To Chemo or Not To Chemo?
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.
Updated: December 7th, 2018
One of the little known facts about veterinary medicine is that chemotherapy does not cure cancer in dogs, with few exceptions (except transmissible venereal tumor or the very rare lympho or something).
I believe that many people are unaware of this fact.
So we are left with a treatment modality that has a goal of improving two things:
- Longevity (or lifespan)
- Life quality
In order to make the choice about chemo, a life quality analysis has to be done (the technique to do this is in The Dog Cancer Survival Guide). Step one is for you to answer the question, “What kind of person am I?”
To learn more about your role as your dog’s guardian, get a copy of the Dog Cancer Survival Guide
This boils down to risk aversion. How important are avoiding any side effects for you?
Most people also don’t know that in conventional chemotherapy, often the more longevity one gets, the higher the risks of side effects. Usually these go hand in hand.
Speaking of side effects, there are some natural compounds (also discussed in the Guide) that can be used to help with these, like indole 3 carbinol.
At any rate, are you willing to accept some side effects for added life expectancy or is your number one goal life quality, for the remainder of the time your canine companion is with you?
Usually there is some risk of less life quality during treatment in exchange for added life expectancy.
By defining what kind of person you are, you create a platform that informs your decision making and gives you a clear idea of where you are headed.
Of course, you need to be aware of data, as step two. Get an oncologist on board if you want chemo, if at all possible. These folks live and breathe chemo and they are the ones you want. If you are able to get an oncologist who is integrative (familiar with diet, supplements, acupuncture etc) that is a bonus.
In getting data, simply ask questions like these:
“How many dogs respond to this treatment?” (This tells Doc that you are aware that not all dogs respond to chemo.)
Get a copy of this informative seminar to learn more on Chemotherapy Side Effects in Dogs
“What is your guess (and I won’t hold you to this), on the added life expectancy for my dog with this treatment, assuming we get a response to chemo?” (note this is different from median survival time…this question says, okay Doc, since you know my dog, give me a little info on what added time I am getting here.)
“In your experience, what are the side effects of this treatment? What are the severe side effects of this treatment that are less common? How often do they each occur? What would they look like if I were seeing my dog having them? What does my dog go through? How long will my dog be in the hospital during treatment? What happens during this time? How often will my dog be at the hospital??”
Questions like these allow you to get the data. Then you can take this info and see how it fits with the type of person you hare, and the priorities of this person given your dog’s age and circumstances.
Using a template like this, you can answer the question, “To Chemo or Not To Chemo.”
Best,
Dr D
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.
Dr. D., My 11 years old boxer made a x-ray and in it slightly appeared a structuralized image, of homogeneous aspect and radiodensidade water. As disgnostic: sub-pleural formation? pulmonary formation? pulmonary densification ? . This structure is promoting a displacement of the trachea and the primary bronchis. The doctor spoke on the possibility of a biopse. My doubt is in making or it chemotherapy, not thinking about the benefits that would also bring but in its quality of life. And if has something more than it can make. Thank you so much.
Dear Larissa,
So sorry to hear this news. I need a little clarification here as there seem to be some typos. I believe you are writing that there is a mass in your dog’s chest displacing the trachea? And that they cannot tell if it is coming from lung tissue, airway, or chest wall?
I believe getting the information (aspirate) is the first step in being an active guardian. Without this, it is very hard to make a call on the most logical step. Not all masses are cancer, and not all cancers are the same…
I hope this helps,
Best,
D
Hi,
Our 7 year old lab Duke just had to have surgery for mast cell tumor in the prepuce area. He basically now looks like a female dog underneath. He is Grade II and the surgery got the wide margins. Unfortunately some cancer cells were found in the inguinal lymph nodes. Now looks like chemo will be offered. I have no idea how much that will add on to his life expectancy or detract from the quality. We will be meeting with the oncologist next week. Can anyone share with me what a dog goes through with chemo…….side effects, etc? Thanks so much and I’m so glad I found this blog!
cathy
Hi Cathy
so sorry to hear about Duke. Sounds like you are just staring out on this path. Have you gotten your Guide? There is quite a bit in there about side effects and median survival times and so on. Chemo side effect stats vary depending on what is used and who you listen to. Some say only 2% have serious side effects (i.e. requiring intensive care in a hospital), while there are other protocols where vomiting or diarrea is commonplace (40% or so). The oncologist will give you his or her favorite protocol and can discuss these numbers with you. I hope you are also paying attention to diet. There are also supplements in the Guide that may help with side effects from chemo.
For more:
https://www.dogcancerblog.com/blog/first-dog-cancer-drug-fda-approved-but-not-great/
https://www.dogcancerblog.com/blog/keep-yourself-and-your-dogs-safe-with-palladia/
https://www.dogcancerblog.com/blog/when-to-avoid-chemo-for-canine-mast-cell-tumors/
https://www.dogcancerblog.com/blog/dog-cancer-decisions-in-the-gray-zone/
https://www.dogcancerblog.com/blog/mast-cell-tumor-internal-spread/
Hope this helps,
Best
Dr D
Dr. D,
I have a 6 year old Collie who was diagnosed with Lymphoma. She had no symptoms other than enlarged nodes. We decided to follow your advice and have instituted a comprehensive program of both traditional and alternative treatments. We started the Wisconsin Protocol 2 weeks ago and she is doing fantastic and is in remission at this point. We will have our 3rd treatment on Saturday. In addition, she is on a totally natural raw diet as well as supplementing roughly 12 grams of combined EPA/DHA from Fish Oil, 15 Grams of Glutamine and about 15 Grams of Arginine. We have had NO side effects from chemo. Her supplements are Cell Advance 880, Digestive Enzymes, Onco Support, Immuno Complex(Gland Extracts), Max’s Formula(Chinese Herbs) and Stem Enhance. In addition she gets Carnivora Injections. Her energy level is beyond even that before she was diagnosed. I am working both with a traditional Veterinarian as well as a Holistic Veterinarian. I have now thought about the Apocaps and actually purchased them. My Holistic Doctor is all for anything that we can do to prolong remission. Her attitude is go for a cure and settle for a long remission. Should I wait to use them until we are off the Prednisone in the protocol? Wait until we are done with chemo? Everything is going so well I don’t want to upset the proverbial “apple cart”. Thanks for your help and the great work you do.
Dear Geoff,
So sorry to hear about your Collie. Good for you though on really going after this thing!
Hm..but I have to tell you there is a little mix up in the supplement strategy and a bit of diet stuff you should tune in to. Have you read the Guide? It really is an easy read and there are some data points you need.
For example, here’s some info on raw diet:
https://www.dogcancerblog.com/blog/more-raw-ideas-on-dog-cancer/
You’ve also got antioxidants going with chemo:
https://www.dogcancerblog.com/blog/new-antioxidant-info-for-managing-dog-cancer/
Anyway, in my patients I usually drop the dose of Apocaps to half on days receiving pred.
At any rate, if she is doing well, that is great news.
Best,
D
Diane, one of our concerns was the side affects of chemo, and we were hesitant to do it, but we’re really glad we did.
Mambo, my 4 year old Lab was diagnosed with orbital chondroblastic osteosarcoma. He had a tumor growing behind his eye. An ophthalmologist removed the tumor along with his eye. We were referred to the Guelph University Animal Hospital 3 weeks later to start radiation. They said due to his cancer being as rare as it is, there was a study that wanted to fund his MRIs, 5 of them. We had already done one, and had no intention of doing more, but we thought, free MRIs, why not? It had only been three weeks since it had been removed, and it had grown back. The oncologist at Guelph, Dr. Boston (who’s amazing fyi) took a more aggressive approach to his surgery and removed surrounding skin and bone. She replaced the skin with that from his neck. We asked how she would know if she got all the cancer out if she’d have to do another MRI. She said they look for what they call clean margins, which is when the edges of the skin and bone they removed have no cancerous cells on them. Sure enough, they did, and he didn’t have to do radiation at all, just the chemo, it was originally thought we’d need to do both. The first round of chemo is always tricky they said. They base the dosage on the dog’s weight among other things I’m sure. But they never truly know how an individual dog will react to chemo until they’ve done it the first time. The first round for my dog was heartbreaking to say the least. It was the worst out of all of them. He had no appetite, he felt nauseous and kept vomiting, had diarrhea. I took him to the vet 3 times within 5 days following chemo. On the final day, he was so weak, he couldn’t get out of the car. They brought him in on a stretcher. They originally had him scheduled to do one round every week. This proved to be way too much, so they reduced his dosage of chemo by 25%, gave him the anti-nausea med, cerrenia, which is way stronger than the stuff they originally gave him. Then they scheduled his chemo 3 weeks apart. By the time the second round came, you would have never known he had chemo, he was exponentially better. It’s been almost 2 months since his last chemo, we still can’t say for sure if he’s cured, but as this article says, we shouldn’t expect that. He is back to his normal self, he’s got so much energy, he chases the stick, he chases the ‘gator’ (john deer and golf cart love child thingy), he grabs his leash and runs, with you attached, so you’re running too. He chases me up and down the hallway just for fun. He’s definitely got his energy back. It was just that first round of chemo that was so horrific. But after that, he was slowly but surely getting back to normal. If you are in the position to do chemo, I would really consider it. The first round is hard and scary, it always is, but after they can adjust the dosage, frequency and medication to suit your dog.
I just thought you’d like to know that, faced with this dilemma 2.5 years ago, we chose chemotherapy. The tumor (it was high-grade malignant lymphoma) began to shrink within the first week of treatment. The drugs certainly took away from Molly’s quality of life, at one point nearly killing her, but she has now been tumor free for two years. We were told she had a 10% chance of survival. I opted for optimism!!
I’m very interesting in your book, but is it possible to get it a version in spanish? ( I write you from Spain)
Thanks
Dear Dr. Dressler:
I have left many comments on your page when my Border Collie Cassie had a mast cell tumor on the bend on her leg. The only alternative to chemo was cutting off her leg. We thought a lot about it and opted to give her chemotherapy. She had NO adverse side affects at all. She has been cancer free for almost two years now and is very active and in great spirits. She goes for her six month blood test in December and we are hoping that she still remains cancer free. Having said all of this we give her Dog Immune, Curcumin, flax seed oil, fat free yogurt and only the best dog food with no grains. It all seems to be working for her.
All the Best to You
Joanne – Ottawa, Ontario CANADA
Great news Joanne!!
Good work and so pleased to hear!
Best,
Dr D
Dr. D, I can hardly even believe this question! My Jack Russell terrier Rambo was literally on the brink of death from lymphosarcoma 13 months ago when I was lucky enough to find an area vet who could administer chemo. Yes, there were side effects: He lost control of his kidneys for several months, and he still has a weakness in his hind legs. But he’s alive, happy, plays ball and barks at the cat, and totally enjoys life……just as I more than enjoy having him with me in remission! I wish the treatments were for a cure rather than just remission, but something beats nothing.
Dear Barbara,
as ironic as it is, in the world of cancer of the canine, you are lucky your Rambo had the most chemo-responsive cancer there is. Yes, something does beat nothing and it is super he is well. Good to hear.
Best,
D
Thank you for all the info u have shared. Since my beloved girl Dea was diagnosed with osteosarcoma, I did all the search I could. That concerned serious college books, net and vetenerians. I knew how to ask questions, because I was armed with knowledge. But there are so many people that know nothing about the meanest sickness in the world, and have the greatest confidence in the vets. The truth is sad, but when something like this happens, one can only be dissapointed with quantity and quality of the real knowledge that vets have and can give you.
We just found out that Duke’s mast cell cancer has spread into his lymph nodes. We decided not to do chemo as he seems healthy at the moment. We would rather have quality time with him and not subject him to the side effects of chemo that may not even work. Keeping our fingers crossed and praying that the prednisone and benadryl will keep the mast cells at bay for a while.