What happens after a diagnosis of cancer is made?
To help remember what you are told, you may wish to take notes or ask whether you may record the conversation. Some people also want to have another family member or friend with them when they talk to the veterinary surgeon. They may take part in the discussion, take notes, or just listen with you.
You do not need to ask all your questions at once, you will have other chances to ask the veterinary surgeon or nurse to explain things that are not clear and to ask for more information.
Your veterinary surgeon may refer you to a specialist, or you may ask for a referral. Specialists who treat cancer include surgeons, medical oncologists and radiation oncologists. The treatment plan may change over time.
The treatment plan depends mainly on the type of cancer and the stage of the disease. Veterinary surgeons also consider the patient’s age and general health.
Sometimes the goal of treatment is not to cure the cancer but to maintain as normal a quality of life as possible in your pet for as long as possible with palliative therapy. In this case, the goal is to control the disease or to reduce clinical signs associated with the cancer for as long as possible.
Before starting treatment, you may want another opinion about your pet’s diagnosis and treatment plan. A second opinion is usually sought when there is doubt about the diagnosis or treatment whereas a referral is usually to seek specialist management of the case.
Can cancer in pets be treated?
Just as in people, there are 3 major forms of cancer treatment which can be used alone or in combination.
- Radiation therapy
Surgery can often be curative if performed early enough. Radiotherapy and chemotherapy can be used to increase the chances of cure but are more often used to achieve periods of remission with a return to a good quality of life.
Whether or not to treat a pet with cancer is an important decision and needs to take into account many factors including any concurrent illness (such as coexisting kidney or heart failure), quality of life for the pet, logistical implications and finances.
If remission or a cure is unlikely, palliative therapy to make the pet more comfortable without a curative intent can prolong good quality of life while owners come to terms with end of life decisions.
Is my pet too old?
It is often said of people that you are as old as you feel – this is equally true of animals. If an individual is healthy and active, their age should not be a barrier to treatment. Treatment is aimed at prolonging a good quality of life for as long as possible. One way to think about this is that one extra year for a 10-year-old dog is 10% of its life.
While cancer is more common in older pets, age alone is not a major factor when considering whether to treat. If it were not for their tumour, many older pets are otherwise healthy individuals. Some pets can be young in years but seem old, whilst some older pets can still seem extremely youthful.
One of the best indicators of outcome (prognosis) for many cancers is response to initial treatment.
Also, just because you decide to start a course of treatment, this does not mean that you are obliged to complete the course of treatment. Circumstances often change and treatment decisions can be changed at any time.
Is cancer treatment worth doing?
As in people, cancer is treatable and is even curable in some cases. Early diagnosis and appropriate treatment are the keys towards a successful outcome. Your pet cannot choose what cancer they will get but you can choose the best course of action taking into account your pets’ personality and your needs and limitations.
Many neoplasias, including a number that are malignant, can be cured if caught early. Some tumours, whilst not curable, may be kept under control for some time allowing the pet to enjoy a normal, happy quality of life. Unfortunately, some tumours are too advanced for any treatment and then euthanasia may be the kindest option.
Veterinary surgeons may use one method or a combination of methods to treat cancer, depending on several factors, including:
· Type and location of the cancer
· Whether there is spread of the disease
· Patient’s age and general health
Since treatment for cancer can also damage healthy cells and tissues, it can cause some side effects. People often worry that the side effects of treatment are worse than the disease.
Owners and veterinary surgeons should discuss the treatment options, weighing the likely benefits of killing cancer cells and the risks of possible side effects. Veterinary surgeons can suggest ways to reduce or eliminate problems that may occur during and after treatment.
Many owners want to take an active part in making decisions about their pet’s medical care and it is natural to want to learn all you can about your pet’s disease and treatment choices. However, it is often difficult to take in everything that your veterinary surgeon says after the diagnosis is made.
It often helps to make a follow-up appointment and to prepare a list of questions before the appointment.
How is cancer in pets treated?
There are many different types of tumours and the treatment for each will differ.
To ensure the most effective treatment is given and to get an idea of the likely outcome an accurate diagnosis is needed. This is usually performed before any treatment is begun.
There have been major advances in the treatment of cancer in humans and many new medicines and techniques can be used in pets too. There are 3 major forms of treatment:
- Radiation therapy
Surgery remains one of the best ways to treat most tumours and in many cases can be curative. However, surgery must be bold and well planned; any tumour cells left behind will cause the tumour to grow back. Surgery may be used in combination with radiation or chemotherapy.
Radiation therapy or radiotherapy can be useful to treat a variety of tumours, particularly some of those that occur in the mouth, nose, skin and brain. Certain tumours can be cured, some have their growth slowed and some, unfortunately do not respond at all.
Anti-cancer drug therapy (a form of chemotherapy) can be used against some tumours (especially leukaemia and cancer of the lymph glands [called lymphoma]).
The doses used in animals are carefully calculated to aim to avoid unpleasant side effects. For this reason, most forms of chemotherapy used in veterinary medicine are considered to be a form of palliative therapy rather than curative although we can achieve good periods of remission with a return to a good quality of life in some cases.
Referral to a specialist centre for treatment may be necessary for more advanced treatments. Specialist centres will have oncologists that are veterinary surgeons that specialise in diagnosing and treating cancer.
What is palliative therapy?
Palliative therapy is often used to make your pet more comfortable when the chance of achieving a remission or a cure is unlikely.
Surgery, radiotherapy or chemotherapy can all be used as a form of palliative therapy when there is not a curative intent. It can prolong good quality of life while you come to terms with end of life decisions. Chemotherapy given at the carefully calculated doses used in most of our pets to avoid the most serious side effects is a form of palliative therapy that can result in periods of remission with a return to a good quality of life in some cases.
Palliative care involves using medication to relieve pain and discomfort, including non-steroidal anti-inflammatories (NSAIDs) such as meloxicam, opioid pain relievers, steroids such as prednisolone and sometimes local anaesthetics. It may also involve giving anti-nausea medication or appetite stimulants.
Palliative care can make your pet more comfortable, giving you an opportunity to spend some quality time with your pet and make the most of the time they have left. Owners often comment on how much of a difference a little pain-relieving medicine makes in making their pet more comfortable and even improving appetite.
In most instances you should be able to arrange for palliative care in your home with the help of your veterinary practice.
What about nutrition?
Your pet needs enough calories to maintain a healthy weight, they need enough protein to remain strong. Eating well may help your pet feel better and have more energy.
Sometimes your pet may not feel like eating, they may be uncomfortable or tired or may find that foods do not taste as good as they used to. Warming the food or adding sauces and gravies may help increase intake.
In addition, the side effects of treatment (such as poor appetite, nausea, vomiting, or mouth sores) can be a problem. If your pet is having trouble chewing and swallowing, you may need to give soft or blended food.
Many owners want to know how they can help their pet fight cancer by eating certain foods or taking vitamins or supplements. Unfortunately, there are no studies that prove that any special diet, food, vitamin, mineral, dietary supplement, herb or combination of these can slow the growth of cancer or keep it from coming back. In fact, some products can cause other problems by changing how your cancer treatment works.
It is best to talk to your veterinary surgeon before putting your pet on a special diet or giving any supplements.
What about complementary and alternative therapy?
Some people with cancer use complementary and alternative medicine (CAM). An approach is generally called complementary medicine when it is used along with a standard treatment(s).
An approach is called alternative medicine when it is used instead of standard treatment. Acupuncture, massage therapy, herbal products, vitamins or special diets, visualization, meditation, and spiritual healing are types of CAM.
In human medicine, many people with cancer say that CAM helps them feel better. However, there are no controlled trials in pets that show any benefit and some types of CAM may change the way standard treatment works; it is often unknown what effects or interactions may occur with herbal or other CAM therapies when an individual is undergoing chemotherapy or radiotherapy.
Before starting these types of treatment for your pet, you should discuss this with your veterinary surgeon