Douglas H. Thamm, VMD, Diplomate ACVIM (Oncology)
Wednesday, January 21 • 8:00-8:50, Marriott
Critically important decisions about euthanasia, treatment, and referral may be made by owners of pets with cancer on the basis of information provided by their veterinarians. Thus, any myths or misconceptions held by owners, veterinarians, and veterinary staff must be dispelled. Among those discussed are that up to 50% of dogs and 30% to 35% of cats will have some type of tumor in their lifetimes, as a consequence of living longer. There is no association between a pet's environment and the vast majority of cancer types. Treatment of cancer can provide an excellent quality of life for pets. It is better to diagnose what a lump is and treat it aggressively than to take a "wait-and-see" approach. With few exceptions, performing fine-needle aspiration or biopsy will not increase the risk for spreading cancer and should be done before tumor removal to help plan the surgical approach. All tumors that are removed should be submitted for histopathology. Regarding chemotherapy-fewer than one third of veterinary patients have unpleasant side effects. Systemic side effects generally do not occur with radiation therapy as it is used locally. Finally, corticosteroids should be used as a last resort for palliative care of cancer patients as they can be potentially harmful. Alternative analgesics and appetite stimulants should be considered first.
COMMENTARY: This presentation reinforces the concept of compassionate cancer care and is a good reminder that gentle discussions with owners, not limited by time and schedule, are always better than an adversarial interaction about who knows what's best for a patient. Primary care veterinarians are the "care ambassadors" in identifying the best cancer treatment options. The important difference in veterinary versus human cancer treatment is the goals of therapy. In humans, many cases of cancer are cured, and survivors may enjoy many decades of comfortable life. For this reason, treatment of cancer is aggressive and may be associated with side effects. While pet animals are very similar biologically to humans, the chance for survival of decades is remote. Therapies are therefore directed at preserving quality of life; and tumor control, or remission, is the aim rather than cure at any cost.