Bias (prejudice) is an important issue in medical treatments being withheld. Some of these treatments may have benefit, and dog cancer is no exception.
Managing the side effects of chemotherapy is an important part of cancer care. Chemotherapy is most commonly delivered at the Maximum Tolerated Dose (MTD). This means the highest doses that the patient can handle are given so that we get the highest kill rate of cancer cells. When MTD’s are used, some side effects can be inevitable. Different dogs are more or less sensitive to side effects of one drug or another. At least some of these are due to genetic differences.
One of the most common chemotherapy drugs used is doxorubicin, also called Adriamycin. This is an injectable drug used in chemo treatment for common cancers, such as lymphosarcoma, hemangiosarcoma, and many others.
This drug has benefited many dogs with cancer. However, like any medical intervention, side effects must be handled. Other treatments having possible side effects are acupuncture, homeopathy, herbs, diet changes, supplements, and so on. However, it is definitely true that due to the doses of chemotherapy drugs used, side effects using these medications are generally much greater in severity than “alternative” treatments.
One of the most serious side effects of doxorubicin is heart toxicity. As a result, dogs that may be prone to the toxic reactions (and possibly other dogs as well), should receive treatment steps to protect their hearts when receiving this medication. The Guide covers over-the-counter supplements that can help. However, there is an FDA approved drug that is used to protect the heart from doxorubicin’s effects called dexrazoxane.
Now, here’s the rub. One of the ways this medication works is through its antioxidant effect. Almost all conventional veterinarians advise against the use of antioxidants, across the board, when combined with chemotherapy. There have been many posts on this topic here in this blog. It is not nearly as strait forward as one would guess, given the blanket “anti” position our profession holds towards the combination.
The more one looks at these issues, the more clear it becomes that there are rarely “always” and “never” rules that are accurate in medicine. There are only actions and results, some being desired and others not. Realizing this basic truth allows us to avoid our own prejudices in what we use to help pets (and people for that matter), and thoughtfully select from a larger menu of helpful treatments.
Those who wish to read more about further available treatments will appreciate the Guide.