THE BIG “C”: CANCER
Scary to hear, but it might not be as bad as you think.
When it happens to someone else, we are empathetic. We feel sorry for the person and those close to him or her. We also breathe a secret sigh of relief; thinking to ourselves how lucky we are to have dodged that bullet. After all, it can happen to anyone. We feel guiltily happy that the diagnosis isn’t ours or any member of our family.

What if cancer does hit a member of your family? What happens when you find out your pet has cancer? Who will treat the disease? What treatments are available? Is it a death sentence? As animals take on a more central and important role in our lives, those questions need to be answered.

To answer the “cancer” questions, I decided to go to an expert. Board certified in Oncology by the American College of Veterinary Internal Medicine, Dr. Heather Heeb, DVM practices veterinary oncology at the Veterinary Specialty and Emergency Center (VSEC) in Overland Park. Dr. Heeb received her undergraduate degree from the University of Kansas, did her internship at Texas A & M, did her residency and received her veterinary degree from Kansas State University & is the only board certified veterinary oncologist within 100 miles of Kansas City. Who could ask for anything more?

First, I thought I should get educated. Dr. Heeb told me that the most common type of cancer seen in dogs & cats is lymphoma. If we narrow it down after that, other common types include oral (mouth) tumors, mast cell (skin) tumors and bone tumors. Certain breeds of dog are even more susceptible to certain types of tumors than others. There are also some cancers that are rarely seen. Some examples Dr. Heeb gave me are: Ovarian & Uterine; that is because most animals are spayed these days, embryonic tumors and primary kidney tumors are also fairly rare. Tumors are complicated and will behave in many different ways. For example, Dr. Heeb told me, that not all tumors are malignant and not all malignant tumors will metastasize. What does that mean? It means that not all tumors are inherently dangerous & the ones that are potentially dangerous can often be treated.

How are they treated? The same ways they are treated in humans; with surgery, chemotherapy and radiation. The equipment used is even the same equipment used to treat humans & the veterinary specialists are just as intensely trained as those for humans. The main difference between animals and humans when it comes to treatment options is that there has been very little need for the development of prosthetics for animals since animals can compensate quite well after an amputation and they tend not to spend too much time in front of a mirror.

I asked Dr. Heeb about the side effects of cancer treatment for animals. Most humans have, themselves, experienced cancer treatment or watched someone go through it (even if we saw it on television or in movies). Not one of us would say it was a pleasant experience and perhaps might even be worse than the disease itself. Why should we put our pets through that? Dr. Heeb explained some things to me that might make everyone feel a bit better about that. She said that she “takes great care to ensure that there isn’t more harm done.” “Since the protocols are different,” she explains, “there is usually a less than 15% chance that the animal will feel sick from the chemotherapy.” Additionally, animals simply don’t react to medication the same way humans do. That works in their favor and they don’t get as sick from the treatment as humans. As far as deciding whether or not treatment should be pursued, Dr. Heeb always encourages owners to consider the needs of the individual animal. For example, some animals experience an extraordinary amount of stress when going to the vet’s office. Cancer treatment requires frequent vet visits and the harm done by that stress may very well outweigh the good of the treatment. Expenses will also come into play when considering treatment. The treatments are very expensive and if there is no insurance already in place, it may not be feasible. Additionally, not all pet insurance will cover it. The owner’s lifestyle is also an important factor. This type of treatment can be very intensive and may be very time consuming. It is no reflection on the owner; however, there simply may be too many time constraints (work, kids, etc.) on an owner to allow for it. The most important thing is to give the animal a good quality of life during the time he/she has left. A lot can be done to diminish the side effects and to manage the disease in either case. What should you be looking for? What are the red flags, so to speak, that might tell you to rush right out to the vet to have it tested? There aren’t any as a general rule. Symptoms that indicate cancer are the same symptoms that may indicate any number of illnesses (both serious and not so serious). Symptoms can be as varied as there are pets and can range from changes in eating habits, drinking more or less than usual, behavioral changes, etc. The rule of thumb, Dr. Heeb suggests, is to pay attention to what is “normal” for your pet. Changes that are unique to your individual pet are the best indications that there may be changes in your pet’s health. Some things to be particularly concerned about and should be checked out right away include blood in your pet’s urine or in the mouth.

Everyone knows that when men get to a “certain” age their doctor checks their PSA level to see if there is a possibility of prostate cancer; women begin getting mammograms in their 40’s (sometimes earlier) and go for yearly exams to check for ovarian and cervical cancer. Aren’t there tests vets can give to find certain cancers early? Actually, Dr. Heeb informed me, there are no “tumor specific antigen tests for animals.” However, she reminds me about the importance of annual physicals for our pets. “If an annual physical includes blood work, that can determine whether or not things are functioning properly”, Dr. Heeb explains. She further mentions that a once pets are around 8 or 9 years old, it’s a good idea to include a radiograph of the lungs. Your regular vet can do it and that is a good way to find lung tumors at an early stage. Since a blood work up and lung x-rays are not routine tests for a pet’s annual physical exam, you should consider discussing it with your vet and have them added. Remember, however, those tests involve additional costs, so when you discuss adding them with your vet, make sure to discuss the cost involved so there are no surprises.

Cancer treatment for your pet involves not only the choice to begin, but sometimes the choice to stop. I asked Dr. Heeb if there were times that the pet’s owner was insisting that treatment be continued even though her recommendation was to discontinue it (everything has been tried). She told me that it happens “occasionally, but usually people will eventually understand [the reality of the situation].” Heeb explains that as long as the animal can remain comfortable, she is willing to continue trying to treat the animal even if it is a long shot. If the treatment isn’t likely to do any good &/or the animal’s condition has deteriorated too much, she will stabilize the animal and make him/her as comfortable as possible. There is a point at which Dr. Heeb would tell the pet’s owner that she cannot, in good conscience, continue treatment.

How do people handle the diagnosis of cancer in their pet and knowing what the ultimate result of the disease will likely be? Some handle it better than others.

Dr. Heeb thinks it is beneficial to look into grief counseling…and to consider it during the illness, not necessarily to wait until your pet actually dies. She adds, “The feelings of grief are real. The benefit during the illness is that the counseling can help people deal with the feelings of powerlessness.” Although Vets are sympathetic to your feelings, they are not trained as grief counselors. Your “knee-jerk” reaction may be to look to them for help dealing with your feelings, but a psychologist or group that specializes in this area would be better for you.

As pet owners, what can we be doing differently? I may be a “pet parent” that takes their pets to the vet too often. Any time I notice anything out of the ordinary, I make an appointment. My rationale is to nip it in the bud, as they say. I’d rather hear that it’s nothing than find out something major could have been prevented. Dr. Heeb agrees that prevention is the best defense. Don’t ignore physical or behavioral changes in your pet. It may not require an emergency visit to your vet, but perhaps an appointment within a few days would be prudent. She also suggests that pet owners keep themselves informed from reliable sources. The Internet is a great resource, for example, but it isn’t all true or easily understood. If you see or hear something having to do with your pet’s health, ask the experts some questions about those things. Knowledge is one thing, but the truth is the only thing that is worth anything. It is that “real” information that will give you a “real” ability to get yourself mentally prepared for what’s coming.