Dr Adel Ferreira gives us the lowdown of how she as a veterinarian experiences the emotions experienced and questions asked surrounding a pet that is diagnosed with cancer.
Cancer treatment: A question of quality of life
In my daily life as a vet, one of the toughest tasks I have, is to tell the pet owner that his beloved pet has cancer.
Cancer is personal.
Some of us might have lost a family member or dear friend. Some of the owners even carry the scars of a battle won.
Cancer is unpredictable.
It might be benign or malignant, take years to spread or be fatal within a few weeks.
Cancer causes a lot of uncertainty.
Was it something I gave him? How long has it been there? Have I missed the symptoms?
Today we will look at one specific cancer question:
To treat or not to treat?
You might feel this is not even a question worth asking. That you will go to the end of the world for your pet and do whatever is necessary to beat this enemy. Your relationship with your vet is exceptionally important in the fight against any disease but more so in the fight against cancer.
To ensure quality of life for your pet we need to consider some of the factors at play during cancer treatment:
- Your pet’s temperament and overall health.
- The nature of the disease and expected course.
- Treatment and potential side effects.
- Your expectations and fears.
Your pet’s temperament
Certain cancers can be treated with surgical removal of the mass. In cases where there is internal spread or the cancer could not be removed completely chemotherapy and radiation might be recommended.
For chemotherapy your pet will have to go to the clinic for repeated visits. This can be as frequently as every 7 days for several months.
If a vet visit is exceptionally stressful for your pet or he becomes fear aggressive he will not be an ideal candidate for successful chemotherapy.
The overall health of the pet, especially the older ones need to be taken in to consideration. Will your dog be strong enough for the general anaesthetic?
Will your pet’s heart condition or severe arthritis limit the life gain from cancer treatment?
The nature of the disease
Fortunately many localized cancers, if detected early, can be removed surgically. Many of the malignant cancers have already spread to a vital organ system when the diagnosis is made.
If the treatment of the cancer can not alter the course of the disease the question needs to be answered if it is fair to put the patient through the discomfort of treatment.
If the type of cancer can be identified prior to surgery –and the risk for spread is known - it is important to rule out underlying internal spread with a complete medical work –up which usually includes chest radiographs, abdominal ultrasound, blood and urine test, to mention a few prior to surgery.
Treatment and potential side-effects
The golden rule with any treatment is that “the treatment must not be worse than the disease”.
Most of us have an idea in our mind’s eye of a cancer patient and definitely do not want our beloved pets to be subjected to treatment side-effects. Fortunately in our pet patients the treatment is often less aggressive than the human protocols.
Some of the possible side-effects are:
- Loss of fur: Most pets will not lose their fur except those dog breeds that have real hair (rather than fur) with continues growth like Poodles and Old English Sheepdogs. Dogs and cats will often lose their whiskers.
- Vomiting and diarrhoea: The most common side effects are gastrointestinal but your vet will usually prescribe anti-nausea medication to use prior to treatment.
- Immune suppression: It can suppress the bone marrow and make them prone to infections – frequent blood tests are done prior to the chemotherapy to ensure that the bone marrow is still functioning.
- Some of the agents can cause heart muscle and bladder wall damage.
- Some of the chemotherapeutic agents are strictly administered intravenous due to its ability to destroy tissue. Vets will strictly adhere to safe practises to prevent leakage of the agent. Accidental leakage can lead to massive ulcers at the injection site and in severe cases to amputation of the limb.
- Post-operative pain. Invasive surgery will have a post-operative pain period. Excellent pain control regimes are available to minimise the discomfort.
Your expectations and fears
Taking care of our animals when they are sick and in pain is exceptionally stressful:
- Taking care of a cancer patient takes a lot of time and patience
- The owner must be able to administer medication and willing to handle certain chemotherapeutic drugs with protective clothing
- Cancer treatment, whether surgically or chemically, can be very expensive
Before rushing in and consenting to cancer treatment asks your vet the following questions:
- How much good quality life is gained from the treatment?
- How long will the treatment be for, and what is the life expectancy with the treatment and without?
- Is the aim of treatment cure or just suppressing the cancer?
- What are the potential side effects of the treatment?
- What is the approximate cost of the treatment?
Unfortunately due to the unpredictable nature of cancers your vet will not be able to give you exact answers.
The most important decisive factor is your pet’s quality of life.
In humans undergoing cancer treatment they receive counselling to help them cope with the stress of treatment. In human patients the disease can be explained to the individual and they can understand why they go through the process.
Our pets do not understand why they are subjected to certain treatments therefore the responsibility is with us, the pet owner (with support from your vet), to make the kindest decision with their best interest in mind.