Hours of Operation
Our Oncologists are here to help your pet Monday-Friday 8 a.m. – 6 p.m. We also have drop-off appointments available for your convenience. Pets may be dropped-off for recheck appointments or chemo/radiation treatment as early as 7:15 a.m. and picked up as late at 6:00 p.m. If you would like to complete the patient information prior to your appointment, please download and complete the appropriate form(s) from our Forms page. Please contact our office at 713.693.1155 for further details, or to schedule an appointment.
What is Cancer?
Cancer is the uncontrolled growth of cells on or within the body. They are either localized to one part of the body as a visible mass (tumor) or spread throughout (metastasis). Cancer is common in pet animals such as dogs and cats and its prevalence increases with age. Dogs get cancer at roughly the same rate as humans, while cats tend to get fewer cancers. Cancer is the number one disease-related cause of death in dogs and cats. Since the cause of cancer is not known, prevention is difficult. The exception, mammary cancer, also known as breast cancer, is largely preventable with early spaying.
Three Rules For Managing The Cancer Patient
Rule 1: Get a Diagnosis
Biopsy, Biopsy, Biopsy. A veterinarian can never give an accurate assessment (prognosis) or develop an appropriate treatment plan for the tumor-bearing pet without a complete diagnosis. Knowing the histologic type of tumor gives the veterinarian a sense of the natural behavior of the tumor (how it will grow, where it will go).
Rule 2: Evaluate the entire patient history
Remember, there is a pet attached to the tumor. Many times we forget the BIG PICTURE. A thorough evaluation of the pet includes obtaining appropriate laboratory information (blood counts, blood chemistry, urinalysis) and survey radiographic images of the thorax, abdomen, and the tumor site. Additional information may be required depending upon the known natural behavior of the tumor (remember that biopsy you took in Rule 1 – it’s extremely important).
These tests may include a bone marrow aspirate, electrophoresis of serum or urine, buffy coat smears, more biopsies, ultrasound of a body area, nuclear imaging, serology, virology, or many other procedures. A thorough knowledge of the entire patient is necessary BEFORE an appropriate therapeutic plan can be presented. The goal is to identify or rule out the presence of concurrent illnesses and tumor metastases to regional lymph nodes or other body tissues (lungs, liver, skin, bone, for example). This information is essential not only for treatment planning but also to determine treatment success or failure.
Rule 3: Develop an appropriate treatment plan
Determine your goal. Is cure possible or should more emphasis be placed on quality of life (or can both be achieved)? In general, there are 3 choices facing every family with a tumor-bearing pet:
- Choice 1: What Is Best For The Cancer?
In today’s world there are basically 2 ways to treat cancer, remove the tumor (with surgery and getting cancer-free edges all around the tumor) or destroy the tumor’s ability to grow (using radiation, chemotherapy, or both; maybe in combination with surgery). There are a number of other innovative strategies under development such as immune stimulants, nutriceuticals, and tumor vessel growth inhibitors, but their true ability to control cancer is not yet known or proven (nor the best way to use them in managing cancer patients – in humans or animals). Veterinarians cure a large majority of cancers with surgery. Those that cannot be completely removed and have not yet spread to other body sites can be cured with additional measures (radiation, chemotherapy, etc) no differently than in people. Common concerns are about “how will my pet look without a leg, a lower jaw, a rib?” or “how much is radiation therapy, and what are the side effects?”. Every pet owner whose loved one with cancer faces these and other questions. There are no easy answers. However, if the objective of the planned treatment is to attempt a cure of the cancer, surgery with or without radiation has to be strongly considered. Talk to a Veterinary Oncologist!
- Choice 2: What Is Best For The Pet?
Remember, for most families, quality of life for their pet is more important than the pet’s remaining quantity of life. Remember, cancer is “uncontrolled growth”. If the abnormal growth cannot be removed from the body or controlled with localized radiation therapy, it is entirely appropriate the use medications (anticancer drugs, nutritional supplements, pain control medications, anti-cough or anti-nausea medications, and many others) to maximize the quality of life of the cancer-bearing pet. To “control” the “uncontrolled growth” of cancer, anticancer drugs (chemotherapy) are used. The goal of chemotherapy is not to cure the cancer but to slow down the growing phase of the cancer. Yes, many cancer cells are killed with chemotherapy and tumor shrinkage can be observed; however, it is impractical for most situations to expect that every cancer cell will be killed by any chemotherapy protocol or strategy. With chemotherapy, the more drugs that are used, the more often they are given, the more cancer cells that are killed. Therefore, to significantly decrease the burden of cancer and increase the lifespan of the pet, combination chemotherapy protocols that prescribe drugs every 2, 3, or 4 weeks throughout the remaining lifespan of the pet should prolong the pet’s survival. Obviously, most chemotherapy drugs do not know a normal cell from a cancer cell, thus, more drugs given more often results in the possibility of more side effects. If the goal is to provide more quality of life than quantity of life, a fewer number of drugs at lesser doses given less often will still slow down cancer just not as much!
- Choice 3: What Is Best For The Family?
It is entirely appropriate not to treat cancer in pets. In fact, in some situations, we should not recommend cancer therapy. However, just because we are not controlling the cancer does not mean we cannot provide the pet a comfortable life. When this cannot be accomplished, we should strongly urge pet owners to consider the choice of euthanasia. It is important to have a support group during this process. Please rely upon the good advice of family and friends during this difficult time. In addition, there are many pet owners who are willing to share their positive and negative experiences. It is essential to provide adequate nutritional support, pain control, and other measures that ensure the pet’s good quality of life. Quality of life is very subjective. Everyone has an opinion. Ask for opinions and listen to them!!!! Then make your best choice. Hindsight is 20:20 but if you follow the above rules – get a diagnosis and evaluate the whole patient – then you should have plenty of information to make the best choice available at that time. We hope this information provides some insights towards our approach in managing the veterinary cancer patient. Always consult with a Board Certified Veterinary Oncologist. Use a team approach and allow your pet owners to participate in the team. Cancer is a battle that can be won – engage into the fight, but realize when it is time to retreat.
- Choice 1: What Is Best For The Cancer?
Supportive Care and Rehabilitation
The complications of cancer and chemotherapy are often the difficult for owners. When treating a veterinary cancer patient, the clinician needs to clearly communicate treatment goals with owners. If a pet seems to worsen with treatment, owners may be reluctant to continue. Because anorexia, nausea, vomiting and diarrhea are obvious outward signs, they may be more disturbing than neutropenia, hypercalcemia, lymphadenopathy or other complications. These signs may also be due to the tumor itself, and distinguishing what is caused by the treatment and what is cause by the disease may be difficult. It is for these reasons that supportive care should be timely and aggressive.
Long-term complications are described as chronic or lingering problems after the cessation of therapy, while problems that appear much later are considered “delayed”. Delayed problems can occur months, even years after treatment. While long-term follow-up will not necessarily eliminate chronic or delayed effects of therapy, it can enable pet owners to make more informed decisions about issues affecting their pet’s quality of life. Risk awareness can encourage changes in behavior that promote the pet’s health (e.g., proper diet) and early detection of tumor recurrence (e.g., regular veterinary examinations), thus optimizing the chances for long-term survival.
System-specific and/or organ damage, failure, or premature aging due to chemotherapy, radiation therapy, biologic modifiers, surgery, or any combination of the above have been described. Some examples include:
- Cardiomyopathy, renal insufficiency, bladder damage, cataracts, muscle atrophy
- Compromised immune systems causing increased risk of infection (viral, bacterial or fungal) and possible increased risk of malignancy
- Damaged endocrine systems leading to thyroid dysfunction, hypothalamic-pituitary dysfunction, or reproductive problems
- Recurrence and second malignant neoplasms
- Increased risk associated with certain therapies (e.g., bladder cancer as a result of cyclophosphamide therapy)
Related problems associated with cancer therapy may include:
- Functional changes (e.g., incontinence, immobility due to weakness or orthopedic problems, orthodontic problems, lymphedema, sleep disturbances, pain syndromes, fatigue, mucosal dryness);
- Cosmetic changes (e.g., amputations, ostomies, skin and hair changes);
- Chronic illnesses (e.g., osteoporosis, arthritis, scleroderma, hypertension);
- Psychosocial effects related to physiologic morbidity (e.g., anxiety, mood changes, depressed behavior)
Cooperation is required between oncologists, primary care veterinarians and other veterinary care staff for continued follow-up appropriate to the pet’s cancer history. Once cancer therapy begins, emphasis on health promotion and wellness is necessary (e.g., nutritional and pain support). Furthermore, everyone involved in the care of the cancer-bearing pet should have a clear understanding regarding the role of cytotoxic agents, radiation therapy, or combinations of both on the incidence and type of long-term and late effect of the prescribed cancer treatment plan.
Medical oncology involves the diagnosis, and more specifically, the management of the treatment of cancer.
A medical oncologist has knowledge of all aspects regarding the treatment of cancer, including biological therapy, chemotherapy, radiation therapy, and surgery. It is the medical oncologist who determines the proper choice, dosage, and schedule of cancer treatment drugs to be given. Medical oncologists frequently combine chemotherapy with consultations from radiation therapists and veterinary surgeons to give each patient the best possible outcome.
The medical oncologist is usually the manager of care received by a cancer patient. Expertise in pain management, treatment of chemotherapy side effects, psychological care, and social needs all are considered by the medical oncologist. While a medical oncologist may have a special interest in a certain type of cancer or cancer therapies, he/she is also equipped with the skills to work with all forms of the disease and the therapies associated with in.
Gulf Coast Veterinary Oncology was the first veterinary radiation oncology practice in the Gulf Coast region. This practice is one of the few veterinary radiation oncology facilities in the United States with linear accelerator therapy capabilities.
A linear accelerator allows for precise radiation therapy fields, decreasing the amount of time necessary for the actual radiation treatment. In keeping with this commitment to provide quality cancer therapy, we also utilizes a radiation physicist and a cutting edge computer-based therapy planning unit. This ensures that the radiation therapy patient is appropriately treated and minimizes the amount of normal tissue affected by this form of therapy.