Featuring Demian Dressler, DVM and Susan Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide.
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But Will Palladia Work?

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.

Best,

Dr D

About the Author: Demian Dressler, DVM


Dr. Demian Dressler, DVM is known as the "dog cancer vet" and is author of Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog's Life Quality and Longevity. Visit his blog and sign up free to get the latest information about canine cancer. Go to http://DogCancerBlog.com.

  • M.A.

    I have a question regarding the interaction with Chinese Herbs and using Apocaps.

    My dog (12 yrs. old, Brit spaniel/Retrv. mix) has been recently diagnosed with mast cell tumor, Grade 3, mitotic activity is moderate. He had his first surgery on 11/30 (rt. shoulder area) and has recovered from that surgery. Recently, 1/1/11 noticed a lump above his recent incision. Vets agreed to have second surgery which was scheduled this morning to remove this lump.

    Once he was diagnosed with cancer I started slowly changing his diet to no-wheat, (Tast of the Wild kibble) but also going toward home-cooked . Is treatment is being managed with Chinese Herbs Stais Breaker and Wei Qi Booster, Benadryl, Vit. C, Prednisone (every other day), Fish Oil.

    Can I give the Apo Caps with his current meds? What can I do to help stop the histamine from spreading? How do I reduce the cause of the inflammation I just recently found your website and ordered your book. I feel your approach is what I have been looking for as the Full Spectrum.
    Will blue algae help reduce the histamine release? What would be the dosage?
    Thank you,
    Mary Ann

    • http://DogCancerBlog.com DemianDressler

      Dear M.A,
      When using pred with Apocaps (same day) I would drop the dose of either the pred or the Apocaps to 1/4-1/2 of the labeled dose. On days not using these together, use the Apocaps as labeled.
      No, blue algae has not evidence for reducing histamine that I am aware of.
      Benadryl is discussed in the Guide and should be used for these dogs.
      Similarly, a H1 blocker like famotidine or cimetidine should be used.
      As to diet, see this post.
      Don’t forget that all health steps with your dog should be done under veterinary supervision.
      Best,
      DR D

  • http://rosiesroad.wordpress.com Michele

    Dr. Dressler,

    Thank you for writing the article. I realize Palladia does not work in all situations. However, in our situation, Palladia worked for our dog because she is still alive and has a great quality of life 18 months after removal of her 2nd MCT tumor and the start of Palladia. I documented her journey the last 18 months on her blog at http://rosiesroad.wordpress.com. I welcome others to share their experiences with their dogs. Several others have..both good and bad.

    When Rosie, our yellow lab, was diagnosed in August 2009 with Mast Cell Cancer (grade II with Mitotic Index of 20 out of 10) the cancer had spread to the nearby lymph nodes and surrounding tissue. She had 2 surgeries to remove 2 tumors. After the second surgery, her oncologist and vet estimated she had about 2 months if we did nothing and kept her comfortable.

    Since Palladia had just been released at the time, we tried that, along with a grain-free diet, supplements, and supportive medicines to offset any side effects of Palladia. Thankfully, for Rosie, it worked. By October 2009 her ultrasound and bloodwork showed no sign of cancer, and currently show no sign of cancer. Rosie continued taking the Palladia with no visible side effects for 10 months. After that a couple times she experienced vomiting and we stopped the Palladia for a few days and then restarted. Twice we have stopped the Palladia for 2 weeks and then restarted. I don’t know how long much longer Rosie will take it. The main thing is that she has a good quality of life. So far she has.

  • Barb

    Dr. Dressler,
    I recognize one of the posts above re: Michelle and Rosie from Yahoo CC group, and I was encouraged by her success with Palladia when my dog Tucker’s MCT metasticized.
    Tucker’s story was much like the results you discussed in your article. She began Palladia in early October after 2 rounds of vinblastine. By the end of December, the drug stopped working.
    She is now on Mastivet, we were the last to get in on the compassionate care program before the drug was approved by the US FDA. I now understand it will cost 2X what Palladia cost, so have no idea how I will afford it… However, more important than that is how well will it work in the context of shrinking tumors, arresting growth, and keeping the cancer under control.
    Do you have any feedback on the response times? Tucker has so far responded to the med and her tumors have shrunk again, I just don’t know how long to expect that to last…
    I understand every dog is different, but just curious what type of results have been seen in Europe where I know the drug has been used for quite some time…
    Any info you have would be appreciated….

  • Kim

    Dr.

    We treated our Rottie for Osteosarcoma. We found her cancer in October. We had her leg amputated and did 3 months of chemo. Her lungs were clear in January but this time we took her for her 3 mo check-up they found a tumor in her lungs. Do you think that this drug Pallidia is worth a try for her? The vet said that even trying this drug will only give her maybe another 15 weeks. In your opinion is it worth trying? How long does a dog usually have after a tumor is found in the lungs without being treated?

    Thanks!
    Kim

    • http://DogCancerBlog.com DemianDressler

      Dear Kim
      Honestly, the chemo questions should really be addressed by your oncologist, who deal with the chemo all day every day. The real question is what kind of person you are? A, B, or C (this is in the Guide). Are you most interested in longevity or life quality? With chemo there is often a trade off to some extent. Palladia has not been used extensively for metastatic osteosarcoma yet and so the jury is still out to some extent. Typically if the tumor is osteosarc we are looking at a few months without intervention. Are 2-3 months extra worth it to you? I would consider:
      diet, immune support, apocaps, artemisinin, oral and possibly nebulized neoplasine, red clover, doxycycline. All should be done under veterinary supervision.
      Hope this helps a bit,
      Dr D

  • Linda

    Hello Dr. Dressler,
    I have a 6 yr. old yellow lab mix (large breed, 85 lbs.) His front left leg was amputated in November due to a Fibresarcoma that grew rapidly once he was diagnosed. The limb was sent up to the Colorado State University, Animal Cancer Center for staging, and type. It came back as a Fibresarcoma and very low risk for spreading, 10%. So Bo was considered cancer free. In the last couple weeks or more he has started to cough minimally or choke like he has something in his throat and also pant a little bit more and breath heavier. The xray of his chest/lungs showed multiple (at least 4) in his lungs and 1 or 2 being fairly large. The Oncologist went over 3 types of Chemo but did say nothing is guaranteed and chemo hasn’t been proven to work on cancer in dogs all that well for most dogs. With that said, I have investigated the University’s clinical trials going on now and he may qualify for one, as I cannot afford the chemo. Do you think his quality of life will deteroriate on the chemo? We don’t know what kind of cancer is in his lungs, if it is the Fibresarcoma that spread or a new cancer. He still eats, plays a bit, runs on 3 legs, is alert, just breating heavier. It’s very nerve-racking! I’m undecided as to what route I want to take here, Chemo or no chemo. Maybe he could be one of the miracle dogs that the vets talked about and it goes into remission. I just worry becasue he has so many of them in his lungs and could in other areas as well.
    Also, can you recommend a good diet? I see above some things he should be on potentially but wasn’t sure if the type of cancer needs to be deteremined in order to know which diet works best?
    Thank you!

  • Linda

    Hello again. I just received word from Colorado State University that the drug Palladia is not part of a study at the moment, although they have a study for Cyclophosphamide (low dose). Are there severe side effects for this drug. They said he would take it every day and stay on it for as long as he could handle it. Any information you can provide on that drug would be greatly appreciated. I know every dog is different and without knowing what kind of cancer he has it is probably impossible to provide advice. The University said they may be able to do a needle aspiration to find out if it’s lung specific or metastatical.
    Thank you!

  • Martha

    I got your very useful Guide, but could not find the answer to these questions:

    1. Do Apocaps and Palladia interact negatively?
    2. Why Amazon.com does not ship Apocaps to Canada?

    Thanks, Martha

  • Kristen

    Hi Dr. Dressler,
    We have found your website and book very helpful – we’ve had two of our Australian Shepherds go thru cancer in the past two years. We lost one female at 11 years old after 18 months of going thru lung cancer surgery, chemo, and Masitinib treatment. Her sister had an emergency splenectomy for hemangiosarcoma 2.5 months ago followed by 4 Doxorubicin chemo treatments and is now on Palladia 1x/day on M/W/F. (We are working with an oncologist at the Vet Cancer Group in Culver City, CA.)

    Her appetite is not great on the Palladia so we were wondering if we
    can we give her Apocaps at the same time she is taking the Palladia? If yes, what dosage? I already have the Apocaps at home.

    We just don’t want to lessen her appetite any more at this point and getting her take pills can be difficult at times. Thanks for your help.

    • http://DogCancerBlog.com DemianDressler

      Dear Kristin,
      as long as the steps you are taking are under veterinary supervision, I do not see a problem using them together. I would address the reduced appetite before starting Apocaps however. Once started, I would give with a full meal. Is there an alternative (masitinib?) that might be tried to improve appetite? How about some mirtazipine or cerenia to stimulate appetite?
      Best,
      D

  • Marion Lindsay

    Hello Dr. Dressler
    I bought your book on dogs with cancer, and thank you. Our boy, Boston, lab/rottie has been diagnosed with hemangiosarcoma. Just started him on K9 immunity yesterday. Need to get the APOCAPS as soon as possible, like yesterday :)
    I can not get them from amazon – will not ship to Canada. Is there a website where I can buy them from to get them to Canada, quicker the better? My email is mariontlindsay@gmail.com
    Thank you
    Marion Lindsay