me and many of my patients, those odds make chemotherapy a no-brainer.

Which Chemotherapy Protocol Works Best?

The most common chemotherapy drugs are doxorubicin, carboplatin, and cisplatin, which you can read about more in the Guide. The published protocols vary on which drugs to use, how frequent treatments should be, and the number of treatments. Consulting with an experienced oncologist who can look at your dog’s own case and weigh all the options that would work best for him or her is your best bet.

At my recent annual Vet Cancer Society conference in the fall of 2012, there was a great abstract from the group at Colorado State University which looked at almost 500 dogs to compare protocols. Dogs either received doxorubicin, carboplatin, or a protocol that alternated the two. Based on this preliminary report, there were no significant differences in the protocols when measuring how long the patients remained tumor-free, and survival times. As always the case with research abstracts, we will need to wait for the published protocol to come out, but at this point, one protocol does not appear to be better than the other. So discuss the different drugs with your oncologist, with regards to your dog’s specific needs.

Doxorubicin and CyberKnife or Stereotactic Radiation Surgery

A word about using chemotherapy with CyberKnife treatments: for my CyberKnife cases, we don’t use doxorubicin.  We avoid this specific drug in cases that have received SRS, because there is a side effect called radiation-recall. This chemotherapy protocol, when given after radiation, can bring back or “recall” some of the early skin side effects that you normally see in the first few weeks after radiation – skin side effects such as redness and burning. (You may hear your oncologist call this “moist desquamation.”) If a dog receives doxorubicin, even months later, those skin side effects can recur.  So I never use doxorubicin after CyberKnife, and instead use carboplatin.

Chemotherapy Timing

The best time to start chemotherapy is soon after surgery or radiation, before metastasis has been detected. I typically start chemo about two weeks after surgery or SRS.

Bottom Line: You Have Time

While a diagnosis of OSA may be very scary, it is not an immediate death sentence. As you’ve seen, there is a wide variety of treatment options. As always, I encourage you to consult with an oncologist and discuss the pros and cons, based on your dog’s underlying health, the extent of the disease at diagnosis, and your budget.

All the Best

Dr. Sue

Vaccination and Dog Cancer

A reader recently posed a question about vaccinations and links with cancer in dogs. I discussed this in more detail in the Guide, along with many other factors that may (or may not) have links to cancer.  But, since it came up, I thought it might make a good post. If reader is looking for [...]

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Is There A Reason For All This Dog Cancer, part 2

In my last post, we looked at some of the connections between the environment, diet, and cancer development. We also examined how similar cancer is to the body’s reaction to an injury, as if it were healing a damaged or wounded organ in a deranged way. Today, I’ll continue some of my thoughts about why [...]

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Osteosarcoma: when amputation is not an option, part 2

In my last post, I went through some “alternatives-to-amputation,” including palliative radiation and limb-spare surgery. Now we will review stereotactic radiosurgery. Stereotactic RadioSurgery: radiation instead of surgery RadioSurgery is used INSTEAD of surgery, when traditional surgery with a scalpel blade is impossible or would cause unacceptable side effects to the patient (for example, in brain [...]

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