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More Facts about Cancer
What is Cancer?
How Common is Cancer?
How is it Diagnosed?
Is Cancer Preventable?
Other Types of Cancer in Pets
How is Cancer Treated?
What is the Success Rate?
Detecting the Signs of Cancer.
What Causes Cancer in Dogs?
What is the Cost of Cancer Treatment?
What are the Side Effects of Chemotherapy
in Pets?
Diagnosis and Staging.
Treatment Strategies
Deciding on Treatment Options
Tumor Biology and Natural History.
Goals of Treatment.
Supportive Care.
What is Cancer? Go
to Top of Page
Cancer is an uncontrolled growth of abnormal cells on or within
the body. Cancer may be benign or malignant. It may be localized
or it may invade adjacent tissue and spread throughout the body.
How Common is Cancer? Go
to Top of Page
Cancer is common in pet animals and the incidence increases with
age. Cancer accounts for almost half of the deaths of pets over
10 years of age. Dogs get cancer at roughly the same rate as humans,
while cats get fewer cancers.
How is it Diagnosed? Go
to Top of Page
Strong circumstantial evidence of cancer can be attained from x-rays,
blood tests, ultrasonography, the pet's physical examination and
medical history. Most cancers, however, will require a biopsy (a
removal of a piece of tissue) for confirmation that cancer exists
and to grade the level of severity from benign to aggressively malignant.
Is Cancer Preventable? Go
to Top of Page
Unfortunately, the cause of most cancers is not known and, therefore,
prevention is difficult. Early detection and treatment are the best
ways to manage cancer in pets.
Other Types of Cancer in Pets. Go
to Top of Page
Skin - Skin tumors are very common in older dogs, but much less
common in cats. Most skin tumors in cats are malignant, but in dogs
they are often benign. Your veterinarian should examine all skin
tumors in a dog to determine if any are malignant.
Breast - 50% of all breast tumors in dogs. Spaying your female pet
between 6 and 12 months of age will greatly reduce the risk of breast
cancer. Surgery is the treatment of choice for this type of cancer.
Spaying your pet at the time of cancer surgery has been shown to
improve prognosis. Follow up treatment may be recommended.
Head & Neck - Cancer of the mouth is common in dogs. Signs to
watch for are a mass on the gums, bleeding, odor, or difficulty
eating. Since many swellings are malignant, early, aggressive treatment
is essential. Cancer may also develop inside the nose of dogs. Bleeding
from the nose, breathing difficulty, or facial swelling are symptoms
that may indicate cancer and should be checked by your veterinarian.
Testicles - Testicular tumors are rare in cats and common in dogs,
especially those with retained testes. Most of these cancers are
preventable with castration (neutering) and curable with surgery
if done early in the disease process.
Abdominal Tumors - Tumors inside the abdomen are common but it is
difficult to make an early diagnosis. Weight loss or abdominal enlargements
are signs of these tumors.
Many of the above signs are also seen with noncancerous conditions
but they still warrant prompt attention by a veterinarian to determine
the cause. Cancer is frequently treatable and early diagnosis will
aid your veterinarian in delivering the best care possible.
How is Cancer Treated? Go
to Top of Page
Each type of cancer requires individual care and may include a combination
of treatment therapies such as surgery, chemotherapy, radiation,
cryosurgery (freezing), hyperthermia (heating) or immunotherapy.
Once you have a diagnosis, your veterinarian will discuss the best
treatment option(s) for your pet. In some instances, your veterinarian
may refer you to a board-certified oncologist (cancer specialist)
depending upon the recommended course of treatment.
What is the Success Rate? Go
to Top of Page
This strongly depends upon the type and extent of the cancer, as
well as the aggressiveness of therapy. Some cancers can be cured
and almost all patients can be helped to some degree.
Detecting the Signs of Cancer.
Go to Top of Page
The signs of cancer vary depending on the type of cancer. Oral cancer
is suspected if there is excessive drooling, difficult eating or
swallowing, or bleeding from the mouth. Lung cancer is suspected
if there is rapid and labored breathing. Digestive cancers may cause
vomiting or diarrhea, or they suddenly stop eating. Bone cancer
in limbs might cause lameness and stiffness. Any lumps and bumps
on any parts of the body are cause of concern, especially if it
is rapidly growing, is warm or painful, is ulcerated or bleeding,
is irregular in shape or is well attached to the tissues under the
skin. Sores and wounds on ears and nose that don't heal could be
skin cancer. Chronic nasal discharge might indicate nasal cancer.
Detecting any of these signs and acting quickly is the first weapon
for fighting cancer successfully. It is always better to be safe
than to be sorry later. Some cancer is so aggressive that it might
become too late when you finally take your pet to the veterinarian.
When in doubt, act immediately.
If your pet is getting older, it is a good idea to routinely examine
the body by stroking and petting and going over the entire body.
Such regular grooming sessions will serve two purposes: Detecting
"anything out of ordinary" as well as deepening the bond
between you and your aging pet. An annual or biannual complete physical
examination along with annual laboratory analysis (complete blood
count, serum chemistry profile) and chest x-ray (radiograph) is
also very useful in catching geriatric illnesses that affect the
kidney, liver, heart or bowel.
What Causes Cancer in Dogs? Go
to Top of Page
We know the cause of very few cancers in companion animals, however
the Foundation is working very hard to change this. The development
of cancer can occur in any organism from excessive exposure to carcinogenic
agents such as certain chemicals, UV or X-irradiation and from some
viral infections. Although we do not know the exact cause for each
type of cancer in pets, the underlying problem is due to abnormal
genes that result in uncontrolled growth of cells, which may invade
into surrounding tissues or spread to other areas. The number of
cancers that are actually heritable (capable of being passed on
to offspring) is unknown in dogs but it has been occasionally documented.
What is the Cost of Cancer Treatment?
Go to Top of Page
The cost of evaluation, diagnosis, staging and treatment will vary
depending on the site of the tumor, the size of the pet, the type
of treatment selected and how well your pet handles the treatment.
In general, the initial evaluation including the diagnosis, staging
and a discussion about the prognosis and treatment options may range
from several hundred dollars upward if the tumor is located in a
body cavity or hard to reach location. Major surgical procedures
that require wide and deep tumor removal, or major reconstructive
procedures, will likely range from about $1500 upward, depending
on the extent of surgery and the recovery period. Chemotherapy costs
vary with size of the pet but for many treatment regimens the cost
of chemotherapy may range from several hundred dollars for palliative
oral treatment to several thousand dollars over a 3-6 month period.
Radiation therapy will range from approximately $2000 to $6000 depending
on the type of radiation therapy and the region of the country.
What are the Side Effects of Chemotherapy in Pets?
Go to Top of Page
The goal of chemotherapy in pets with cancer is to preserve the
highest quality of life possible. However, there may be some side
effects following treatment with chemotherapy. The overall impact
of side effects is reduced by altering doses or eliminating drugs
from treatment if side effects are significant. However, in order
to obtain any benefit from chemotherapy it is necessary to use doses
that can result in some reversible and temporary effects on normal
tissues. The most common side effects of chemotherapy in pets include:
Stomach upset resulting in a reduced appetite, nausea, vomiting,
diarrhea and dehydration. These effects are generally mild and self-limiting
but may require symptomatic treatment or hospitalization in some
instances.
Diagnosis and Staging. Go
to Top of Page
Your pet's general health status is assessed to identify disease
which may adversely affect prognosis, and limit or alter therapy.
After a thorough physical examination the screening laboratory evaluation
generally includes a complete blood cell count, serum biochemistry
panel, and urinalysis. Other general diagnostic tests are performed
as indicated. Survey radiographs are indicated to detect metastasis,
determine potential bone involvement, evaluate orthopedic soundness
prior to amputation or limb-sparing in dogs with osteosarcoma, localize
oral or nasal masses, etc.
Contrast radiographic studies can determine the extent of gastrointestinal
and genitourinary neoplasia. Computed axial tomographic (CAT) scanning
or magnetic resonance imaging (MR) are becoming more available and
defines the invasive characteristics of deep seated tumors much
more clearly than survey radiographs. CAT or MR imaging procedures
are particularly helpful when planning involved surgical procedures.
Ultrasonography can be used to determine the proximity of a tumor
to large blood vessels, to determine the cystic nature of masses,
to evaluate possible intra-abdominal metastases to lymph nodes or
organs, and to assess the initial and post-treatment tumor volume.
The diagnostic plan for a suspected tumor involves the clinical
evaluation described above as well as characterizing the tumor,
the surrounding area and the rest of the body where cancer may have
spread with x-rays, ultrasound or other imaging. The keystone of
the diagnosis is a cytologic or histologic confirmation of malignancy.
Cytologic examinations of bone marrow aspirates, buffy coat preparations
of peripheral blood samples and fine needle aspiration biopsies
of accessible tumors and regional lymph nodes are important diagnostic
procedures. Fine needle aspiration can be accomplished on any accessible
mass. Often, a rapid, inexpensive diagnosis can be made for certain
tumor types (lipomas, sebaceous adenomas, mast cell tumors). However,
cytologic evaluation of fine needle aspirates or bone marrow specimens
must not be over-interpreted. Treatment decisions should be based
on a cytologic diagnosis only when a definitive diagnosis can be
made such as with lymphosarcoma, mast cell tumors, etc.
Many techniques are available for tissue biopsy. The method selected
should safely and simply procure adequate tissue samples to provide
an accurate diagnosis without compromising treatment. Biopsies can
be excisional (complete removal of the tumor) or nonexcisional (removal
of only a portion of the tumor). Nonexcisional techniques include:
a) cytology from a fine-needle aspirate, brush samples, impression
smears or effusions, b) histopathology of cutting forcep biopsies,
cutting needle biopsies, punch biopsies, and incisional biopsies.
Treatment Strategies. Go
to Top of Page
Cancer specialists use a team approach to detect and treat complex
cancers. Depending on your pet’s diagnosis, the cancer specialist
will consult with other specialists, who may include surgeons, medical
oncologists, diagnostic radiologists, radiation oncologists and
other professionals who have been trained in treating cancer.
Whether your pet receives radiation therapy, chemotherapy, surgery
or a combination of therapies, a customized treatment plan should
be designed to most benefit your pet and suit your needs. Supportive
care such as nutritional counseling and pain management can also
be provided. Once treatment has been planned, a team of trained
and certified health care professionals, including nurses, pharmacists,
technologists and others should assist in your pet’s care.
The clinicians and nursing staff should work as a team to monitor
the treatment response and overall health of your pet. Seek bereavement
services in your area to help with your emotional needs.
Deciding on Treatment Options.
Go to Top of Page
The decision making process for management of cancer in pets can
be a complicated and difficult process. The evaluation of the general
health of the patient, the type of cancer, access to specialized
treatments and the emotional, time and financial commitment to conduct
the treatment must be carefully considered. The benefits, risks
and costs cannot be adequately determined without some assistance
and support. Such support is best obtained from family, friends
and veterinary professionals. Once the general health of the patient
has been determined to be adequate and the cancer has been clinically
staged and biopsied, the next decision is to determine treatment
options.
Tumor Biology and Natural History.
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Rational treatment planning involves basic knowledge of the potential
for local recurrence and metastasis of the neoplasm. The key is
the histological assessment or diagnosis. Malignant tumors predisposed
to local recurrence should be managed aggressively from the time
of initial diagnosis. The chance for long-term tumor control is
greatest when the tumor is undisturbed by previous therapeutic intervention.
The risks and benefits of aggressive management must be carefully
considered. However, most people will recognize the obvious benefit
of prolonged tumor response with reduced overall expense if the
tumor can be managed once, albeit initially more costly, compared
to multiple, suboptimal attempts at tumor control.
Goals of Treatment. Go
to Top of Page
Maintaining the highest quality of life for the longest period of
time is always the goal of cancer management in companion animals.
This goal must be considered within the context of emotional and
financial factors. Decisions are often difficult.
The best service that can be provided is a knowledgeable, unbiased
assessment of the condition and a frank discussion of options sufficient
to permit an informed decision. This may involve consultation or
referral to a specialist or a comprehensive cancer center. Curative
therapy is designed to attempt permanent control of the tumor using
aggressive but not excessively debilitating treatments. Multiple
treatment modalities are often employed.
The decision to pursue curative treatment can be difficult. A working
definition of curative therapy often used in veterinary medicine
is the likelihood that a given tumor type will be controlled for
at least 1 year following treatment. If the best available information
suggests this is not possible, palliative therapy may be considered.
Palliative therapy is designed to reduce pain or functional difficulties
such as swallowing, urinating or defecating without attempting to
cure the tumor. The length of time is not as important as the quality
of the time remaining for the pet. The hospital time and side-effects
must be minimal for palliative therapy. Pets with cancer may also
require supportive therapy such as antibiotics, medications to control
some symptoms, blood transfusions and nutritional management.
Supportive Care. Go
to Top of Page
Dogs that have cancer are generally middle aged or older. Age is
not a disease but there often other health problems in older pets
with cancer that must be managed simultaneously with the cancer.
In addition, cancer can produce some problems in other organs such
as anemia, kidney problems and digestive abnormalities. The complete
management of cancer in dogs requires consideration of supportive
measures. These supportive measures can be considered in several
categories: nutritional considerations, blood product support and,
ancillary medication for concurrent diseases or symptoms.
Pets with cancer require consistent, high quality nutrition. The
specific nutritional needs for pets with cancer are not completely
understood. The brands of the food are less important than a complete,
balanced and palatable food for your pet with cancer.
A poor appetite and weight loss can result from cancer in several
ways. Cancer can affect appetite, smell, metabolism and the physical
ability to chew or swallow. Treatment for cancer may also reduce
appetite by inducing nausea or irritation to the intestinal tract.
Numerous means of dealing with nutritional issues in pets with cancer
now exist and this aspect of management should be carefully considered
with your veterinarian.
In some instances, pets may require transfusions of whole blood,
red blood cells or plasma. This type of management is usually necessary
on an acute basis and is rarely used for long-term support. Blood
product transfusions are more available than ever before.
Many dogs diagnosed with cancer also have other health problems.
Some health problems are minor and require little additional consideration
after a cancer diagnosis is made. Others may profoundly affect the
decisions about cancer management. The specific management considerations
for dogs with concurrent medical problems should be thoroughly discussed.
Symptomatic medications are often necessary while cancer is being
controlled. Some medications that may be necessary include anti-emetics,
laxatives, anti-diarrheals, anti-histamines, cortisone-derivatives
and others.
Antibiotics may be necessary to prevent or control bacterial infections
at various times throughout treatment of cancer in dogs.
Close attention to the possibility of dehydration from vomiting,
diarrhea or excessive urination is required for many patients with
cancer. On occasion, fluid administration on an outpatient or inpatient
basis may be required.
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