I recently received a question about whether the chemotherapy drug Palladia would work for a dog with cancer. This guardian wrote that her dog was breathing hard, all night, and that X-rays showed the cancer had spread to the lungs.
She was asking as to whether the drug Palladia would work for her dog.
In answering this question, we need to clarify some ideas. First of all, what do we mean when we ask ourselves whether a treatment will work?
Well, if a simple cut needs to be stitched, then the treatment will help the cut heal. Maybe a scar will be left, but likely the problem will go away. We have achieved success.
How about an infection? Well, many times the infection is gone after treatment. Finished. Cleared up. So we say we’ve been successful.
But cancer, in particular cancer that is systemic (spread into the body tissues), needs to have a different definition of success. At this stage in veterinary medicine, we do not have a cure for systemic cancers.
This means that if we cannot remove the cancer cells with surgery, we likely cannot cure it.
So how can we say anything works in these cases? Well, this is the question. It all depends on how we define “works”.
Whether or not a cancer treatment works (assuming it was not removed with surgery) depends on what our expectations are. If a treatment makes tumors shrink (but not go away), this could be one definition that it works. Or maybe the cancer just needs to stop growing (stay the same size). Finally, maybe the treatment will make the cancer disappear (complete remission).
So these are all ways of looking at whether a treatment works.
Now, having said that, we need to see whether the cancer responds in any of the three ways above. Will 100% of the dogs treated respond at all? In other words, will each of the dogs’ tumors stop growing, shrink or disappear?
It is rare to get 100% response rates in cancer treatments.
Perhaps the most treatable of systemic cancers is lymphosarcoma. Typically, somewhere around 80-90% of the cancers respond to treatment in some way or another, a large chunk of them achieving complete remissions.
Now, if we look at Palladia, a much smaller portion of dogs with mast cell tumors respond (for more on these stats, click here). Of all the dogs with mast cell tumors treated with Palladia, 42.8% responded to treatment. And this response lasted between 11 and 18 weeks, depending on how we define duration of response. This means that the tumor started growing again after about 4.5 months in those dogs that responded.
This does not mean that Palladia is “bad”. Rather, this is simply the reality of what this chemo drug offers. For some, this can be defined as a successful approach. For others, it may be that this is viewed as “not working”.
I have found that using all of the available approaches, at the same time, works best in my patients. I use diet, Apocaps, other supplements, surgery, chemo, acupuncture, radiation if available, and techniques to help convert our dogs’ brain chemistry to a cancer-fighting state.
For those that want to use this approach, you will be interested in the Dog Cancer Survival Guide.