Interview with a cancer specialist
(part 2)

* The following information has been provided by Dr. Phil Zeltzman, a board-certified veterinary surgeon from Whitehall, Pennsylvania as a courtesy to goodnewsforpets readers. To subscribe to his newsletter, click here.

As a reminder, Dr. Sara Fiocchi is a board-eligible veterinary oncologist (aka cancer specialist) at the Veterinary Cancer Group in sunny Tustin, CA.

She knows what pet owners go through, because she has experienced cancer first hand with her own pets: a cat with leukemia, a dog with lymphoma and another dog with squamous cell carcinoma, which required a toe amputation.

Today, she provides some more answers about questions that clients faced with cancer in their pet commonly ask.

And she beautifully explains that cancer is not a death sentence. Cancer is a disease that can be treated effectively in the vast majority of cases, – keeping the quality of life of the cat or the dog in mind at all times.

How much longer is my pet going to live if I choose chemotherapy?

Nobody can answer this with absolute certainty, and the answer differs based on the type and stage of cancer. The bottom line is that, if chemotherapy is recommended, it is because your vet predicts that your pet will live longer (with good quality of life) as a result of being treated with chemotherapy than (s)he would without chemotherapy.Our “predictions” are based either on scientific studies and/or personal experience.

How do I decide if the benefits of chemotherapy outweigh the possible side-effects?

Your veterinary oncologist will explain the potential benefits and risks and help you weigh those. Since the majority of cats and dogs do not experience side-effects from chemotherapy, the benefits frequently outweigh the risks.In fact, if the side-effects are likely to outweigh the potential benefit, I will not recommend treatment. The goal is to make your pet’s life better, not worse.

Am I a bad pet owner if I decline chemotherapy?

No. People decline chemotherapy for a variety of reasons. Some people have had personal bad experiences with chemotherapy that influence their decision of whether to treat their pet. Other people have moral or religious reasons not to treat with chemotherapy. Whether or not to treat cancer in your pet is a very personal decision.

What else do your clients ask you all the time about chemotherapy and cancer?

The most common question I hear about cancer is: “Does it hurt?”

Some cancers can cause discomfort or pain. When that is the case, I do my very best to decrease that pain, either by treating the cancer or decreasing the pain. One of my favorite treatments for pain is a short course of radiation therapy (aka palliative radiation therapy), because it provides significant pain reduction in many patients and very rarely has any associated side-effects.Other pain treatments include pain medications, bone strengtheners, nutritional supplements, acupuncture, chiropractic and massage therapy.

Tell us more about radiation therapy. When do you use it?

One reason is to try to obtain long-term tumor control (i.e., to kill cancer cells). This is called “definitive radiation therapy.” Whether or not definitive radiation therapy will work depends on a number of factors, including the tumor type and how rapidly it is dividing. With definitive radiation, there are usually varying degrees of side-effects, such as skin burns.

The other reason to use radiation therapy is to relieve pain or improve function, and therefore improve quality of life. When used in this setting, it is called “palliative radiation therapy.”

Palliative radiation has been used most often in dogs with painful bone tumors. Many oncologists have also used palliative radiation to improve comfort or function in cats and dogs with a variety of other tumors including nasal, bladder, prostate and oral tumors.

How quickly does radiation work?

Pain relief may be apparent shortly after a dose of radiation is given, or it may take 1-2 weeks before improvement is seen. The effect often lasts between 2-4 months, and when the pain or decreased function reoccurs, a second and sometimes third course of palliative radiation can be administered. For palliation, some oncologists will give radiation once weekly for 3-4 weeks, while others will give it once daily for up to 5 days in a row. Side-effects are rare with palliative radiation.

Are there any myths or urban legends you would like to clarify?

A common myth is: You can tell if a tumor is benign or malignant just by feeling it.

Wrong! Nobody can tell if a lump is benign or malignant just by feeling it, not even an oncologist. Fortunately, most of the time all it takes is a small needle poke into a lump to find out if it’s cancer.If your veterinarian tells you that a mass is benign just by feeling it, beg him/her to test it with a needle! Most of the time they will be correct, but if they are wrong, you don’t want to wait until it’s too late to find out.

Any last words of wisdom?

1.Early detection is critical! Veterinarians who are progressive about preventive medicine recommend a physical examination and fecal exam every 6 months (and blood work, chest x-rays and an ultrasound of the belly at least once yearly for senior pets).

2.Educate yourself on current vaccination recommendations and be proactive about speaking with your family vet about which vaccinations are necessary. Vaccinations can be associated with the development of cancer, so it is important to only vaccinate when necessary. My personal recommendation is to run vaccine titers that check for protection against disease. This can help avoid vaccinating unnecessarily.

3.There is no such thing as a “free puppy / kitten.” Be sure to budget for health care and unexpected incidents, and consider purchasing pet insurance. Particularly as pets age, preventive medicine and disease treatments can become costly.

Few things in life are more heart-wrenching than wanting to be able to treat your pet’s cancer but not being able to for financial reasons. We use the same chemo drugs and radiation machines as in human patients, and the costs of those treatments can add up quickly.

Some pet insurance companies will pay for a portion of cancer treatments. Be sure to do your research before purchasing a pet insurance plan.

4.Enjoy every day to the fullest!

Dr Fiocchi, thank you very much for taking the time to share your knowledge and wisdom with my readers.”


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