Wednesday, April 3, 2013

Diagnosis Cancer: Now What?

By Michelle Spencer, Veterinary Technician

Cat researching optionsWelcome to our series on companion animal cancer. In this article, we address what normally happens after your pet has been diagnosed. In future articles, we will address the ins-and-outs of conventional treatments, alternative treatments and palliative care.

A diagnosis of cancer in your pet can be terrifying. But remember, you are not alone. Your veterinary team and New England Pet Hospice & Home Care are here to support you every step of the way.

Step One: Staging

Staging is the act of running a series of medical tests to obtain additional information.  Staging allows your veterinarian to see the extent of cancer spread throughout your pet’s body and to assess your pet’s ability to handle certain treatments.

 Three types of medical tests are typically run during the staging process:

Imaging: The mode of imaging chosen will depend upon the type and location of the cancer. It may include x-rays, an ultrasound, an MRI or a CT scan. Imaging  shows not only the Getting imagingspread of cancer, but also the integrity of internal organs. For instance, while an echocardiogram may not show spread of cancer to the heart, it may show an abnormality in the heart muscle, which may affect the your pet’s tolerance for treatment. In that case, special precautions may need to be taken or another treatment option chosen.

Blood Work/Urinalysis: Typically, a Complete Blood Count (“CBC”), Serum Chemistry and Urinalysis will be run. These tests are not used to diagnose cancer (except certain blood cancers) but provide information about the cancer’s behavior, any infection and how well your pet’s organs are functioning. For instance, while a pet’s liver may look healthy on an ultrasound, an abnormal blood test measuring liver function may reveal an issue.

Additional Cytology (cell investigation): Your veterinarian may need to look at additional cells under the microscope to get more information about your pet’s disease. This may involve a needle aspirate (a quick and simple procedure under local anesthesia), a biopsy or even surgery.

Step Two: Treatment Options

After gathering further information about your pet’s disease, your veterinarian will present you with treatment options.

Some cancers respond very well to conventional treatments, such as chemotherapy and/or radiation therapy, while others simply do not. Your veterinary medical oncologist and veterinary radiation oncologist are the best sources of information about treatment options, but always keep in mind:

1. The goal of cancer treatment in pets is to control or eradicate the cancer cells while preserving a good quality of life. Your veterinary oncologist relies on you to assess your pet’s daily quality of life at home and communicate that information often. Remember, quality of life is the driving force behind veterinary oncology, and you are your pet’s voice.
Getting treatment  
2. You and your pet are not trapped. Cancer treatment is fluid and there is room for assessment at each step in the road. If, for instance, you begin treatment and your pet experiences side effects, you, along with your veterinarian, may decide that you will no longer use that type of medicine or even that you no longer wish to proceed with that form of treatment. On the flip side, you may cautiously begin treatment and, after seeing a positive reaction, decide that it’s appropriate for your pet to continue or pursue more aggressive treatment.   Remember, you always have choices.

Making decisions about whether and what type of treatment to pursue can seem overwhelming.  In  the next issue of Wag & Purr, we will talk about how to make decisions in times of crisis and confusion that will feel right to you both in the moment and when you look back on them.

Michelle Spencer is a Veterinary Technician with New England Pet Hospice & Home Care.  Michelle has been a Veterinary Technician for 12 years, much of it devoted to the field of oncology, including more than five years at New England Veterinary Oncology Group as a Medical Oncology Technician, at Dana-Farber Cancer Institute as a Clinical Research Coordinator, and more than 5 years at Massachusetts Veterinary Referral Hospital as a Critical Care Technician. 

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