I was recently thinking about a little problem us veterinary professionals are faced with.
We seem to have forgotten about relative risks.
A relative risk is simply the risk of something in comparison to something else. Take the risk of cancer versus the risk of heartworm in a dog on heartworm preventative.
Now, I am a practicing veterinarian and I do annual heartworm tests on my patients. Granted, I live in an area that has one of the highest heartworm rates in the country. However, guess how many heartworm positive dogs I diagnose in patients receiving their heartworm preventative?
Almost zero. I think I had one case in my career, maybe two. I have over 5000 canine patients registered at my hospital. That’s pretty low odds.
Okay, let’s switch it up. How about how many patients do I see with cancer? A lot. Cancer is the number one pathological killer of dogs today, with mortality higher than trauma, diabetes, kidney disease and any other disease state.
Depending on who you believe, somewhere between one in four to one in six dogs will die of cancer.
Clearly there is something wrong with this picture. Why is the public accepting of annual heartworm tests and unaware of cancer as a threat? Why are dog lovers not demanding that every lump and bump be checked?
What about blood work, urinalysis, X-ray and ultrasound for the internal cancers?
One argument is cost. A heartworm test is $40-60 dollars. The screens I mentioned for internal cancers are crude and costly. But, they are what we have.
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So, how would one test for internal cancer, in a way that make sense? Well, it is tough to test for each internal cancer, since there are many types.
There is a specific cancer test for lymphosarcoma made by Pet-Screen, which is in England. Your vet can contact them and arrange for sample processing, although it is not cheap. So that’s one, and they are working on a hemangiosarcoma test next.
And the fact is that our cure rate for truly malignant cancers is quite low these days, so it would seem that we need a slightly different approach. When we diagnose cancer currently, we are late in the game.
Carcinogens, family traits, free radical excess, viruses, and more alter healthy genes, turning them into cancer-causing genes.
Testing for these altered genes that set up cancer is going to be quite complex and costly. There are many of them and they are not clarified yet. Sure, we are aware of gene sites of mutations leading to cancers like ras, erk, trk, myc, the b proteins, and the huge family of the protein kinases, among others.
The problem is that the number of these genes quite high, so I believe it makes less sense to test for the mutations leading to cancer.
There are other factors, aside from damaged genes, that are responsible for cancer development. These include metabolic abnormalities, many involving sugar.
In addition to abnormal metabolism setting the stage, we have factors creating immune system suppression.
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And a major one, I believe perhaps the biggy, is inflammation in the body, and the chemical signals that are tied to it.
Ongoing chemical signals in inflammation increase free radicals (which promote mutations), suppress the immune system, and are tied to metabolism problems that promote cancer growth.
One of the central genes involved in inflammation is called NF-kB.
If this gene is being turned on over abnormally long periods, you have lots of inflammation. This is not healthy at all.
Why not test for excessive, prolonged NF-kb signaling? This could help screen for increased risks for cancer development. Many cancers make a lot of NF-kb. There are other health risks seen when this gene is turned on excessively that a dog’s guardian would want to know about.
On top of that, we could be proactive much earlier, perhaps even before detectable cancer development. One could be more vigilant, begin antioxidants, cut the carbs, begin anti inflammatory supplements, eliminate body fat, and then reassess.
We could also start our cancer hunt earlier and more aggressively in these dogs.
Yes, this is just one idea and requires a lot of work. Yet it is a candidate for a cost-effective way to take action when it really counts, possibly before cancer starts. You heard it here first, folks.
Take home message?
Focus on catching cancer early. For the time being you will have to settle for blood testing, X-ray, ultrasound, urine testing, and checking every growth on your dog. And don’t forget the Pet Screen lymphosarcoma test.
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.