When The Diagnosis Is Cancer
by Nancy Kay, DVM
A veterinarian’s advice for helping yourself—and your pet—face the future
Ask your veterinarian how urgently decisions must be made. An extra day or two can make a significant differencein terms of settling down emotionally and doing the research to deal with the decisions at hand.
Cancer, neoplasia, growth, tumor, malignancy, the big “C”: no matter which word is used, it is the diagnosis we all dread. It’s not that cancer is always associated with a terrible outcome. But whenever cancer is diagnosed, it is inevitable that lives are going to change. And change isn’t something we relish when it comes to our four-legged family
If your veterinarian suspects or knows that your pet has cancer, you will be asked to make several decisions. Some of them will have to do with diagnostic testing and others will pertain to treatment options. Such decisions can be tough in the best of times, and if you’ve just learned your dog or cat has cancer, the decisions can feel downright overwhelming. What can you do to gain some control over the situation?
Here are some suggestions:
Put away preconceived notions of what you imagine will be your pet’s experience. People often get sick, experience profound fatigue, or lose their hair in response to cancer therapy. This is uncommon for dogs and cats.
Read, “surf,” and ask lots of questions. The more you learn about your pet’s cancer, the more you will feel empowered to make good decisions on her behalf.
Take things one step at a time. Being asked to make decisions for your dog with cancer is akin to being asked to climb a tall mountain. It’s strategically and psychologically better to break your ascent into small manageable increments (and there’s less likelihood of tripping and falling when your eyes are not glued to the summit). Similarly, it is easier when you focus your attention on the medical decisions at hand rather than those that may (or may not) arise later.
Follow your own heart. Steer clear of folks intent on convincing you that he is “just a dog” or “just a cat,” and that the appropriate treatment is to “put the poor thing out of his misery.” Likewise, avoid those people who think that all animals must be treated aggressively for anything and everything. Wear a thick skin around such people or take a sabbatical from socializing with them. Surround yourself with people who are open-minded (including the veterinary staff) and interested in supporting you rather than influencing you. Remember, you know better than anyone else what is right for you and your best buddy.
Know your cancer therapy options. The three most common treatment methods used to treat feline and canine cancer are surgery, chemotherapy, and radiation therapy. Sometimes, only one type of treatment is needed to effectively treat cancer. For example, a small solitary mass
might be cured with surgery alone. It’s not uncommon, however, that a combination of treatments is most beneficial, and chemotherapy or radiation therapy may be used adjunctively to destroy any cancer cells that may have been left behind after surgery. Whether or not various complementary or alternative therapies such as Chinese herbs, homeopathy, or acupuncture are capable of chasing away cancer cells is controversial. Most people, veterinarians included, do agree that they help support the cancer patient’s overall health and mitigate the side effects of cancer treatments. How does your veterinarian know which treatment plan is the best choice for your cat or dog? First, she needs to know which type of cancer she is dealing with. Some are sensitive to radiation therapy or chemotherapy; others are resistant. In addition, the stage or grade of the disease (how advanced and aggressive the cancer is) allows your vet, or an oncologist or internist to whom you’ve been referred, to know which treatment makes the most sense. That’s the easy part. What’s not nearly so easy is determining whether such a treatment plan is reasonable for you and your dog or cat.
Is your pet’s personality well-suited to the recommended therapy? If your dog or cat is a pushover for anyone and everyone who gives him some loving and a treat, he may relish the opportunity for weekly chemotherapy visits. On the other hand, if he turns into a quivering quaking emotional wreck as soon as you turn into the vet clinic parking lot, perhaps he’d be better suited to a chemotherapy protocol that involves coming in less frequently. You may not really know how your dog or cat will respond emotionally until you’ve made your first few visits.
Here are some thoughts and questions to consider that will help guide your decision-making.
Is your own schedule flexible enough? Many chemotherapy protocols initially involve once-weekly visits. Rarely are evening or weekend appointments available. If radiation therapy is recommended, you may need to drive a considerable distance to a treatment facility. Radiation therapy is typically administered each weekday for three or more consecutive weeks.
Is it financially feasible to proceed? Combination chemotherapy protocols, radiation therapy, and many surgical procedures are “bigticket” items. Remember, some chemotherapy is almost always better than no chemotherapy. If your budget is limited, your veterinarian will be able to create a protocol that provides “the most bang for the buck.”
Is it emotionally reasonable for you to treat your pet’s cancer? For someone who has just experienced the ravages of cancer therapy either for herself or a loved one, it may simply be impossible to consider such treatment for her dog or cat (no matter what kinds of reassurances are provided). And that’s perfectly okay. Remember, whether or not to treat your pet’s cancer is a highly personal decision.
You can call it quits at any time! When you say yes to chemotherapy or radiation therapy, you’re only committing to the next treatment. If you don’t like what you see, you can call it a day. Sometimes, simply knowing that this out-clause exists gives people the wherewithal to give cancer therapy a try.
Focus on the quality rather than the quantity of life. When I counsel people about the potential pros and cons of treatment, I describe the three goals of cancer therapy as “quality of life, quality of life, and quality of life.” There’s no doubt in my mind that we have failed our patient enormously when we achieve quantity (longer life) only.
Enjoy the honeymoon. If your best little buddy is doing fabulously well, it may be tough for you to enjoy his company when your mind is preoccupied with sadness and worry about the fact that he has cancer. Your happy, playful, loving cat or dog doesn’t vanish just because cancer cells live in his body. He doesn’t know he has cancer; he gets off easy when it comes to enjoying life and staying in the moment. If he is acting glum, he may be responding to the way his favorite human is feeling!
Dr. Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine.
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award