The Internet can be a dangerous place for owners of pets with cancer. The sheer amount of virtual information available immediately at one’s fingertips is astonishing; bordering on overwhelming.
As an example, a quick search of the phrase “canine cancer” in a popular search engine returns over 3,240,000 hits. "Canine lymphoma" yields over 1,050,000 hits, while "feline lymphoma" reveals a mere 565,000 hits. How can an owner sift through all those pages and discern the "good from the bad" when it comes to learning more about their pet’s diagnosis?
When a diagnosis of cancer is made, owners are often placed in the difficult position of having to make decisions regarding diagnostic tests and treatments for their pet, frequently with limited information. This can lead to a feeling of helplessness and depression, or even defensiveness at times. I think it’s natural to turn to the Internet as a source of information, self-comfort, and self-education.
What I’m not so sure of is when exactly did entering phrases or words into a search engine begin qualifying as "research?" Having endured many years of rigorous academic training, when I think of actively researching a topic, it conjures up images of pouring over textbooks and critically reviewing clinical studies. To me, it means learning objective facts and studying information for accuracy of content, not clicking on random websites and reading unsubstantiated opinions backed typically by emotion rather than truth.
It is not unusual for owners to come to their first appointment armed with notes, printouts, suggestions, and/or questions they have garnered from searching their pets’ diagnoses on the Internet. My visceral reaction is typically one of tempered insult. I’m the one who endured many years of education and training and have several years of experience working as a clinical medical oncologist, yet I often joke in some cases that the (in)famous "Dr. Google," who never went to vet school, once again has managed to usurp my recommendations. It’s challenging for me to remember that the intentions behind my clients’ questions or suggestions are typically pure. Owners simply lack the medical knowledge to review the Internet information accurately, but they really only want the best care and best treatment options for their pets.
I’ve discussed before how I understand that a diagnosis of cancer can be emotionally provoking for owners, and a common frustration many will express is their complete lack of control over the situation. Owners cannot alter progression of the disease once it occurs, they are simply told, "Here are the facts and here are the recommendations."
An example would be an owner focusing on nutrition and diet after a diagnosis is obtained. What food their pet ingests is one of the few things pet owners can control in an otherwise uncontrollable situation. It is also one of the most Internet-searched topics owners will discuss with me during an appointment. Unfortunately, the lack of evidence-based information supporting nutrition as playing a role in the outcome for animals with cancer makes it difficult to make solid recommendations.
This isn’t to say I can't relate to the need to try to learn as much as possible about a diagnosis, and I’m aware of how daunting terminology related to science and health and medicine can be for individuals not trained specifically within those subjects. The vocabulary is unfamiliar, anxiety provoking, and even uncomfortable for some. Equally as challenging on my end is determining how to present complicated diagnoses and treatment options in terms the average non-medically inclined individual can understand. Despite my best efforts, even with the most medically educated clientele, I know the emotional aspects surrounding a diagnosis can create barriers to truly understanding the technicalities.
Following initial consults, I provide owners with an in-depth written summary of all the points discussed during the appointment. I believe this is something unique to the veterinary profession. Think about the last time your human MD counterpart provided you with a written summary of any aspect of your visit. Even with the information literally in hand, it’s not uncommon for owners to specifically ask for websites they could use to better understand all the topics I’ve discussed. I’m not sure I will ever understand the need to turn to non-validated sources of information when it comes to learning about health and disease, but I do understand my obligation to being able to point people in the right direction.
Therefore, I generally recommend websites directly affiliated with veterinary schools, professional veterinary organizations, and websites run by respected and prominent veterinarians and advocate such pages as resources for owners seeking additional information. I also have no problem discussing the pros of seeing another medical oncologist for a second opinion when appropriate.
I think one of the main reasons I enjoy being able to write weekly articles for petMD is because I feel it is my small way of contributing factual information about veterinary oncology on the Internet. Though I’m still frequently challenged by owners about something they read on a website or through an online forum, I try to maintain patience when these topics come up.
I take comfort in knowing there are good resources for pet owners, and that I play an active role in keeping truthful information available to a large-scale audience, one week at a time.
Dr. Joanne Intile