Friday, June 21, 2013

Palliative radiation therapy


One of the things that I have come to realize as a radiation oncologist is that palliative treatment is a large part of what we do for animals.  As a veterinarian who is trained to treat cancer, our tendency is usually to want to try to cure our patients.  For this we often recommend aggressive surgery, definitive radiation and/or chemotherapy to try to beat back our patient’s cancer as much as possible.  But when I looked back over the majority of patients that I treat I realized that about 65% of these patients were treated with palliative radiation.  By palliative radiation I mean using a small number of treatments with a large dose each time.  The goals of this type of treatment are to cause as little effects on the patient as possible with as little impact on their quality of life, while trying to either shrink or slow down their tumor or in many cases just providing pain control.  However, palliative radiation very rarely is enough to control the tumor for a significant period of time.  Many times owners elect this course of treatment because they just want to try to keep their pet comfortable and they do not want to go through the side effects that you can get with definitive treatments.  Some cannot afford to go through a definitive treatment course.  Definitive surgery, radiation and chemotherapy can be unaffordable for some pet owners. 

Palliative radiation can help decrease pain in dogs with bone tumors, or any tumor involving the bone.  If animals cannot eat because of a tumor in the mouth palliative radiation may make it possible for them to eat for a period of time.  Tumors that are ulcerated and bleeding will often dry up with palliative radiation.  When owners cannot afford a definitive course of treatment, palliative radiation may help slow down progression of their pets tumor.  What I have found in treating so many pets with palliative radiation is that many pet owners tell me that they are so happy that the treatment was able to keep their animal comfortable for a period of time, without a lot of side effects.  What this has made me realize is that palliative treatment for animals is just as important, if not more important than trying to cure tumors because in the long run, keeping our animals comfortable for as long as we can is the most important goal.

Dr. John Farrelly

Saturday, May 4, 2013

Kobi's story

http://www.animalci.com/wp-content/uploads/2009/05/kobi.png

As promised, I’d like to share with you the story of Kobi, a tri-colored Collie that participated in one of our clinical trials in 2009. There have been many more stories just like his since then. My decision to share Kobi instead of a more recent patient was not without thought. Several months after Kobi’s passing, the Masilamani family was asked to share their story for the ACI (Animal Clinical Investigations) website as a success story. They were generous with their time, honesty and emotions by writing this wonderful story that walks you through from the time of Kobi’s diagnosis all the way until the end. While it would be wonderful if the last paragraph of Kobi’s story read, “He was cured and will be with us for another 5 years!”. Unfortunately, we know that is not how most of these stories end. The GREAT NEWS is that, as you read this, you will see that Kobi’s story doesn’t actually end in sadness. In fact, Kobi’s story hasn’t ended! The clinical trial that he participated in will likely result in approval of a new cancer drug for use in dogs! His story is still up on the website for all to read and now you are getting to meet Kobi! The more you share his story or repost, the more his story gets to continue… In my next blog, you will meet Frida, an amazing dog with unbelievable owners that flew her from their home in Cancun, Mexico all the way to us in Connecticut to participate in a clinical trial. Frida’s story has unlikely (happy) ending to her clinical trial journey and the start of a new chapter in her life and you won’t want to miss it!

This is the Story of Kobi (as told by the Masilamani Family) http://www.animalci.com/for-pet-owners/success-stories

Kobi was a 3-year old, tri-colored collie I got from a rescue. He was our first family dog, and a wonderful addition to our family. He stayed true to the collie temperament and we had the most memorable 7 years with Kobi. A few days before Thanksgiving 2009, I had noticed a swelling on his mouth, and had taken him to get it checked out. After a week of antibiotics the swelling had not gone down, so the veterinarian ran a test. He soon informed me it was cancer. Kobi was diagnosed with a mast cell tumor, and was given 3 months to live. I did not have many options; it was either treatment in NY, which would cost thousands of dollars, or enjoy him for the next few months and provide him with a life of love and comfort. Although it was a hard decision, I chose not to seek medical treatment, knowing that any treatment would only prolong the inevitable. That Thanksgiving was a very difficult time, knowing he wouldn’t be with us the next year. That said, we were grateful for the time.

A week later I received a call from my vet, telling me about a clinical trial that was testing a new treatment for cancer for dogs. They were curious as to whether I would be willing to talk to the folks at the oncology and hematology center (The VCC) in Norwalk, to see if I would want to participate. As soon as I was off the phone with my vet, I called the office in Norwalk and set up an appointment to meet with their team of vets and staff. While I know that no cure for cancer has been found, I wanted to know if this trial would help to understand and treat this illness, and maybe someday help to eradicate cancer from the world.

After meeting with the folks at The VCC, I was happy to enroll Kobi into this trial. As much as Kobi was doing his part in the treatment, our family was also involved in documenting his progress through the series of treatments for the next 4 months. These four months were difficult for all of us, including some of Kobi’s reactions to the medication, but through the care provided by The VCC and love from everyone involved we kept on, knowing our experience would someday help toward the cure for cancer for dogs.

After the 4-month trial, Kobi’s cancer “burden” was greatly reduced, and I knew that this trial had extended Kobi’s life. For the next 18 months, Kobi lived a full and fun life; we cherished every moment we had with him. Sadly one weekend, it came to a sudden end. Just a day before, he was out in the backyard running around with me and my kids, and the next morning, he was all worn-out. He wouldn’t eat and just laid down breathing heavily. The next day I took him to the vet’s office and they did an x-ray on his stomach, which showed a large gray mass. Knowing his previous condition, the veterinarian was sure it was cancer. He gave me some medication to ease the pain that Kobi could be experiencing, and told me it was a matter of time before the end. That night, as Kobi lay on his favorite bed, each of us prayed with him and said our goodbyes. I pulled a sleeping bag next to him, and prepared to spend the night with him. I knew he was not going to make it through the night – his breathing got shallower as the night progressed, and around 2am I could not hear his breathing anymore. I reached over to him, resting my ear to his chest, and I knew he had passed on.

We had Kobi cremated, and a print of his paw taken in clay. My family and I are ever so grateful for the opportunity we were given through this clinical trial, and for giving us 18 more precious months with Kobi. Kobi is not with us any longer, but we know that through his life not only did he give us love, but a chance that someday other dogs may not have to go through what he did.

- The Masilamani family

Monday, April 1, 2013

The Influence of Dogs on Human Development


A recent archaeological dig found what is believed to be a dog’s head carbon dated over thirty-one thousand years ago. Whether our relationship with dogs goes back twelve thousand years or a hundred thousand years the fact remains that our relationship with “man’s best friend” goes back further than any other animal.

The debate about how dogs became domesticated is still widely debated. Most scientists and researchers believe that cave men would not have had the resources needed to breed wolves’ generation after generation culminating in today’s domesticated dog. These early humans would have been too busy hunting, gathering and would need to have pooled all of their resources just to survive.
The fact remains that there are very few animals that are both social hunters, carnivores, and hunt by the light of day. This combination of behaviors could have created a natural teamwork between man and wolf (the predecessor of domesticated dogs).

The domestication of the wolf likely fundamentally changed human life style by allowing us to be better hunters and thereby providing more food. This would enable the survival of more human offspring and helped to ensure our success as a species. There is also the theory that the domestication of the dog led to the creation of agriculture by helping early humans guard and protect their flocks as well as their crops. Some people even postulate that without dogs, man would still be hunter-gatherers and that civilization as we currently know it would not have been possible.
 
Recent studies by cognitive behaviorists showing that dogs are the only other species that responds to us pointing to an object – something that we take for granted with our dogs. These studies show that even highly intelligent species such as chimpanzees are not capable of understanding this type of gesture.  This does not imply that dogs are (arguably) smarter than most species, but it does show how uniquely suited they are for human companionship.
 
Dogs not only respond to finger pointing, but also are remarkably good at understanding our eye movements. Humans are one of the only species that have sclera (whites of the eye) that is visible. This is believed to be an adaptation to enhance human communication using nothing but our eyes. The dark coloration around most other animals’ eyes suggests an adaptation to camouflage gaze direction so that predators could not predict movements by watching their prey’s eye movements.
  
The truly fascinating aspect is that even though dogs do not use either of these two characteristics to communicate with each other, they have learned to watch for this type of input from people. Dogs are also very good at reading our emotions and body language, making them the undisputed winners of the title “man’s best friend”.
 
Chief Operating Officer, and Practice Co-Owner of

Co-Founder, and Treasurer of
 
 

Saturday, March 23, 2013

No one is immune.


President George W. and First Lady Laura Bush’s dog Barney, a twelve-year-old Scottish Terrier, died this week of lymphoma. Lymphoma is one of the most common diseases veterinary oncologists diagnose and treat in dogs and cats.  In many practices, almost 50% of the cancers treated are lymphoma. Canine lymphoma is virtually identical to non-Hodgkins lymphoma in people in terms of biological behavior, as well as molecular and genetic changes.  What we learn about better diagnostics and treatments in dogs that have lymphoma can help people and the new effective therapies yet to be discovered for lymphoma in people may help our pets.
Treatment for lymphoma typically involves chemotherapy, as lymphoma is really a systemic disease, a cancer of the lymphatic system. Many pet owners assume chemotherapy causes severe side-effects such as nausea, vomiting, loss of appetite and weight loss; however,  most pets treated with chemotherapy do not respond this way.   Veterinary oncologists working alongside pet owners have made a conscious decision to modify chemotherapy protocols to lessen and eliminate reactions, maximizing both quality of life as well as survival time.  Because pets live compressed lifespans, the veterinary professional and the owner consistently evaluate the quality of life of a pet to determine if continuing treatment is the best option.

The death of Barney from cancer reminds us that no dog, no cat, no person is immune from the reach of this devastating disease. Our hearts go out to President and Mrs. Bush, not because of who they are, but because they have lost a beloved member of their family, their pet, to cancer.
For more information about lymphoma in dogs, go to http://www.vcchope.com/resource-center/typesofcancer.

For more information about the similarities between human and pet cancers go to http://www.acfoundation.org.
 
Dr. Gerald Post

Saturday, March 9, 2013

“What is it again that you do exactly?”

Even my closest friends and family frequently ask me, “What is it again that you do exactly?”.. I am now a full-time Clinical Trial Coordinator at The Veterinary Cancer Center. As I mentioned in my previous blog, this job allows me to help patients receive cutting edge treatment (sometimes for free) while at the same time helping to further research for animals and humans with cancer!

 Before I can explain my role, I’ll need to give you a little background on where these clinical trials come from, for the most part. We work very closely with Animal Clinical Investigations (ACI), a veterinary CRO (Contract Research Organization) based in Washington, DC. They give us the opportunity to offer our clients some wonderful treatment options. According to ACI’s website, “As a pet owner, participating in a clinical trial provides you with an opportunity to help your pet when conventional treatment options are either not effective or not accessible. Your participation may provide immediate benefit for your pet and will provide more effective treatments in the future for other pets with serious diseases…” The VCC is proud to be an ACI-designated clinical trial partner “Center of Excellence” and I couldn’t be happier working with these two companies! Everyone wants to feel like they are truly “making a difference”. Fortunately for me, not a day goes by where I don’t whole-heartedly believe that the work we are doing through clinical trials is making a difference. We are making a difference in individual families and in the future of cancer prevention, diagnosis and treatment for animals and people. More to come about the specifics of day to day clinical trials at The VCC in my next blog… stay tuned.
 

Saturday, March 2, 2013

Animal Cancer Foundation and Melanoma


I recently returned from a Melanoma Tumor Board Meeting in Washington, DC and I do not remember being more excited by the outcome of a conference. There were close to 50 people in attendance ranging from medical oncologists to molecular biologists to geneticists to veterinary medical and radiation oncologists to pathologists-both veterinary and human. This group of people represented the “best of the best” in terms of melanoma researchers and clinicians.

This conference, supported by the Animal Cancer Foundation, will result in the publication of a “white paper” describing a consensus statement espousing the value of canine oral malignant melanomas as a model for certain types of melanomas in people. People from both sides of the “human and veterinary aisle” passionately and eloquently described the need for developing this model.

The organizers of this conference have done what no one has been able to do for 20 years—effectively guide such a diverse group of cancer researchers to reach a consensus statement.  They have truly allowed me to see a dream of mine move towards fruition. Since starting the Animal Cancer Foundation in 1999, I have hoped to galvanize the cancer community in this manner. It is such a wonderful feeling to be excited about the direction of cancer research.


Dr. Gerald Post

Saturday, February 23, 2013

Cancer…….What does that word mean to you?


Often times  when a person hears the word cancer you can see the immediate impact that word has on them, no matter what setting or context it is used in.  It is a scary word that carries a tremendous amount of weight with it. But I believe it means something different to everyone.  Webster’s defines the word cancer as a malignant tumor of potentially unlimited growth that expands locally by invasion and systemically by metastasis.  I don’t know about you but to me that means very little. 

In its simplest form and to some people cancer means sick, very sick, life threatening sickness.   To others cancer can mean a far different thing.  Maybe it means facing the biggest challenge of your life, maybe it means finding a newfound perspective on life, maybe it means growing a moustache every November to raise awareness for prostate and testicular cancer (which a number of men at The VCC were  doing and if you would like to check it out you can go to www.movember.com and search “The Burly Beards of VCC”), maybe it means fear, anxiety and distress. 

The meaning changes for everyone based on their own personal experiences with cancer.  And we all have had an experience with cancer.  Half of all men and one-third of all women in the US will develop cancer at some point during their lifetime. That means virtually all of us will be touched by the disease in some way, either personally, or through a friend, relative, coworker or neighbor.  The statistics for our furry friends are almost identical.  Fifty percent of dogs over the age of 10 develop cancer at some point in their life.  Put these together and it’s safe to say that you will have an experience with cancer at some point in your life. 

I mention these statistics not to be the bearer of bad news but to give you some perspective on the prevalence of cancer.  It is because of this that places like The Veterinary Cancer Center exist.  A place solely dedicated to the diagnosis and treatment of cancer in animals.  A place that helps its clients to understand that a diagnosis of cancer is not a death sentence.  A place that provides compassionate care, support and most importantly - hope.