The news that a loved dog has cancer turns the world upside-down.
Shock, dismay, disorientation, anger, and profound feelings of loss or sadness are common. Another common response is questioning the diagnosis.
“My dog seems fine. The lump does not seem to bother her. His appetite is good. She still plays. How can he have cancer?”
This question can point in two directions. One direction is the four legged family member actually does not have cancer, and a misdiagnosis has been made. The second direction is the diagnosis is correct, but does not appear to be.
First, let’s examine when an incorrect diagnosis has been made. The most common way this happens is when no sample has been collected containing cancer cells, but cancer has been declared. Samples include tissue, fluids, or cells. These are normally reviewed to see if there are cancer cells in the sample.
Sometimes a veterinarian will proclaim cancer but has not collected a specimen for analysis. This can happen when there is a high suspicion of cancer, for example, an enlarged spleen in a dog who is not acting right. The problem here is that many things can enlarge the spleen above and beyond cancer. One example is a hematoma, which can look a lot like cancer on an X-ray or ultrasound, but it not.
Sometimes a skin lump can look a lot like a cancer. However, there are many kinds of skin lumps. One example of a growth that can mimic skin cancer is called a granuloma, which is the body’s reaction to long-standing infection, inflammation, or some foreign material within the skin.
Of course, it is obvious what is needed under these circumstances. Collect the specimen for analysis! See if there are cancer cells, and if so, what kind of cancer.
Why might this not occur? Usually the veterinarian will not recommend further testing due to fear of bringing up a cost discussion, or other concerns raised by the guardian. Rarely, the test itself will be too invasive to justify the procedure (biopsies of brain tumors, for example).
Sometimes, other parts of the process are to blame. Here, we have proper methods being performed: the specimen is collected to find out if there are cancer cells. The dog’s human received the news. However, a mistake has been made. (It should be noted that these following errors are extremely rare.)
A sample gets switched. A name gets mistakenly put on the wrong form. These types of errors are extremely rare, but can happen. Under these conditions, a second specimen review will correct the issue.
This is discussed in detail in the Guide (as well as the steps every person dealing with dog cancer should take). The Guide points out that the very first step necessary step is getting a copy of the pathology report.
In the report, the pathologist will directly state the name of the cancer. This is important. A pathologist report should almost always be a part of the accurate cancer diagnosis.
Occasionally, the pathologist will be stuck and cannot decide what class of cancer we are dealing with. When this happens, a second pathologist review of the same specimen can usually clear it up, or re-sampling the area in question.
We have covered ways an incorrect diagnosis has been made. What if the diagnosis is correct, but the guardian can’t seem to believe it?
Many times dogs will act “fine” even though they have cancer. This is because the cancer load often has to be large before a dog will act sick. Dogs also have a inborn instinct to hide disease. This is because dogs acting sick in the wild are targets for predators, or may lose their pack position.
In these cases, our dogs will seem okay, but their bodies have cancer cells developing. When this happens, it is time to change to the Dog Cancer Diet, and consider surgery, apoptogens, chemotherapy, immune support, pain control, radiation, side effect management, other supplements, and all the other steps in the Guide.
Finally, there are rare reports where the disease just goes away. Mother nature deals with it. This is called complete spontaneous regression. I have seen one case in the dog. Here, the cancer was real, but the body clears it. This is very, very rare, but deserves mention in this discussion.