When The Diagnosis Is Cancer

by Nancy Kay, DVM

A veterinarian’s advice for helping yourself—and your pet—face the future
Cancer, neoplasia, growth, tumor, malignancy, the big “C”: no matter which word is used, it is the diagnosis we all dread. It’s not that cancer is always associated with a terrible outcome. But whenever cancer is diagnosed, it is inevitable that lives are going to change. And change isn’t something we relish when it comes to our four-legged family members.

If your veterinarian suspects or knows that your pet has cancer, you will be asked to make several decisions. Some of them will have to do with diagnostic testing and others will pertain to treatment options. Such decisions can be tough in the best of times, and if you’ve just learned your dog or cat has cancer, the decisions can feel downright overwhelming. What can you do to gain some control over the situation?

Here are some suggestions:
  • Ask your veterinarian how urgently decisions must be made. An extra day or two can make a significant differencein terms of settling down emotionally and doing the research to deal with the decisions at hand.

  • Put away preconceived notions of what you imagine will be your pet’s experience. People often get sick, experience profound fatigue, or lose their hair in response to cancer therapy. This is uncommon for dogs and cats.

  • Read, “surf,” and ask lots of questions. The more you learn about your pet’s cancer, the more you will feel empowered to make good decisions on her behalf.

  • Take things one step at a time. Being asked to make decisions for your dog with cancer is akin to being asked to climb a tall mountain. It’s strategically and psychologically better to break your ascent into small manageable increments (and there’s less likelihood of tripping and falling when your eyes are not glued to the summit). Similarly, it is easier when you focus your attention on the medical decisions at hand rather than those that may (or may not) arise later.

  • Follow your own heart. Steer clear of folks intent on convincing you that he is “just a dog” or “just a cat,” and that the appropriate treatment is to “put the poor thing out of his misery.” Likewise, avoid those people who think that all animals must be treated aggressively for anything and everything. Wear a thick skin around such people or take a sabbatical from socializing with them. Surround yourself with people who are open-minded (including the veterinary staff) and interested in supporting you rather than influencing you. Remember, you know better than anyone else what is right for you and your best buddy.

  • Know your cancer therapy options. The three most common treatment methods used to treat feline and canine cancer are surgery, chemotherapy, and radiation therapy. Sometimes, only one type of treatment is needed to effectively treat cancer. For example, a small solitary mass might be cured with surgery alone. It’s not uncommon, however, that a combination of treatments is most beneficial, and chemotherapy or radiation therapy may be used adjunctively to destroy any cancer cells that may have been left behind after surgery. Whether or not various complementary or alternative therapies such as Chinese herbs, homeopathy, or acupuncture are capable of chasing away cancer cells is controversial. Most people, veterinarians included, do agree that they help support the cancer patient’s overall health and mitigate the side effects of cancer treatments. How does your veterinarian know which treatment plan is the best choice for your cat or dog? First, she needs to know which type of cancer she is dealing with. Some are sensitive to radiation therapy or chemotherapy; others are resistant. In addition, the stage or grade of the disease (how advanced and aggressive the cancer is) allows your vet, or an oncologist or internist to whom you’ve been referred, to know which treatment makes the most sense. That’s the easy part. What’s not nearly so easy is determining whether such a treatment plan is reasonable for you and your dog or cat.

  • Here are some thoughts and questions to consider that will help guide your decision-making.
  • Is your pet’s personality well-suited to the recommended therapy? If your dog or cat is a pushover for anyone and everyone who gives him some loving and a treat, he may relish the opportunity for weekly chemotherapy visits. On the other hand, if he turns into a quivering quaking emotional wreck as soon as you turn into the vet clinic parking lot, perhaps he’d be better suited to a chemotherapy protocol that involves coming in less frequently. You may not really know how your dog or cat will respond emotionally until you’ve made your first few visits.

  • Is your own schedule flexible enough? Many chemotherapy protocols initially involve once-weekly visits. Rarely are evening or weekend appointments available. If radiation therapy is recommended, you may need to drive a considerable distance to a treatment facility. Radiation therapy is typically administered each weekday for three or more consecutive weeks.

  • Is it financially feasible to proceed? Combination chemotherapy protocols, radiation therapy, and many surgical procedures are “bigticket” items. Remember, some chemotherapy is almost always better than no chemotherapy. If your budget is limited, your veterinarian will be able to create a protocol that provides “the most bang for the buck.”

  • Is it emotionally reasonable for you to treat your pet’s cancer? For someone who has just experienced the ravages of cancer therapy either for herself or a loved one, it may simply be impossible to consider such treatment for her dog or cat (no matter what kinds of reassurances are provided). And that’s perfectly okay. Remember, whether or not to treat your pet’s cancer is a highly personal decision.

  • You can call it quits at any time! When you say yes to chemotherapy or radiation therapy, you’re only committing to the next treatment. If you don’t like what you see, you can call it a day. Sometimes, simply knowing that this out-clause exists gives people the wherewithal to give cancer therapy a try.

  • Focus on the quality rather than the quantity of life. When I counsel people about the potential pros and cons of treatment, I describe the three goals of cancer therapy as “quality of life, quality of life, and quality of life.” There’s no doubt in my mind that we have failed our patient enormously when we achieve quantity (longer life) only.

  • Enjoy the honeymoon. If your best little buddy is doing fabulously well, it may be tough for you to enjoy his company when your mind is preoccupied with sadness and worry about the fact that he has cancer. Your happy, playful, loving cat or dog doesn’t vanish just because cancer cells live in his body. He doesn’t know he has cancer; he gets off easy when it comes to enjoying life and staying in the moment. If he is acting glum, he may be responding to the way his favorite human is feeling!


  • Cancer Therapy: Is it the Right Choice for Your Pet?

    Last week, in honor of Pet Cancer Awareness Month, I provided some pointers for constructively dealing with the diagnosis of cancer. This week I will deliver information about the treatment of cancer and tips for determining if a pet is a good candidate for such therapy.

    Treatment Options
    The three most common treatment methods used to treat animals with cancer are surgery, chemotherapy, and radiation therapy. Often only one type of therapy is needed to effectively treat the cancer. For example, a small solitary mass might be cured with surgery alone. Not uncommonly, a combination of treatments is most beneficial. Chemotherapy or radiation therapy may be recommended as an adjunct to surgery to destroy any cells that may have spread outside of the surgical incision.

    Whether or not various complementary/alternative therapies such as Chinese herbs, homeopathy, or acupuncture are capable of chasing away cancer cells is controversial. Most veterinarians agree that what they do best is help support the patient’s overall health and mitigate any side effects of cancer therapy.

    How does your veterinarian know which treatment plan is the best choice for your dog or cat? First, she needs to know which type of cancer she is dealing with. This is accomplished by evaluating a sample of the abnormal cells under a microscope. An experienced pathologist at a commercial veterinary laboratory typically performs this testing. Additionally, determining the stage or grade of the disease (how aggressive and widespread the cancer is) via blood and urine testing and imaging studies allows your vet to know which treatment makes the most sense.

    Making the Choice for Your Pet
    Diagnosing and staging the cancer is typically the straightforward part. Determining whether or not to treat one’s four-legged family member is often the more challenging piece of the puzzle. If ever you find yourself squaring off with this decision, strongly consider consultation with a veterinarian who specializes in cancer therapy (a board certified oncologist or internist). In no way does such a consultation obligate you to proceed with treatment. Rather, it is an opportunity to gather a bunch of useful information that will assist you in your decision-making process.

    Now, here are some important thoughts and questions to consider when the diagnosis is cancer:

    Is your pet’s personality well suited to the recommended therapy?
    If your dog or cat is a pushover for anyone and everyone who provides an ear scratch and a treat, he may relish weekly chemotherapy appointments. On the other hand, if he turns into a quivering quaking emotional wreck as soon as you turn into the vet clinic parking lot, perhaps he’d be better suited to a chemotherapy protocol that involves appointments spaced farther apart. You may not really know how your dog or cat will respond emotionally until you’ve made the first few visits.

    Is your own schedule flexible enough?
    Many chemotherapy protocols initially involve once-weekly visits. Rarely are evening or weekend appointments available. If radiation therapy has been recommended, you may need to drive a consider-able distance to a treatment facility. Radiation therapy is typically administered daily, Monday through Friday for three or more consecutive weeks. Many radiation facilities offer the option of boarding their patients during the workweek and then sending them home for weekends.

    Is it financially feasible to proceed?
    Combination chemotherapy protocols, radiation therapy, and many surgical procedures are “big-ticket” items. Remember, some chemotherapy is almost always better than no chemotherapy. Don’t by shy about discussing your budget. Your veterinarian can use this information to create a treatment protocol for your pet that provides “the most bang for the buck.”

    Is treating your pet’s cancer reasonable for you from an emotional point of view?
    For those who have experienced the ravages of cancer therapy either for themselves or a loved one, it may be impossible to consider such treatment for a family pet, no matter what reassurances are provided. And that’s perfectly okay. Remember, whether or not to treat your pet’s cancer is always a truly personal choice.

    You can call it quits at any time!
    When you say, “Yes” to chemotherapy or radiation therapy, all you are really committing to is the very next treatment. If ever you don’t like what you see you can call it quits. Sometimes, simply knowing that this “out clause” exists gives people the wherewithal to give cancer therapy a try.

    Focus on the quality rather than the quantity of life.
    When I counsel people about the potential pros and cons of cancer treatment, I describe the three goals of therapy as, “Quality of life, quality of life, and quality of life.” There’s no doubt in my mind that we fail our patients miserably when we achieve “quantity” (longer life) only.

    Enjoy the “honeymoon.”
    Even when a fabulous response to therapy is achieved, it’s difficult for some people to enjoy this time because theirs minds are so preoccupied with the underlying diagnosis. Keep in mind that those happy, playful, loving pets of ours don’t simply vanish because they have cancer. Even with their disease, they are wonderfully adept at “living in the moment.” When an animal undergoing cancer therapy behaves in a glum fashion, it’s important to consider that they may be responding to the way their favorite human is feeling. If you opt to treat your pet’s cancer, be prepared to enjoy the honeymoon!

    Have you ever said, “Yes” to cancer therapy for one of your pets? If so, were you ultimately glad you did so?

    CREDIT:
    Dr. Nancy Kay, DVM Diplomate, American College of Veterinary Internal Medicine.
    Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award Recipient, 2009 Dog Writers Association of America Award for Best Blog Recipient, 2009 Eukanuba Canine Health Award

    Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
    Website: http://speakingforspot.com
    Spot’s Blog: "http://www.speakingforspot.com/blog
    Email: dr.kay@speakingforspot.com
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