Q: Bridget is our 9-year-old German shorthaired pointer. She was just diagnosed with a tumor in her spleen called hemangiosarcoma.
Her spleen has been removed and she is currently doing well. Despite feeling they had removed the entire tumor, we have been told that there is no effective chemotherapy for this cancer and that she will probably only live about 6 months.
We are heartbroken and a little confused. What do you think we can expect and is there anything else we can do?
A: Hemangiosarcoma is a nasty, and all too common, tumor that usually develops in the spleen but can also first appear in the heart, liver, skin, etc.
Hemangiosarcoma accounts for approximately 80 percent of all tumors in dogs' spleens, making it the most common by far.
These are still overdiagnosed, however. Hemangiosarcoma only makes up 9 percent to 24 percent of all splenic masses. So it is very important to have the diagnosis confirmed with a biopsy.
I hate to be the bearer of bad news, but the survival times for hemangiosarcoma in the spleen are actually only about 3 months, not 6. And only 7 percent of these patients will make it one year.
Surgery is considered palliative versus curative because by the time the tumor is found, nearly all have already spread to distant sites. These metastases are usually microscopic and virtually undetectable in the early stages.
Here are some things to consider:
Yes, I've said it. Aside from a truly vulgar word, no other utterance can make people grimace quite like it.
Most of us have known someone on chemotherapy and we tend to assume these unpleasant experiences will apply to pets. Generally, however, chemotherapy is very well tolerated by cats and dogs. They do not typically experience the negative side effects that are so common in humans, such as hair loss, gastro-intestinal upset, bone marrow crises, etc.
I see dogs and cats at our oncology service come and go all day long wagging their tails and purring on the way in and out.
To say that chemotherapy is not effective with hemangiosarcoma is not entirely accurate.
“No, it does not cure them, but it does kill cancer cells and it does double their expected survival time,” said Dr. Kathryn Taylor, one of our board-certified oncologists.
Even though it does not predictably provide even an additional year, it maintains an excellent quality of life and it is well-tolerated. The average survival time with chemotherapy is 6-7 months.
The traditional therapy involves intravenous administration of a drug called doxorubricin.
According to Taylor, there is a new treatment called a metronomic approach that has been available for about a year. A low, continuous dose of chemotherapy is administered orally at home. The animals are evaluated at the hospital every three weeks during treatment to look for side effects.
The advantages are the convenience of in-home administration and lower dosages, which means less toxicity. Studies have indicated that this treatment is as effective as earlier modes.
Precautions are observed and this is not for everyone, such as pregnant or nursing women.
Homeopathic approaches such as nutritional supplements certainly have a place alongside medical treatment, especially in situations where traditional approaches offer only modest results.
Natural, however, does not necessarily mean harmless, so be sure all attending clinicians are aware of what's being given to minimize the chance of toxic interactions.
Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to firstname.lastname@example.org.