Dog Cancer Surgery: They Didn’t Get It All Out
BySound familiar? Did this happen to anyone out there?
Removal of all the cancer cells from the body during surgery is pretty important. How can we tell?
The most important thing to do is get that biopsy report. Some don’t want the extra cost. “Just get it out” is a line I have heard from time to time. However, the report from the path lab can be absolutely critical.
Why does it matter? Well, there are a couple of reasons. First, the pathologist can evaluate the borders of the tissue I, or your vet/oncologist, submit after removal. This is called comprehensive margin evaluation.
This evaluation tells us if there are cancer cells still left in the dog or not, around the surgery site anyway. If there are cancer cells at the border of what gets turned in to the lab, there are probably some left in the dog.
So, if you get the path report back and there are cancer cells at the edge of the submitted specimen, it would be wise to go back in and remove more tissue. Yes, I am talking about a second surgery.
Some cancer types spread out around where the lump actually is resting. So the dog will have cancer cells around the tumor that you can’t see with the naked eye. Some examples are osteosarcoma, some mast cell tumors, squamous cell carcinoma, fibrosarcoma, hemangiopericytoma (nerve sheath tumor), some mammary cancers (inflammatory carcinomas especially), hemangiosarcoma, malignant melanoma, and more.
In these cases, sometimes a wide excision (removing more than what “looks like” the cancer at the time of surgery is the way to go. A fine needle aspirate or small biopsy before surgery can actually save cost in the end, by ascertaining whether a wide excision is needed before surgical removal.
Best to all,
Dr Dressler
About the Author
Dr. Demian Dressler, DVM is known as the "dog cancer vet" and is author of Dog Cancer Survival Guide: Beyond Surgery, Chemotherapy & Radiation. Visit his blog and sign up free to get the latest information about canine cancer. Go to http://DogCancerBlog.com.
5 Comments
October 25th, 2008 at 7:50 pm
aloha,
I have pennypie, and I saw Dr. Dressler, in the begining of
her lymphoma. Now it has been 1 1/2 years, and she is still
alive. I was giving her, Q10, Vit e, C. and good food. I was
told low, but good natural protien, was good. Also, I guess
the standard treatment was pred. She had a bad incident,
a couple of weeks ago, and I thought we would loose her. However, I was told to double the dose, of pred, and it brought her back, ufortunately, she has become paralized in her back legs, but she is happy and eating well, except for her paralysis. She is incontinent, mostly with urine. She can wag her tail, and she knows something is wrong, but I don’t know what to do from here. They say she was not supposed to last
this long, and I know it was the antioxidants, at least in part, what I don’t know is what to do from here.
Deann Colton
I had very little money to have extensive testing done.
I also gave her salmon oil, and vit d3, and some tabs from
shitake mushrooms.
thanks, and aloha from Kihei, Deann
October 27th, 2008 at 11:41 am
See my comment from your other post…
D
February 27th, 2009 at 12:23 am
My 11 1/2 yr old cocker had a 13 pound tumor chondrasarcoma removed two months ago. During the surgery which was a last ditch effort to save her life, her heart arrested three time. She was revived by heart massage and epi injections. The incision made by the vet was as big a he could do but the tumor was so big (the size of a deflated basketball) that he had to close her up. She was in ICU for 3 days and received 2 blood transfusions. Within a few weeks it was obvious that part of the tumor was still there. Six weeks after her original surgery, when her blood stats were good enough, she had a second surgery to remove a tumor the size of a large golf ball. Within 2 days she was bouncing around the house like nothing had happened. Both tumors were on her abdominal wall and during the second surgery he reoved as much of a margin without doing damage to her diaphram. He also biopsied spots on her liver which came back no cancer. She will likely be on wholistic cancer meds for sometime just in case. A picture of my dog with the tumor laying next to her can be seen at photobucket.com/patricia1594. Thank you for this wonderful and informative website.
March 1st, 2009 at 7:16 pm
Dr. Dressler,
I have an 8 y/o Black Lab who is a 2 year MCT survivor. Started out with a pimple looking bump on her lip and ended up being a Grade 2 (borderline 3). The soft tissue surgeon cut a large wedge from her lip. She was then prescribed a regimen of 4 doses of Lomustine. It was after she started her chemo that more places started popping-up like crazy. The tumors did not slow until near the end of her last dose. She did not have any observed negative side-effects. We have continued with an ongoing dose of Prednisone (10 mg three times per week) and she has responded well to this dose. Still feeling well. This was a dog who was getting sick to her stomach multiple times per week prior to diagnosis, but she is healthy as can be and rarely ever sick now. Her energy level is dramtically improved as well!
Shock for me came this month when my younger Chocolate Lab was also daignosed with MCT. She developed a little open sore on her chest. My vet aspirated and didn’t see any granulation. He recommended peroxide and neosporin. The spot did begin to dry up, scab, and appeared less inflamed. However, she eventually went back to messing with this same spot. The area was tested a second time and still no signs of granulation. However, my vet decided to remove it as it was obviously causing discomfort to my dog. He cut out the area under local anasthesia at the time of her vaccinations (lucky for me she takes large doses of Benadryl prior to vaccinations due to her negative reaction to the vaccinations). However, he was very shocked when it was reported by pathology as a MCT (grade 2). We went to see the oncologist that worked with my first Lab (three hours away). They did an ultrasound which was unremarkable, and they attempted to check her lymp node on the side of the tumor, but had difficulty manipulating her node as it was so small. The oncologist felt that all we needed to do was get better margins in light of the medical findings and the fact that she is not a repeat offender for MCT. So, my vet proceeded to go after better margins. Unfortunately, the second pathology still shows remnant cells at the incision site of the sample after securing better margins. My vet says that he doesn’t feel that he can take any more tissue without effecting locomotion as he has gone all the way down to the muscle sheath and the incision is about 6 inches in length with nearly 20 staples and sutures holding this together. The pathologist told my vet that he wouldn’t do anything further. I’m currently awaiting response from the pathologist.
Based on your experience and expertise, do you think we should proceed with any other treatment? My baby acts like she feels just fine. She is alert, eating, and sleeping quite well. I don’t want to put her in undue pain, but I do want to be responsible and provide the appropriate care.
I asked the oncologist (during our visit) about using supplements and she told me we could certainly try some supplements if we would like, but she did not want to supervise or make any recommendations as she feels there is not enough scientific evidence or FDA control to make such recommendations. My lab is 73 lbs. and I am open to any suggestions you might make.
Thank you in advance for taking the time to read this, and thank you so much for all the helpful information and kind responses you are giving to folks such as myself.
March 7th, 2009 at 4:33 pm
Susan, I cannot make individual recommendations for specific dogs. However, various supplements can be used, including luteolin, apigenin, curcumin, cordyceps/beta glucans, omega 3 fatty acids, artemisinin, and others. There is a full spectrum plan that might help in the e-book, The Dog Cancer Survival Guide. You can also find blog posts on these.
Best
D