The last post focused on the newest version of a canine “Bone Marrow Transplant.” In a nutshell, this is a brand-new procedure that may produce a good number of actual dog cancer cures. Curing canine cancer essentially unheard of in conventional veterinary care using chemotherapy, radiation, and surgery, at least with the systemic dog cancers.
This new procedure is called Autologous Peripheral Blood Stem Cell Transplantation.
Very briefly, the patient is treated with chemo to remission, then a week of antibiotics and Cytoxan. Then a stretch of Neupogen which boosts stem cells in the blood which are harvested pretty simply from a vein. There is no bone marrow used. Next is Total Body Irradiation (TBI) to kill remaining cancer cells. The stem cells are then transfused into the dog to repopulate the body with healthy cells.
Anticipated cure rate in many cases of lymphosarcoma? About 6 in 10!
So what are the down sides to consider before embarking on this journey? First is cost. The bill may be around $15,000 on the low end. Second is location: you may not live close to North Carolina State College of Veterinary Medicine, which is where the procedure is available, although you may be able to get a similar procedure done at Bellingham Veterinary Critical Care in Washington State. The bill there will likely be higher there than at NC State.
You need to make sure you have a veterinarian’s referral, which may mean you need to sit in the driver’s seat in more ways than one.
Count on a hospital stay for your dog of roughly 3 weeks, give or take. That , depending on your viewpoint, may be a long time of separation.
Once there, we need to consider the treatments. This is not mickey-mouse stuff. Not only are we looking at Cytoxan and Neupogen, which can be strong drugs with some side effects, we have to deal with Total Body Irradiation. Radiation therapy can have its drawbacks.
Nausea, lethargy and digestive upset would be expected following TBI. Sometimes the skin reacts to the beam like a severe sunburn. Occasionally stomatitis develops, which is a painful inflammation of the lining of the mouth. Low blood cell counts can occur, and secondary infections (these would be in addition to similar effects from cyclophosphamide).
This stuff is most often manageable. However, the parts that many overlook include a syndrome called delayed radiation toxicity, as well as the development of secondary cancers due to the radiation itself. Months or years after radiation is performed, delayed radiation toxicity can rear it’s ugly head.
This can be seen as cataracts with vision loss, kidney disease, bone and ligament damage, fibrosis of the lung, injury to the liver, and other issues.
The incidence of secondary cancers in dogs later in life due to TBI are five times higher than dogs who do not receive radiation. If one where to look the odds of a young dog getting TBI, and this dog lives to ten years of age, there is a very high probability there will be a secondary cancer from the radiation. You could almost expect it, since estimates are that 50% of dogs that did not receive TBI (normal dogs) over 10 years old succumb to cancer as cause of death.
Five times that? Ouch.
By the way, there are steps that can be taken to help with these potential side effects. They are discussed, along with other ways of mitigating adverse reactions, in the Dog Cancer Survival Guide.
The take home message here is that we need to be armed with data before embarking on a treatment plan. I think this development has huge potential. Meanwhile though, we must know what could happen. We need to be alert to signs so we can react earlier. We need to be emotionally prepared to deal with crises that could arise from treatments. And most importantly perhaps, we need to assume responsibility for our choices.
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.
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