When I am presented with a cancer case that is of a type that is likely amenable to successful remission rates and management with chemotherapy, often the mere mention of the word chemotherapy causes clients to cringe. This is understandable given what we see on the human side of cancer treatment via chemotherapy. I am writing today to assure you that the paradigm and reality of chemotherapy in pets is very different from human medicine because our goals are very different.
In human cancer medicine, the primary and ultimate goal is eradication of the cancer. In the process of attempting to reach this goal, chemotherapeutic agents and doses are chosen that often make the patient very ill as healthy cells are compromised or even killed as collateral damage as the drugs are killing cancer cells. Rapidly dividing cells such as those that grow hair, line the GI tract, and produce blood cells within the bone marrow are especially sensitive to chemotherapy. Thus, we commonly see hair loss, gastrointestinal sickness, and red and white blood cell suppression (leading to anemia and immune system suppression, respectively) in people undergoing chemotherapy.
In pets, we are mandated to balance our therapeutic goals with maintaining quality of life. This means choosing chemotherapeutic agents and dosing that will both treat the cancer, possibly achieve remission, all while maintaining quality of life. For some cancers remission times can exceed 2 years. For example, I currently have a 14 year old feline patient that I diagnosed with lymphoma of the liver. She is currently 27 months into remission and we have been able to back off the oral chemotherapy dosing frequency to once every 3 weeks.
Still chemotherapy, depending on the type of cancer and the treatment necessary to manage it, may not be appropriate for every pet. For example, if a chemotherapy regimen requires frequent initial visits to the hospital because the agents need to be administered intravenously, if that patient were fractious, aggressive, or otherwise a high stress patient when at the veterinary clinic, frequent visits reduce quality of life. For such cases, I actually steer clients away from pursuing chemotherapy because, what is the point of achieving remission when we have to make the pet repeatedly miserable to get them there? There is also sometimes considerable expense involved that is hard for owners to justify so that they may have their pet with them for months to a couple of years longer.
The main point of this article is not to necessarily convince owner to pursue chemotherapy for pets with treatable cancer but instead to encourage maintaining an open mind about it and give the veterinarian a chance to explain what it entails, what the treatment expectations are, and what the cost is. With the alternative of shutting down once the word chemotherapy is uttered, an owner of a pet with treatable cancer could be missing out on reasonably affordable, minimally invasive, and cost effective treatment that will restore and maintain quality; and buy more precious time with his/her beloved pet.
Dr. Roger Welton is a practicing veterinarian and highly regarded media personality through a number of topics and platforms. In addition to being passionate about integrative veterinary medicine for which he is a globally recognized expert, Dr. Welton was also an accomplished college lacrosse player and remains to this day very involved in the sport. He is president of Maybeck Animal Hospital , runs the successful veterinary/animal health blogs Web-DVM and Dr. Roger’s Holistic Veterinary Care, and fulfills his passion for lacrosse through his lacrosse and sport blog, The Creator’s Game.