Chemo stress in vet medicine: Why I recommend chemotherapy and how I get past client reluctance
As if cancer isn’t bad enough, chemotherapy decisions are grueling in pet medicine. I guess that’s inevitable. After clobbering the client with the C-bomb, it makes sense they’d shut down all rational faculties and hear the buzzing in their heads overwhelm my well-rehearsed discussion of treatment options.
Gentle though we vets may think ourselves as we launch into the statistics and the survival times, these words are likely lost on even the most reasoned of clients. Getting through takes patience and persistence—and repeated conversations.
Almost invariably, the word “chemotherapy” is a death knell for further rational discussion—if approached to quickly. It’s almost invariably met with: “I’d never put my pet through that hell” and other such statements presumably delivered emphatically with the express goal of ending all discussion right there and then.
I used to back down pretty quickly after such an outburst. At times I even felt guilty having offered such an apparently unwelcome option. But now I remind myself to press ahead. Unless money s a major issue, there’s work worth doing here, I tell myself.
After all, chemo in pets is NOT like chemo for people. The goal is not to make them feel better after making them…well…sick as a dog. Rather, our approach is designed to make them either feel better immediately or to halt the spread of the disease without provoking drug-induced side effects.
In other words, chemo in pets is humane Though a percentage does get sick with side effects, the alternative is death by cancer—and euthanasia is always an option to prevent any suffering chemo might cause.
The flip side of this kind chemo concept is that it won’t cure cancer. But it will give them a chance to live longer in a comfortable state.
“But I’d feel like I was sitting on a time bomb,” they often express. What’s the point when she’ll die anyway? “Well, we’re all going to die someday,” is what I try to express euphemistically. Why not try to give her a little longer?
Recognizing the stress and preconceptions that come with culturally loaded terms like chemotherapy, I try to use softer language to describe it—at first, anyway. “Drug therapy” is OK for the first discussion, I think, though the next one requires that owners understand the kind of drugs we’re talking about and their potential side effects.
Take-home information works wonders at the outset, so that all family members can calmly pore over it later when the initial shock subsides, but keeping chemo-treatment take-homes up-to-date and specific in light of the rapidly evolving field of companion animal oncology is back-breaking work that makes ill use of a vet’s time.
That’s where websites can make all the difference. I particularly like client-driven sites for their personal touch, but sometimes they can have the opposite effect on those unable to envision passing through the hard work and emotional strain others freely admit to. Most of my clients have to first digest the basics before launching into these often-complex forums for their pets’ specific disease.
For that reason, it seems we end up doing a lot of hand-holding after providing very basic information on the cancer in question—in my case after sending them to specific encyclopedia-style sites where they can educate themselves on the fundamentals.
(PetPlace.com is my favorite of these. Though the ads grate and the format is choppy, I know the information is thoroughly vetted and assiduously updated by a team of vets.)
But often there’s no getting past the ingrained aversion to the common chemo conception. And that’s OK. In the end, I have to respect an owner’s final decision—no matter what…and without judgment.