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
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