Yesterday’s chemotherapy on a mammary cancer kitty got me to thinking: I see so much cancer among my patient population yet I perform so few chemos—and it’s not just because I send all my cancer cases to the oncologist or internist (I try but owners don’t often choose to comply with this recommendation).
From my daily entries I’m sure you’ve already ascertained that cancer is no stranger to vets. Indeed, any pet lover lucky enough to have pets that live long enough will eventually experience cancer firsthand as well. It may seem odd, given that among humans cancer seems somehow strange and exotic—that is, unless you, a close friend or a family member have been afflicted.
How many new cancer patients do I see every week? Maybe four. Including rechecks, I see cancer almost every day of my working life.
Animal cancer and cancer treatment has exploded in the past decade. Oncology is one of the most rapidly growing fields in vet medicine. Mostly, it’s because pets are living longer—long enough for cancer to eventually affect older, dividing cells. But it’s also because we’re spending more on our pets. Now we have the luxury of identifying previously undiagnosed non-specific disease as cancer.
In years past, most pet owners would bring their old, sick pets to the vet with the expectation that their pet would have to be euthanized. Now they’re more likely to walk in the door looking for answers. But when the answer is cancer, chemo isn’t an option they’re happy to hear about.
Because specific cancer techniques and medicines have made cancer treatment more feasible, chemotherapy is a word that escapes my lips frequently. And it never fails to elicit a strong reaction from pet parents—usually a negative one. In fact, most owners recoil as if I’d just suggested we remove two limbs.
Truth be told, chemo is not so scary as it sounds and need not be so uncommonly employed. Many cancers, detected early enough, respond well to chemotherapy. Since the goal of chemo in pets is to restore or prolong a high quality of life, we seldom see the kind of crazy reactions that are the hallmark of chemo in human cancer patients.
In pets, chemo will not make hair fall out, will usually not cause nausea or vomiting, and very infrequently leads to medication-related death. If significant side effects are noted after the drug is administered, whether immediately or in days or weeks to follow, we usually recommend the chemo course be discontinued. Similarly, if the pet’s cancer does not respond to the chemo drugs in a measurable way (reduction is the size of tumors, for example), we stop using it altogether.
Most often, though, chemo does help for the cancers we know respond well to it. Because the goal is not a cure, and because our chemo approach is so mild by comparison to that of humans, the cancer inevitably rears its ugly head within months. It’s this inevitability, coupled with its fearsome reputation that makes all the difference to pet owners. Why put Fluffy through something so drastic if it’s just going to come back?
If that’s the case, why put her on antibiotics? Why perform surgery? Why administer steroids? We know she’s going to die. Why keep her alive at all?
Make no mistake, I’m not advocating the indiscriminate use of chemo, nor am I disrespectful of my clients’ choice to decline it. Rather, I’m suggesting that it should perhaps be considered in more realistic terms and not dismissed out of hand for personal emotional reasons.
Yes, it’s true. I’d like to see chemo used more frequently. The possibility of an increase in quality of life is too great. Furthermore, there’s no way that we’ll make strides in our treatment of cancer for all pets without making it a more commonplace alternative to immediate euthanasia. The more we know the more we can help. The more animals helped the better vets feel about recommending it enthusiastically.
The last ten years have seen more diagnostics and more cancer. I’m hoping the next ten will see more treatment. It starts with you and your pets. Just think about it.