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Featuring Demian Dressler, DVM and Sue Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide

Carcinoma of the Anal Sac, part 2

Updated: November 18th, 2019

In the last post, anal sac carcinoma was discussed, including diagnosing these malignant tumors in the dog.  In this post, we will cover more on treatments and some data concerning outcomes.

If a guardian is coping with a diagnosis of canine anal sac carcinoma, often major questions arise soon after the news is received.  Chemotherapy?  Radiation?  Diet? Supplements?

As a proponent of guardianship in dogs, my advice is always to get whatever data you can to use as rough guidelines for your particular dog.   In this spirit, below is some information concerning survival statistics for dogs with anal gland carcinoma.  Please remember that these numbers don’t apply to your dog necessarily, as they are calculated based on groups of different dogs.

One study showed the median survival time for dogs with treated tumors was 544 days overall.  The upper limit of the range was up 1, 843 days!  Those tumors that measured greater than or equal to 10 square cm was 292 days while those with smaller tumors had a median survival of  584 days.  (A rough way for your vet to measure the square cm is to measure the radius of the tumor, square it, multiply this by 4, and multiply this by 3.14)

As to which treatment, it looks like the Big 3 conventional steps combined give the best survival chances. These are surgery, chemo and radiation.  If you have to pick, go for the surgery as your minimum.

As usual, the additions of apoptogens, diet, immune support, anti-metastatic treatments, and life quality enhancement are a part of the Full Spectrum Plan provided in the Dog Cancer Survival Guide.


Dr D

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  1. Melinda on September 1, 2013 at 6:41 am

    Hi, Dr. Dressler and Dr. Sue,

    Just reporting that Paco who had been given 6 mos prognosis w/inoperable anal gland adenocarcinoma with spread to lymph nodes, is still with us and doing well. I started radiation at a facility that I can afford (barely). Just doing 6 treatments. My questions are, how dangerous is this? I just read up on all Dr. D’s posts about radiation. 6 seems at least a little safer than a full regimen but still now I’m nervous. Our challenge with Paco is everything from arteminisin to avemar to fish oil to AHCC and mushroom blends gave him diarrhea. And one metronomic chemo pill/piroxicam also made him very ill. Everything I tried systemically was depleting him. Pro-biotics didn’t seem to make a dent. And I didn’t want to keep him on flagyl. I was told we couldn’t do surgery way back when he was diagnosed (too tricky location of lymph nodes. they’d have to open his pelvis??)

    He’s still pooping okay (tho’ still loose even though he’s on nothing but raw diet and some cooked food ala dog cancer diet protocol, no grains. orijen 6 fish kibble at night cuz he likes it.)

    Also, I give him k9 immunity plus every day. colostrom plus every day. carcinosin every day. and healthy nuggets by Dr. Goldstein (earth animal).

    I was told no anti-oxidants during radiation. Onc said, just no mega doses of C and E. Is there anything else I shouldn’t be giving him? I’m just trying to keep him happy as long as I can. It’s about quality of life for me not quantity which is why I took him off things that made him feel sick. I’m hoping side effects of this radiation won’t be bad. And I’m still wondering even though I asked Dr. Sue when I saw her, if I shrink this would it then be a candidate for cyber knife?
    Anyway, thanks for reading/listening…
    Melinda & Paco

  2. Melinda Buckley on March 24, 2013 at 5:12 am

    Hello, Dr. D and Dr. Sue,
    I could have sworn I had posted this comment last week but it doesn’t seem to be here so I’m re-posting. First of all, thanks for all the info. I’ve been reading and re-reading the Guide, got the Apocaps, K-9 Immunity Plus and transitioning as best I can to the cancer diet. I had appt with Dr. Sue last week but unfortunately, with my Mom in Hospice I couldn’t make it. I’m rescheduled but it’s over a week away.
    Here are my questions:
    I gave Paco (who has inoperable Anal Gland Adenocarcinoma with spread to intrapelvic lymph nodes) a single does of Cytoxan/Piroxicam. the next day he had diarrhea and threw up. And he looked so sick. I immediately stopped and we went thru some flagyl and bland diet to get his tummy settled. it spooked me about metronomic chemo though and I was pretty disappointed that the prescribing onc took four days to respond to my call when it happened. I keep hearing from my holistic friends that I should steer clear of chemo and radiation. That his life quality will be poor even if the treatments extend his days. Right now, I’m cooking for him, loving him to pieces getting him outside more than ever and he’s full of beans. No one would know he’s as sick as I’m told he is. But I understand the ‘compensation’ factor from reading the guide and the link Dr. D recommended. My heart is breaking though and I’m in a panic. Holistic advice I’ve gotten: Ozone treatment, chinese herbs and diet with supplements. I’m praying A LOT. I think palliative radiation might be okay but it is so expensive and I’m told it will extend his life only a couple of months. I just don’t know how I’ll manage the cost, the side effects (?), etc as I’m the long distance care giver for my Mom, which means I’m driving over 4 hrs each way and of course, I have to work but between care taking them both I don’t know how I can– and my own health is starting to deteriorate. I know no one can make this decision but I’d really like your opinion… If radiation will shrink the tumor on his gland and lymph nodes, could it then be operable? (I’m told where his affected lymph nodes are makes it to risky regardless). So even if they just got the tumor out, I’d still be looking at chemo to manage the lymph spread. And then I’m back to square one. I’ve read about graviola, neoplasene… both seem troublesome and unproven. I think I fall into the ‘B to C’ type (from the guide) of owners who want to do everything they can, but I want my boy to enjoy his life and not have it be an endless round of treatments and management. I say this, but then I have my desperate moments when it’s all too much to bear. ugh… Any thoughts appreciated. And thanks again, for all the research and for being a beacon of sanity and reason in this sea of chaos.

    • Dr. Demian Dressler on March 26, 2013 at 4:32 pm

      Hi Melinda
      I’d be looking at low dose Palladia here or oral neoplasene if I were you. Use mirtazapine with oral neoplasene or your dog will get sick again. All these meds have to come from the vet so get your vet involved as always as I cannot make accurate calls online..but these are more options to consider, having researched all this stuff ad nauseum over the yeras…under veterinary supervision please…
      Dr D

  3. Luke Moseley on March 19, 2013 at 4:15 am

    Dr D, my mini schnauzer Chloe was originally thought to have hemangiosarcoma but a biopsy revealed it to be ASAC. It appears to have spread to lungs and possibly liver. Surgery is out and so is radiation. I can’t see where this would help. Would you (or Dr E) suggest carboplatin,mitoxantrone, or something else? I’m hoping we can treat this as Metronomic Chemo orally if thats possible. Chloe is on the dog cancer diet, Apocaps and K-9 Immunity/wtransfer factor. She is also taking Mirtazapine to help with her appetite because she only wants to eat meat (or treats). Her weight appears stable at about 17lbs.
    I’m not sure if you have received my previous messages as they do not appear on the blog. If you get this message please let me know. Thanks, Luke.

    • Dr. Demian Dressler on March 19, 2013 at 4:40 pm

      Dear Luke
      under these circumstances I might be considering Palladia, in addition to dog cancer diet, Apocaps, and immune support as outined in the Guide…all under veterinary supervision of course. I’ll see what Dr Ettinger says too.
      Dr D

  4. Melinda Buckley on March 13, 2013 at 6:45 am

    I just made an appt with you for next week. If by chance you have an opening before next Wed. pls let me know. I don’t want to wait as this is so aggressive and I don’t want to start the chemo until I see you. Or should I? Just sent the records to your office.

    • Dr. Demian Dressler on March 19, 2013 at 5:35 pm

      Melinda, I have been lecturing at the American Animal Hospital Association conference and have not been at the practice, I am sorry…
      Dr D

  5. Melinda Buckley on March 13, 2013 at 5:55 am

    Hi, Dr. Sue,
    Thank you for responding here. I think I would like a second opinion. The Oncologist I took him to recommended either a round of 4 radiation treatments or cytoxan. (Which just arrived in the mail) I am honestly hesitant to do anything. I am worried about the stress of radiation (going to vet, anesthia, etc) and the cost and then the idea that all that will just give us a couple of more months. My biggest concern really is his pain and suffering. If the chemo makes him sick and causes him pain, but keeps him around a few months more, is it fair to him? And if going to the Vet for radiation stresses him so much (he literally shakes like a cartoon almost, his entire body visibly vibrates), is that fair to him, too? He had acute kidney failure almost 3 yrs ago. We think he ate something toxic, we never really found out, but I spent almost 15K on his treatment and we got through it. I think he spent so much time in the hospital that this is why he is so fearful now of Vets. Anyway, I don’t want to sound like I don’t love him but to spend another 10K or so on treatment that will give him a little more time but also possibly prolong his suffering, I just don’t know if I can justify it. Thanks for responding.

  6. Melinda Buckley on March 7, 2013 at 8:08 am

    Dear Dr. D,
    Thank you so much for your time in responding. I asked the vet again yesterday why we couldn’t do surgery to remove the lymph nodes along with the tumor and he said that it’s because of where they are… it’s not just one over by the kidney but a cluster of them and they are misshapen so he feels it would be a very invasive surgery with a high risk of hemorrhaging and if he survives he might just have cancer somewhere else in a month. I guess there’s always a second opinion but my Vet and now the oncologist have not been very encouraging. Thank you for the articles, I just read them. I’ve decided not to do radiation first but will start him on the chemo pills as soon as they arrive. He didn’t tell me which ones he was prescribing. I have to admit cost and the stress of bringing him there (he is ‘over’ the Vet and literally his whole body shakes profusely there) is an issue for the radiation. they quoted me close to 9K for 4 treatments. That was the high end of the range but in my experience these things never come in at the low range. I feel badly but his kidney failure cost over 12K… and the testing for this has been already close to 2K. I tried to buy your ebook version of the guide but there isn’t a tab for it? Am I missing something?
    Thank you for being here… I am emotionally a mess as my Mom is also in Hospice. It’s a lot to lose them both at the same time… 🙁

  7. Melinda Buckley on March 4, 2013 at 3:00 pm

    I just came back from oncologist. My almost 10 yr old PWD has anal gland cancer. It has spread to the lymph nodes in his pelvic area (?). The Onc said we could operate but would it be worth it? It was risky and difficult to get to the lymph nodes – said they’d have to pull apart his pelvic bones? And because of the size of the tumor he might have fecal incontinence.
    He said I could either do 4 wks of radiation which might buy him a few more months of comfort or chemo pills. He had a kidney issue a few years back that he fully recovered from but they worry about the toxicity of the chemo pills. I don’t know what to do. He is happy and bouncing around, eating and drinking and pooping just fine still. This was supposed to be one of the best oncologists in NY. I’m beyond devastated…Any advice help would be appreciated.

    • Dr. Demian Dressler on March 6, 2013 at 4:06 pm

      Dear Melinda,
      I am very sorry to hear this. Dog cancer sneaks up on us.
      You should read this post:
      Also, I would start thinking about treatment plan analysis:
      And finally, it may be time to start thinking about what else you can do:
      This will get you started. Discuss these other steps with your veterinarian so they can be an effective part of your team. Sometimes people have to search around to find the right vet, but many times this is not necessary.
      Hope this helps
      Dr D

    • Dr. Susan Ettinger on March 11, 2013 at 7:29 pm

      I am sorry to hear about your dog and it is great he is still feeling well. Palliative radiation is a reasonable option if the cancer has spread to the lymph nodes. Still, it’s hard to make specific recommendations over a blog, but I am in NY if you would like a 2nd opinion. After reviewing the medical records and doing an exam, we could review prognosis and treatment options. You can call for an appointment if you would like.

      Also check out the Guide for other support. I know, the whole thing is not easy!
      All my best, Dr Sue

  8. Robin and Michael on August 16, 2012 at 12:18 pm

    Thank you for your reply Dr. Sue.

    Just to clarify since Charley weighs 85 lbs. the recommended dose of Apocaps for that weight is 3 capsules 3 times a day. Should we give him 1 capsule 3 times a day which would be 1/3 of the recommended dose or should we give him 1 capsule 2 times a day which would be less than a 1/4 of the dose? We understand that the dosage can vary but we want to make sure that we are not giving him too much of the Apocaps while he is on chemo and piroxicam.

    Thank you again Dr. Sue. We are truly grateful for all the information, assistance and support that you and Dr. Dressler provide.

    Best Regards,
    Robin and Michael

  9. Robin and Michael on August 8, 2012 at 8:25 am

    Hello Dr. Dressler,

    Our 8 year old neutered Golden Retriever, Charley, was diagnosed with an inoperable anal gland sac adenocarcinoma with metastasis to sub lumbar lymph nodes and lung about 8 weeks ago. He just completed palliative radiation treatment. He had one treatment a week for 6 weeks and he also received Carboplatin 292mg IV during the first and 4th treatments. The radiation oncologist
    feels that Charley has responded well to the treatments and the anal sac tumor has been reduced in size.

    Charley is also currently on Piroxicam 12mg one capsule daily and his calcium levels are now within the normal range.

    We recently purchased your book The Dog Cancer Survival Guide and are finding it to be extremely helpful and empowering. It is comforting to know that we are not alone in our current situation and that there are things we can do to help our dog.

    We would like to start our dog on Apocaps and some of the other supplements mentioned in your book. However, we read in your book that certain supplements should not be given during the course of radiation treatment. How long should you wait after the completion of radiation treatments to begin to use Apocaps and the other supplements you recommend?

    Thank you in advance Dr. Dressler.

    Best Regards,
    Robin and Michael

    • Dr. Susan Ettinger on August 10, 2012 at 11:29 am

      Robin and Michael,
      Sorry to hear about Charley. I typically recommend starting Apocaps 2 weeks afer raditiaon. I also suggest using the dose for the weight category below his weight while on chemo. But if he is on piroxicam, I would reduce to 1/4 the recommended dose. There is more info on
      Good luck!
      All my best, Dr Sue

  10. Tina on June 27, 2012 at 9:34 am

    Update on Kia – They did the ultrasound and found one lymph node enlarged that was pressing on her rectum, but no other tumors found so surgeon was hopefull he could get it all – we proceeded with the surgery removed the one anal sac and both lymph nodes on 6-8-12, she was real soar first few days home but by day three she was jumping on the couch – doing just great – had her calcium levels checked on 6-21-12 and she was at 11. She’s back on the K-9 immunity – has been since we brought her home on 6-10-12. Kia has been on grain free diet since her spleen sarcoma 5 yrs. ago. I will pull out my cancer guide book from the last time and freshen up on other supplements. We have made the decision to not do any chemo. We are just going to love her to pieces as long as we can – keep up with the K-9 immunity, and pray for as much time as we can get. Thanks – for the suggestion on diet and getting out my guide to freshen up.

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