I recently got a comment from a reader who was quite upset with her veterinarian because he didn’t fully explain the survival times he expected with her dog’s cancer.
Her dog underwent a splenectomy (spleen removal), presumably for treatment of a hemangiosarcoma (a malignant tumor of the blood vessel walls) of the spleen. This dog lover was incensed that the vet indicated this procedure, combined with the removal of a lipoma (fatty tumor) at the same time, would extend her dog’s life for a “long time.”
Later she was dismayed to find out, according to certain people, that this procedure would only extend her dog’s life for an additional 3-6 months. To her, this was not a “long time.” She became “furious” at her vet, reasoned that the vet was trying to get her money, and sent in the comment.
I think there are various aspects to this scenario that deserve attention.
Hindsight Is 20/20
First, it’s important to remember that hindsight is always 20/20, but we can never be sure if we will be accurate in the future. No matter how well-educated or experienced any veterinarian is, their word should never be understood as “completely accurate.”
Veterinarians are humans, too, and sometimes we say something vague when we should be more specific. And sometimes we just have a different perspective than a layperson, and don’t realize that we’re communicating badly.
So whenever your veterinarian suggests a time frame or talks about side effects, you should ask as many questions as you need to be sure that you are really understanding what they mean. Don’t be embarrassed or hesitant.
Being your dogs primary health care advocate implies that the information is gathered before the action is executed. Although it is not always natural, I think it is so important for everyone to please try to gather as much data as you can before embarking on what can be a complicated journey. This was one of my main reasons for writing the Dog Cancer Survival Guide.
Take a look at the chapter on working with your veterinarian for a detailed list of questions you could be asking your veterinarian. It will help you to get organized.
For more invaluable tools and information, get a copy of the Dog Cancer Survival Guide
What’s a “Long Time” When It Comes to Survival Times?
I assume that from the vet’s perspective, the removal of the dog’s spleen would indeed extend life for “a long time.”
But this is relative, right? What does that a “long time” mean, really? It depends upon your perspective.
Some animals only live a few days. Others live decades and a few live hundreds of years. A long time is different for each of these creatures.
For example, for a creature who is expected to live an average of two years, one year is half the lifespan. One year is not “a long time” for humans unless you are a five-year-old who wants to be six. But for the two-year-lifespan creature, that’s definitely a long time.
Dogs have an average life expectancy of 12 years. So one year is 8.3% of life for dogs. (Here is a good link for average life expectancies.)
For perspective, humans on average have a life expectancy of 72.6 years. So for humans, 8.3% of their lifespan is 6 years.
Is that a long time? It depends upon your viewpoint. If I’m a father looking at my little girl, and the doctor is telling me that she will probably live another 6 years, I’m not thinking “hey, great, that’s 8.3% of her lifespan!” No. I’m thinking, “she’s only going to live to be 12??” Six years is not “a long time” in this scenario. At least, not to me.
But if I’m looking at an elderly relative who is sick, and a doctor tells me he is probably going to live another 6 years, I might feel relief. Living close to the average lifespan of a human is often considered “a long time” when we near the end of our lives.
Managing Expectations When You Hear Survival Times
Most dog lovers don’t really get just how short-lived dogs are. We just can’t even contemplate the fact of their death. It’s too painful, so we kind of forget it’s going to happen. This is REALLY common, even for those of us in the veterinary profession.
The average lifespan for my dog might be ten — but MY dog is going to live at least a decade longer. Right?
Unfortunately, no, it’s probably not. Although there are outliers, most dogs live about as long as their average lifespan would predict.
So when you hear your veterinarian tell you that your dog has “X amount of time,” it’s really useful to put that time into perspective for YOUR dog.
If your dog is 8, and the average lifespan for his weight and breed is 10 years, and your veterinarian tells you that his survival time for his cancer is about 18 months to two years, and calls that a “long time,” he’s right from a medical perspective. From a medical perspective, having a dog live the average lifespan is a good result.
But to you, the dog lover who wasn’t contemplating your dog’s eventual death, it might sound dismissive, or even like you are being “lied” to. But I promise you, no veterinarian is actually motivated to lie to you about outcomes.
You just might have different perspectives on them.
So is 3-6 Months a Long Time, or Not, Doc?
In the case of this reader, her dog had hemangiosarcoma, which is an aggressive disease.
A dog with hemangiosarcoma who gets a splenectomy, with no further care of any kind, could live 3 months or longer according to the statistics. (See the chapter on hemangiosarcoma for the many more detailed stats on this disease.)
With chemotherapy, a dog with hemangiosarcoma could have maybe 7 more months past diagnosis. So the addition of chemotherapy doubles the median survival time. But still, that might not seem like “a long time,” even though it’s doubled!
And as many readers who have battled hemangiosarcoma will attest, using all the full spectrum treatments — surgery, chemo, diet, supplements, and lifestyle modifications — could result in even longer survival times. And certainly great quality of life, which is what most of us most want for our dogs.
But is that true for EVERY dog? Of course not. Every dog is different, every cancer is different, and nothing is 100%.
The bottom line is this: everything is relative. Gather the data before you set sail and do what makes sense to you while using compass-ion as your compass.
Best to all,
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.