Recently I heard the comment that medicine (in my case, veterinary medicine) is primitive.
This is a very interesting comment, especially if we are talking about canine cancer.
When you are coping with a canine cancer diagnosis, the question of curing cancer comes up frequently. Now, shifting back to this idea about medicine being primitive, let’s look at some assumptions so we can clear up some concepts about cancer in the dog.
First, the idea of cancer care being primitive would be based on expectations. Second, many of us have heard that we do not have a cure for cancer. “The Cure For Cancer” is a goal of modern science.
But wait. I recently read in USA today that at an event in Estes, Colorado, it was proclaimed that we cure half of the dogs with cancer.
If we are able to cure half the dogs with cancer, why is it that we are still searching for the cure for cancer?
Well, we are of course talking about the other half.
So what makes a cancer curable? Let’s look at a concept that needs more attention: systemic disease.
If a cancer is located in a single location in the body, and that location can be removed surgically, and there are no cancer cells (or late stage pre-cancerous cells) left in the body, then we have a situation where the cancer can be cured.
The situation is different if there are cancer cells dispersed in the body, either in the area around the surgery site (having moved from the central location into the surrounding neighborhood), or in a distant location (spread in the circulation).
In these cases, the phrase used in The Dog Cancer Survival Guide is Hard to Cure. These are the ones where the cancer cells have spread into the body, and this is what most clinicians might call systemic disease.
Those cancers where the cells are isolated to a single location can be removed with surgery. This is perhaps the only way, at this point in time, that cancers can be cured.
Perhaps this is why my client made the statement that medicine is primitive. The sole way that we cure cancers in veterinary medicine is by cutting them out, when it is possible.
It is important to realize what the goals of treatment are for those cancers that are more systemic (Hard to Cure). These would include lymphosarcoma, osteosarcoma, many mammary cancers, hemangiosarcoma, osteosarcoma, many mast cell tumors, and others.
Other Hard to Cure cancers would be the ones that might be removable with surgery, but are in a location that makes them difficult to remove. These tend to send out cells into the surrounding neighborhood around the tumor itself. Common examples are fibrosarcoma, squamous cell carcinomas, transitional cell carcinoma (often in the bladder), and spindle cell tumors of various kinds.
So, the bottom line is finding out what type of cancer we are dealing with is critical. This is part of your data collection stage of the plan in The Dog Cancer Survival Guide. Once this is established, clear goals and expectations can be defined by you and your vet or oncologist.
Best,
Dr D
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