Many Guardians are faced with difficult decisions when facing a dog cancer diagnosis. One of the toughest is whether to choose a treatment that seems more aggressive than others.
A guardian should first get an idea of whether the expectation of the treatment is worse than the treatment. Many times dogs receiving chemotherapy treatment do not experience the side effects that would be imagined by a Guardian.
Generally, chemotherapy is better tolerated in dogs than it is in humans. My colleague, Dr. Sue Ettinger, lives and breathes chemotherapy in dogs, as she is a full time oncologist at the Animal Specialty Center in Yonkers, NY. We have discussed her impression of chemo side effects compared to the public opinion, and her feeling is that on average the anticipated side effects are worse than the real ones.
Having said that, it is true that chemotherapy is not a minor treatment, and a frank discussion of side effect odds and severity should always be had with your vet or oncologist.
The question of whether a treatment is too aggressive really has to do with what your dog (and you) gain from the treatment, compared to what you must pay or sacrifice.
For this reason, a critical question to always ask your veterinary professional is this:
“What is the gained life expectancy from this treatment?” You must emphasize the word “gained”. This is because the question is not commonly asked, although it should be. Rather, Guardians usually ask some version of “How much longer does my dog have?”
Notice that these are different questions. Gained life expectancy is how much more time a treatment can be expected (approximately) to give a dog, compared to without the treatment. Life expectancy is how much time a dog will have with the treatment overall.
To explain further, let us consider two examples. A dog with lymphosarcoma receiving chemotherapy only (no diet change, supplements, etc) has a median life expectancy of somewhere around 12-14 months with the best protocols. This is a rough rule of thumb. So life expectancy, very roughly, could be 12-14 months from when we started chemotherapy.
This is very different from gained life expectancy. For this, we have to know what the life expectancy would be without treatment. In this case, a few months (maybe 3?). So the gained life expectancy would not be 12-14 months with the best protocols. It would be 9-11 months, since that is the difference between treatment and no treatment.
When you weigh the gained life expectancy against the costs of treatment for both your dog and you, and the odds of side effects, you will be on your way to answering whether a treatment is too aggressive or not.
For more ways to help you chart a course through dog cancer, check out the Dog Cancer Survival Guide.
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.