Because cancer is the most common disease-related cause of death in American pets, it is important for veterinarians to understand some basic principles of oncology. A thorough history and physical examination are essential. In trying to determine the most appropriate therapy, 2 questions must be addressed: “What is it?” and “How far has it spread?” Determining whether a tumor is malignant or benign (ie, “What is it?”) can be accomplished via fine-needle aspiration (FNA) or biopsy. The trephination technique of FNA, in which a needle is redirected through several planes of the mass without concurrent aspiration, is preferred to the aspiration technique. The gold standard for diagnosis is biopsy, either incisional (or core) or excisional, and tumor grading can be done with these samples. It is important to note that incisional biopsies will not yield accurate grades. Staging tests are performed to determine how far the disease has spread; the tests done (eg, radiography or computed tomography) will depend on the tumor type and its typical metastatic sites. Even if the disease appears localized, adjuvant chemotherapy is recommended if the tumor type is known to have an aggressive biologic behavior. Treatment options are divided into local therapies (eg, surgery and radiation) and systemic therapies (eg, chemotherapy). Client communication is especially critical with oncology clients. Empathetic, honest, and consistent communication that establishes realistic goals and focuses on quality of life will provide the basis for an excellent foundation from which the best possible decisions can be made for both client and pet.
COMMENTARY: At times, establishing a diagnosis and outlining a treatment program for a pet with cancer can be both frustrating and intimidating. This presentation on how to approach the cancer patient will provide a basic understanding of the fundamentals of cancer diagnosis, staging, and therapy, and covers all aspects of cancer diagnosis and treatment. In addition, there will be an invaluable review on client communication, which covers how to break the news of a cancer diagnosis, offering options, providing support, and dealing with end-of-life decisions.
NAVC: Ruthanne Chun, DVM, Diplomate ACVIM (Oncology)/Wednesday, January 20, 8:00-8:50 a.m. Marriott