You REALLY treat dogs and cats who have cancer??
That’s usually the first question I hear when people find out I am a veterinary oncologist. You may get a similar response from your family and friends when you share that you are thinking about or are treating your pet with cancer – you are really going to treat your dog with cancer?
Why would anyone do this for a living? I first became interested in cancer cells in vet school. I was fascinated by the cell biology and the steps that turn a normal cell in a body to evolve into an uncontrollably dividing malignant cell. But that is not why I became an oncologist.
People think it is depressing to be an oncologist. Actually it is the opposite. Don’t get me wrong. It can be frustrating, saddening and heartbreaking to lose a patient after sharing months or years together with the pet and Guardians. But the majority of the time, it is about hope and cautious optimism. You can – and should – get educated about the cancer, how it progresses, what the statistical chances are for response to treatment, and what the survival times are, but then decide on your treatment path and keep the hope alive.
Here are a few things I’ve learned over the years as an oncologist:
ONE: Cancer is a big name for many different cancers. Each cancer is a different disease from every other cancer. So while it may be helpful to talk to other people that treated their pets for cancer, one dog’s lymphoma is very different than hemangiosarcoma, oral melanoma, or osteosarcoma. If you know someone’s dog that received Adriamycin (aka doxorubicin) or Palladia and did not tolerate, it does not mean your pet will not. That dog may have had cancer in advanced stages or had other pre-existing conditions that complicated the treatment. Each dog is an individual.
TWO: Dogs handle chemotherapy so much better than people. I have had human friends and family members receive chemotherapy treatment. They can get pretty sick. They can spend time hospitalized from side effects. I am grateful that is not how dogs respond. The large majority of pets lead very normal lives with minimal side effects from treatment. Hospitalization from chemotherapy-induced side effects is uncommon (<5%). In contrast, I cannot tell you how many times Guardians report that their dog has more energy that it did 6 months or a year ago. In most cases, the cancer was not around then, but I think it is testament to how well most pets feel during and after treatment. I always tell Guardians, if you are thinking of trying chemotherapy, give a dose or two and see how they do. Most Guardians are so pleased that they continue with treatment.
THREE: Your pet does not “know” they have cancer. They feel pain and do not enjoy feeling unwell. But they do not have to absorb all the information about the cancer, the survival statistics, and stress over whether the cancer or the treatment will make them feel sick. They do not deal with the psychological aspect that we do – that is your burden as their Guardian, but luckily they do not have that worry. They live in the moment, and I think in this situation, a little ignorance is bliss.
(And remember stressing over how they will respond and how long we can control the cancer does not change the outcome. Let me or your oncologist worry about the treatment, the doses, and the cancer. Your part is to give me feedback about how the last treatment went at home and give the medications as directed. And your biggest job is to enjoy each day, for each day is a gift with our four-legged companions.)
FOUR: When your veterinarian or oncologist tells you statistics, remember there are no guarantees. There are pets that happily make liars out of me because they live longer than the statistics we quote. On the flip side there are pets that do not live as long as we predict, even if you follow all our recommendations.
FIVE: We all want a cure for cancer, but it is important to think of many cancers as chronic conditions that may require therapy. While a generalization, I recommend treatment when your pet is likely to live longer with treatment than without. And thankfully most pets feel good during the treatments.
It is actually a very exciting time to be an oncologist. Cancer treatment is evolving. RadioSurgery is a new alternative radiation treatment that treats some cancers like brain and nasal tumors in 1 to 3 treatments, with fewer side effects, less trips to the hospital and less anesthesias. (We offer CyberKnife RadioSurgery at my practice, the Animal Specialty Center, in Yonkers NY.)
Metronomic chemotherapy is a newer approach that is being used more commonly and involves low dose oral chemotherapy. Instead of direct cancer cell killing, the goal is to target the blood vessels that allow tumors to grow and spread. I commonly use this approach with Palladia in dogs that come in with metastasis (spread). In my residency, I was taught these patients may live 1, 2 or 3 months, but with this approach, dogs are living longer – 10, 12, 16 plus months with their cancer. Cancer is not cured, but dogs live well despite the cancer and while on treatment.
So yes, I really DO treat dogs and cats with cancer. You should consider the treatment for your pet even if your support circle does not agree. There is reason to be hopeful and cautiously optimistic. Many dogs with cancer not only live longer but live well.
Sue Ettinger, DVM. Dip. ACVIM (Oncology). Dr. Sue is a boarded veterinary medical cancer specialist. As a Diplomate of the American College of Veterinary Internal Medicine (Oncology), she is one of approximately 400 board-certified veterinary specialists in medical oncology in North America. She is a book author, radio co-host, and an advocate of early cancer detection and raising cancer awareness. Along with Dr. Demian Dressler, Dr. Sue is the co-author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity.