Using technology to improve radiation treatment for animals

     As a radiation oncologist one of the tumors that I have disliked treating the most are nasal tumors in dogs.  Nasal tumors usually fill up one or both sides of the entire nasal cavity and sinuses.  In a dog’s head this means that the tumor is basically wrapping around the eyes and the brain and the tumor sits right above the mouth.  So when we treat these patients we usually have to include a great deal of the mouth the eyes and the brain.  In some dogs, treating these areas causes severe short-term side effects, and animals are usually very painful during and for a few weeks after radiation.  We have much better pain medications so it is possible to get these patients through their treatment, but for many pet owners and their animals treating a nasal tumor is a difficult decision and I feel that a lot of dogs were not treated because of these side effects. 

     With the advent of newer radiation technologies this has changed.  Intensity Modulated Radiation Therapy (IMRT) is a newer radiation technique that is becoming available to treat difficult tumors like nasal tumors.   With IMRT the patient is positioned in a positioning device so that their head is very still, and a CT scan is done not only to identify exactly where the tumor is, but also this CT scan is used by a three-dimensional treatment planning computer.  Radiation beams are aimed at the tumor from a number of different directions so that the radiation can approach from all sides. Then the radiation oncologist tells the computer what dose they want to give to the tumor as well as the maximum dose they want to give to the important normal tissues.  Then the computer figures out how to accomplish this.  For each field, small leaves up in the head of the radiation machine are used to deliver different doses of radiation to different parts of the field.  For example, if one of the fields is pointed at the tumor and the brain, the field might give little or no radiation to the brain while at the same time giving a high dose to the tumor.

     For dogs with nasal tumors this means that the radiation can be directed to the tumor and the dose to the normal tissues is minimal.  Dogs that are being treated with IMRT usually have small areas of redness and irritation in their mouths, but most of their mouths, eyes etc. have little to no significant side effects.  This means dogs are much more comfortable going through treatment, but also it most likely will decrease the number of permanent side effects, making radiation much safer.

 

 

Dr. John Farrelly

Sometimes the “where” matters.

When scientists write about themselves, others or our profession, the topics are often about the “whats”. What we do, what topics or areas of interest do we have, or what we produce in terms of research. However, sometimes, the “where” is the most important question.

 I recently had the fortune to travel to Tanzania to witness the Great Migration of wildebeest and other grazing herbivores across the Serengeti. It is truly one of the greatest spectacles in the natural world, being the largest land mammal migration on Earth. There are over one-and-a-half million wildebeest, about 200,000 zebra and 500,000 Thomson's gazelle in the herd.

 Millions of wild animals surrounded me and it was not only a visual spectacle but an auditory one as well. As I closed my eyes, I heard thousands upon thousands of baby wildebeest and zebra calling to their mothers and an equal number of mothers returning the call. The sound was almost deafening.

 This experience took me outside of my day-to-day life and myself. I am one of the lucky few that loves their job and truly, I have never worked a day in my life. Nevertheless, to experience the Great Migration, not just see it on television, but to truly be there, was a life affirming and life changing experience.

 
The most important words I have ever read about this wonderful phenomenon did not come from Science, Nature or for that matter any other respected scientific journal. The words that matter most, were written on an old T-shirt that our driver wore—“The Serengeti Shall Never Die”.

Dr. Gerald Post

“What does a Clinical Trial Coordinator do?”

While this blog may not be the most exciting, there are many more exciting blogs to come about clinical trials, our clinical trial patient success stories and interesting things happening in the comparative oncology arena! Comparative oncology?? If that’s what you’re thinking right now…. Here’s a fun homework assignment: search the internet (or Google “Dr. Gerald Post”)and then leave a comment on what you understood it to be. Anyone that comments regarding “comparative oncology” will receive a free gift from The VCC!  If that’s too much work and you hate free gifts, you can be in suspense until a future blog when I discuss it! J

Back to the “What does a Clinical Trial Coordinator do?” question. Who knows? Maybe someone out there will decide this is what they want to do! My job is to manage our clinical trials from start to finish. This process begins with informing our area veterinarians that a new trial is open and which types of cancers and patients are eligible (mailings, faxes, emails and calls). Once that happens, calls and emails come in from around the country (even Mexico!) to inquire about pet eligibility. 

Working closely with the doctors at The VCC, we determine which patients might benefit from the study and we begin a screening and enrollment process. If a patient passes all screening tests, they are officially enrolled. Many studies even pay for those screening tests to be done on the patient. Once a patient is enrolled, it is my job to oversee all of the study drug administrations, accurate documentation (very important when a drug is trying to get approved), side effects, lab work, ensuring that the protocol is strictly followed, close communications with ACI (Animal Clinical Investigations), VCC oncologists, and the pet owner. 

Each individual patient is monitored closely and if necessary, for the well-being of the patient, he/she may be withdrawn by our oncologist, by the study sponsor or by the owner at any time. While we are all serious about the data that we gather from the trials, our first priority is always the health and well-being of each patient. We will never compromise on what is best for our patients, so no need to worry about these beloved pets being “guinea pigs” or “lab rats”! We treat each patient as if it was our own family member and that never changes – clinical trial or not! There you have it. 

That’s the broad overview of what a Clinical Trial Coordinator at The VCC does. The truth is, it’s so much more and I hope you’re starting to catch a glimpse of why I love my job! As an example, my next blog will highlight a clinical trial patient from a few years ago. Even after Kobi passed away, his family was very excited to write a “Success Story” about his journey through a clinical trial. Check back soon for that story!

 

Maria Salas

Radiation Side Effects

In a previous blog I mentioned how we use technology to minimize side effects to our pets when treating them with radiation.  However, there are many situations where we cannot or do not want to completely avoid normal tissues.  Almost all tumors have microscopic cells that extend into the surrounding normal tissues.  We often use the analogy of an octopus to describe a cancerous tumor.  The body of the octopus is the part of the tumor that we can see either with our eyes, or by some imaging (such as ultrasound, CT scan, MRI etc.).  If we just needed to treat this cancer would be easy to cure with surgery.  The cancer cells that extend into the normal tissue, like the arms of an octopus, often cannot be removed with surgery and these are often what we are treating with radiation or chemotherapy.  When we treat these cells we usually have to treat the normal tissues that they are invading into and this results in side effects in the normal tissues.

Radiation side effects in animals can be severe in some cases, but we are able to manage them, to get pets through treatment.  They usually start around the middle of a course of radiation, but they can get worse for up to a week after treatment is finished.  When the skin, the lining of the mouth, the eye or the colon is treated these side effects usually include redness and irritation of the area.  This looks a lot like a sunburn.  It starts as mild redness and itch, but usually gets worse until the area is very red and/or ulcerated.  When this happens pets usually need pain medications, anti-inflammatories and antibiotics to help keep the animal comfortable.  Fortunately we have many more pain options available for dogs and cats to help get them through this time.  The area is usually itchy so it is also very important that animals not be allowed to lick or chew at the area, so sometimes they need to wear a cone type collar to prevent this.

Fortunately for cats the short-term side effects are usually much less severe than in people or dogs.  Most cats who are treated with radiation usually just get dry, flaky skin or mild redness in the radiation area and they usually are not very painful.

Long-term side effects from radiation usually do not cause problems, things such as changes in hair coat color or thin skin.  Fortunately dangerous long-term side effects, such as bone destruction or radiation induced tumors, are typically very rare and can take many years to develop.

Although side effects from radiation can cause significant pain and discomfort, the radiation protocols that we use to treat animals are designed to try to minimize these effects so that we can get pets through treatment with as little discomfort as possible.

 

 

Dr. John Farrelly

New Technology for diagnosing and treating cancer in our pets.

We see technological advances around us every day.  Things that we couldn’t even imagine ten years ago are happening every day.  I am going to reveal my age here, but when I first started working with computers the text was green on a black background and graphics were cursor-sized boxes.  Today you might be looking at this blog on a smartphone while walking through the park.  Hopefully we use these changes in technology to make our lives better. 

 When it comes to caring for our pets the same is true and it is making a huge difference in the care that is available to our pets.  Today Computed Tomography or CT and MRI are available in many different centers.  PET scans (Positron Emission Tomography) These tools allow us to get an incredibly detailed look inside the body to identify diseases.  When it comes to cancer this is crucial to help diagnose tumors and to identify exactly where the tumor is in relation to the normal tissues.

However, this technology is not just useful for diagnosis.  New advances in technology are changing the ways that we have available to treat tumors.  There are approximately 70 centers in the world that have radiation therapy capabilities for treating animals.  Most of these facilities have linear accelerators for treating cancer, which allow us to focus radiation to the tumor, while avoiding the normal tissues.  Some of these facilities have a technology called intensity modulated radiation therapy (IMRT) or stereotactic radiation.  These techniques, used with advanced imaging techniques, allow us to truly pinpoint the radiation to the tumor, and minimize the dose of radiation to any normal tissues in the area.  By doing this we are able to effectively treat our pets with cancer, while making sure not to damage their normal tissues…helping us achieve our goal of effectively treating cancer, while keeping our pet’s quality of life as normal as possible.

 

I look forward to seeing what the next ten years brings to allow us to provide the best care possible for our pets.

Dr. John Farrelly

“Sammy-a simple story”

Sammy is a 9 year old Golden Retriever whose story is so simple yet so revealing that I needed to share it with you.

 

Sammy had no prior medical problems before being brought into the emergency service of one of our partner hospitals for a severely swollen left rear leg. On the initial examination, the leg was swollen from the tip of the toes all the way up to the hip. The swelling was among the most severe cases I had ever seen.  There was no history of trauma, no chance the dog was hit by a car, motorcycle or even bicycle.

 

Physical examination revealed no evidence of a fracture, insect bite, snake bite or anything else—just severe, severe swelling.

 

Unfortunately, as in many cases these days, finances were a big concern for the owner and she was considering having Sammy humanely euthanized. Our criticalist decided to try and convince her to see if –by chance—one fine needle aspirate of this swelling would give us the information we needed in order to save Sammy. Luckily the owner said “yes.” After checking the entire leg, a small area that was very slightly firmer than the rest of the leg was found. A fine needle aspirate was performed.

 

The aspirate revealed mast cells on cytology. The owner was devastated to learn that here beloved dog had cancer and again, she was considering euthanasia. But yet again, luck smiled on this very special dog. I convinced her to try one week of prednisone-before she made that final decision. By the following week, Sammy was a new dog. The swelling in his left rear leg had completely resolved—except for an area the size of a quarter right near his knee (stifle).

 

Because Sammy was now doing well, enjoying life and the massive swelling had changed to a small mass, the owner elected to have the mass removed. A “Trifecta”—the mass was found to be a low-grade mast cell tumor and our surgeon was able to get a complete excision. Sammy was cured.

 

This was not the most complex case, nor was it a case that required combination therapy or a new or novel therapy. What this case represents, is the value of a good physical exam, the value of honest heart-felt communications, and the value of hope (along with a little bit of luck).

 

Every time we see Sammy—we are so thrilled that his mom said yes.

 

 

Dr. Gerald Post - 2013

The Veterinary Cancer Center

Study Shows that Lymphoma in Dogs and Humans is Almost Identical

 

Comparative oncologists have been investigating the links between canine

and human cancers to develop effective treatments for both.  They believe dogs with spontaneously occurring cancers are especially relevant models for human cancers because dogs and people share the same water, breathe the same air, and in some households eat the same food. One of the most common subtypes of cancer, lymphoma, appears to be identical in both dogs and people.

In a recent wonderful study article published in Cancer Research (http://cancerres.aacrjournals.org/content/early/2013/06/19/0008-5472.CAN-12-3546.abstract), veterinary oncologists and researchers from North Carolina State University College of Veterinary Medicine, University of North Carolina, and Duke University show that diffuse large B-cell lymphoma is molecularly almost identical in dogs and people.

This NC State study is the first that uses molecular analysis by gene expression profiling (determining which genes are over or under expressed) and immunohistochemistry (staining a biopsy sample to determine the specific cell type) to compare canine lymphoma with human lymphoma. 

This study is very important as it clearly demonstrates the similarity between lymphoma in dogs and people. Because of this similarity—from what the cells look like under a microscope, to the expression pattern of the genes in the tumor—scientists can use lymphoma in dogs as a model to develop treatment for human lymphoma.

Animal Cancer Foundation Executive Board President Dr. David Levine applauds this study as “an incredibly important step in the development of a more representative animal model for diffuse large B-cell lymphoma in people. ACF believes that through the support of comparative oncology studies such as this, we will make significant strides in our work to better diagnose, treat and prevent cancer in both pets and people.”

 

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

Kobi's story

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

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”.

 

 David Duchemin

Chief Operating Officer, and Practice Co-Owner of

The Veterinary Cancer Center

Co-Founder, and Treasurer of

The Riedel & Cody Fund

 

 

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

“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.

 

Maria Salas, Clinical Trials Coordinator

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

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.

 

Ryan Shepherd

 

Life Lessons

Most of my inspiration for writing these blogs comes from the patients we treat here.  I am always so amazed by them…how they handle coming in week after week, being treated and not having a clue why they are here, dealing with the side effects that come with some of the these treatments, but always happy, wagging their tails or purring, as if nothing is wrong.   They are true examples of what being brave means.   We can learn a lot from their outlook on life and the how they deal with their diagnosis.   Their hopeful and positive spirit is contagious, and gives their owners and others around them hope that all animals can be cured of this awful disease.

One example of this is when I met Tria; a 9 year old Belgian Sheep dog, who has been in remission for 3 years with B-cell Lymphoma.  She is an adorable dog with the sweetest disposition. What struck me the most during her recent visit was the interaction between her mom and a new client that was in the waiting room.  When she heard my conversation with Tria’s mom about her remission, the woman was so happy to hear that.  By seeing Tria, she knew she was doing the right thing for her dog and was reassured that there is hope.   Tria is a true example of what we are working so hard to achieve with each and every patient that we treat. 

Her success, I believe, is partly due to her lack of knowledge about her disease and living solely to bring joy to others.  Most of our pets have an “ignorance is bliss” life.  Which leads me to believe this is why they tend to cope with their diagnosis and treatment so well.  They have wonderful owners who have brought them here to try to cure them or, at the very least, give them a better quality of life as they are affected by cancer.   They are greeted (with lots of cookies and kisses), loved, and cared for every moment of their visit here with us.   And get to go back home to be pampered and spoiled again.   I feel that as humans, when we know too much, we put a tremendous amount of stress on ourselves.  I believe, that stress hinders our healing process and how our body fights disease.  We are too busy worrying about everything rather than enjoying the life we have.  Luckily, our pets have that luxury and we can learn from them.   I am so lucky to be able to in their circle and hopefully, learn something along the way, myself.

 

TaraMcNama, LVT

The most terrible things about life

I grew up with two golden retrievers, Luke and Rusty.  There was nothing better than seeing their expression of bliss when I got home from school, seeing the satisfaction they received from bringing me back a tennis ball, or the comfort they brought me when I was feeling down.  I thought of them the day I met Ginger.

Ginger’s family learned this year that osteosarcoma is the most common primary bone tumor of large breed dogs, often occurring in the metaphysis of the long bones.  Unfortunately, most owners of a dog diagnosed with this cancer are confronted with a decision of whether to amputate a limb or to help the dog maintain its quality of life as long as possible while living with this painful bone lesion.  The outcome of this decision varies and is dependent on several factors.   When it comes to making sure you are making the right decision for that loyal companion, you want to be sure that you have all of the information you need to make it.

Several people have told me that I must have been temporarily insane when I chose to become an oncologist.  Cancer and chemotherapy are not words that people look forward to hearing and chemotherapy is certainly not something they look forward to giving to their pets.  I have even been told by my clients “I hope I never see you again, Dr. Linderman” and I tell them “The feeling is mutual.”

This aspect of the job is quite challenging, but the results make it worth coming to work every day.  It is not always the right decision to perform a radical procedure, such as an amputation, or to recommend a course of chemotherapy; but, for the right patients, it is a life saving decision.  The video attached to this blog was taken 6 months after Ginger’s amputation.  Like most dogs after surgery, she had no side effects while going through her course of chemotherapy.  No evidence of recurrent disease was seen on the work-up that day and we are looking forward to seeing her beautiful face again in 3 months for another quick check up.

 I once watched a documentary about the artist Bruce Bickford and learned that there are two terrible things about life:  1. “it is so terrible” and 2. “it is so short!”  While cancer is one of the most terrible events that life has to throw at us, we do not have to give up.  There have been many incredible advances in veterinary cancer care.  With a little sacrifice in the right places, we can find hope and continue to give back to our pets the same devotion they show us.

Dr. Michael J. Linderman


"Ginger just a few week after her surgery"

"A hug can be a very powerful thing"

I would like to remember a very special patient in this month's blog.

I can still remember getting ready to walk into the exam room to meet Pebbles for the first time. I was all caught up on her previous medical history and was fully prepared to discuss her recent diagnosis of Lymphoma and to make a treatment plan with her owner. What I was not prepared for was the amazing greeting that I would receive upon entering the room. I walked into the room and exchanged a very pleasant greeting with Pebbles' mom who I would grow to be good friends with but this was not the amazing greeting that I am referring to. The AMAZING greeting was yet to come.

 

I looked at Pebbles for the first time and she looked up at me with warm, loving eyes that asked me to bend down without ever saying the words. I knelt down to say hello to Pebbles and she offered me one front paw and then the second and then leaned forward to hug me.

Well, that was the most amazing greeting I have ever received. I was extremely blessed to receive such a greeting from Pebbles at every one of her visits with me. I would look forward to her hugs and to the joyful spirit that she had at each visit that seemed to be contagious when you were around her. She was a living example of both joy and comfort as she brought both feelings to all those she came into contact with. I would often tell Pebbles' mom that I wasn't quite sure that Pebbles was really a dog as she had such perception of human emotions and seemed to constantly speak to you with her eyes. Pebbles enjoyed an excellent quality of life and truly understood how to live in the moment. I learned so much from her and I will forever be a better person for having known this very special dog.  I know Pebbles’ mom feels the same way and she wrote the below in honor and memory of her sweet girl.

Gina Olmsted, DVM

Remembering Pebbles-Authored by her human mother

We all believe our dogs are special, and each one is in his or her own way. But I know Pebbles was a gift from God. I walked into a shelter almost 10 years ago, saw this beautiful dog right away, and said, "tell me about that dog." The staff raved about her, how sweet she was, how obedient, how calm, but most of all, how loving she was. They loved her and there were tears when she came home with me. I waited three weeks while she was treated for mange. I visited her every day, and ignored the "don't touch her” advice, putting my hand through the bars of her kennel door. She would put her head right in my hand.

I have dreamed about Pebbles twice that I remember. The first time she was running away from me across a huge field alive with butterflies, flowers and trees, a brook, puffy white clouds in the sky. I called and called her, but she would not come to me. I went home, crying all the way and woke up crying. Then I realized she was running across the Rainbow Bridge and that no matter how long I called for her, she was now in a different world, and she was happy and excited. When she first died, I would shout at her picture, "I want you to come home!" The dream was the answer to my cries. The next time I dreamed about her she was no longer a black dog; her fur was all white. I knew she was an angel-dog now. She was an angel in life, too. She was a Therapy dog and we visited Griffin Hospital in Derby for several years. Patients loved her; Doctors and nurses got down on their knees to greet her and she knew where the snacks were kept for her. She was everybody's favorite.

She sat up on her haunches to greet you and first gave you one paw, then crossed her paws and gave you two, or put her paws out to hug you... She was a happy, loving dog who never withheld her affection and trust. I wish I could be more like her. Even when she started being treated for Lymphoma, she bounced gaily through the front door... but then I had to walk with her down the hall to get her into the treatment area. She did not want to leave me in the waiting room. She was blessed with the most wonderful care-givers any patient, human or canine could ever have. I will always be so grateful for the love they gave her. And the extra time they gave us.

When she died I received dozens of cards and tributes, and a wonderful blanket with her picture on it that I cuddle up with in the evenings. It makes me feel close to her. One of my friends wrote, "the world is a lesser place without Pebbles." This says it all. I love you, Pebbles, and miss you with all my heart.