It has been three months since Cody's surgery. You would think that in three months I would have my act together and have Cody on an established anti-cancer regimen, but no....I'm still working the kinks out. And I don't even have all that personal family stuff like kids and a husband to deal with!! Personal life aside, it is hard to find enough time in the day to accomplish everything on one's to-do list.
I did have a phone consultation with Dr. Demian Dressler, the author of the Dog Cancer Survival Guide. I will share my notes with you from our conversation. First I would like to mention that one of the first comments Dr. Dressler made to me after he asked me if I had his book was "you've probably skimmed through some of it, but haven't actually read it yet, right?" Bingo! How does he know me so well? Then over the next hour and a half he basically proceded to give me the abridged version of the book. Well geesh, I could have just saved myself $300 bucks by reading the book! Not really. It was very worthwhile being able to speak directly with Dr. Dressler and ask him questions that related specifically to Cody. I would still recommend reading the book before setting up a consultation!
The gist of the conversation:
Get Cody on a home-made cooked cancer diet.
Minimize the amount of anti-oxidant supplements.
Supplement with omega 3 fatty acids only, do not add omega 6 fatty acids (they already get enough in the food).
Give Apocaps.
Give K-9 Immunity.
Give transfer factors.
Give probiotics and digestive enzymes.
Optional: give a trace mineral supplement (he recommended Beres Drops) and give modified citrus pectin.
The nitty-gritty: Diet
The Dog Cancer Survival Guide provides guide lines and a recipe for a home-cooked diet. There is a link to the diet on Dr. Dressler's blog: http://www.dogcancerblog.com/
The nitty-gritty: Anti-oxidants
You may have heard that taking antioxidants is good for you and your dog, right? Why? Well the theory is that antioxidants bind with free radicals preventing them from doing damage to cells in your body, thus causing cancer, heart disease, and general overall deterioration of the tissues of the body. All healthy people and pets should be taking antioxidants and enjoying the protective effects. People and dogs who are getting chemotherapy should not, in theory, take antioxidants. This is because when we give chemotherapeutic drugs we are creating free radicals in an effort to attack the cancer cells and kill them. Antioxidants theoretically block the action of the chemotherapy. Dr. Dressler has a good discussion on his blog (http://www.dogcancerblog.com/anti-oxidants-versus-pro-oxidants/) about antioxidants and pro-oxidants. In summary he says: " Thus, before true clinical cancer actually develops, you want antioxidant effects, not pro-oxidant ones, in general. In contrast, after cancer clinically develops, one could choose pro-oxidants as the anti-cancer weapon. " There is a lot of debate over this subject so Dr. Dressler's approach is to at least try to separate supplements that are pro-oxidant, such as Apocaps, from supplements that have an antioxidant effect (K-9 Immunity). Hopefully we can get the best of both worlds with this approach? I don't think we really know yet.
I had Cody on a very good quality supplement called Veterinary Immune Tabs by Ramaekers Nutrition (http://ramaekersnutrition.com/vitpro.html). Dr. Dressler was concerned about the oxidant, superoxide dismutase (SOD) and recommended I discontinue the supplement. For now I've stopped giving it, but I'm thinking the amount of SOD in this supplement is not very much and I may consider giving to Cody again. Especially if it works out economically.
To be continued with the nitty-gritty on Apocaps, K-9 Immunity, transfer factors, and omega 3s.
Sunday, November 20, 2011
Monday, October 31, 2011
Support Groups
Cancer...the big 'C'... it conjures up all kinds of emotions and seems these days we are all touched by this scary disease in some way. A family member, a friend, your dog, your friend's mom....I'm willing to bet the degrees of separation between you and cancer is 1 or 2, certainly not 6.
There are people working on the question of why. There are people working on the question of when. There are people working on the questions of what. There are people working on the question of how. How do you deal with the diagnosis, the treatment, the emotional fall out? Well, there are resources and with the good 'ol internet most are just a few clicks away.
Recently a blogger reached out to me and asked me to post something about cancer support groups. Here is his post:
There are people working on the question of why. There are people working on the question of when. There are people working on the questions of what. There are people working on the question of how. How do you deal with the diagnosis, the treatment, the emotional fall out? Well, there are resources and with the good 'ol internet most are just a few clicks away.
Recently a blogger reached out to me and asked me to post something about cancer support groups. Here is his post:
Support Groups Take Away the Loneliness
When you are facing difficult times, it helps to talk with people who understand what you are going through. Cancer, in particular, is a lonely road to travel that not everyone can relate to. Whether you are recently diagnosed or a survivor who has marked the 5-year milestone, support groups can help you travel this path and take away the feelings of isolation.
Tell someone you have cancer and they are sympathetic. They will tell you they’re sorry, they’ll say they’re praying for you. But they really don’t want to hear about how your bowel movements have been affected and how every stray hair now leaves you’re worried about the ones that remain.
Talk to another cancer patient, however, and you have someone who can relate and truly understand. They’ll share their experiences, assure you that what you’re going through is normal and help you find effective coping strategies. More than sympathy and prayers, you’ll get information that you can really use, and a friend who might even help you find some laughter in this difficult time.
The support groups can meet in person or they can be online. The method will depend on what works for you. Whether you are diagnosed with a common cancer such as breast cancer and chat online or going through a rare cancer like mesothelioma and meet in person, the therapeutic effect is the same: You won’t feel as alone anymore.
Support groups can also provide each other with valuable resources, referrals for doctors or tips on how to handle the debilitating exhaustion that sets in after treatments. Because these other people know exactly what you’re going through, they have a good idea of what you are looking for and can help you find it. They know which doctors have the best bedside manner and will share that information with you. They also know which clinics are using the most ground-breaking procedures for treatments and will guide you to that information, as well.
There is hope for anyone struggling with cancer. You don’t have to travel this road alone and you don’t have to isolate yourself to get away from the sympathetic glances that start to hurt as much as the diagnosis. As a survivor who lives in constant fear of a relapse, you can find comfort and relief in support groups. People in all stages of the process can find healing and help by sharing their stories and offering help to others. Find a support group today and get involved so you can say good-bye to the suffocating isolation.
Tell someone you have cancer and they are sympathetic. They will tell you they’re sorry, they’ll say they’re praying for you. But they really don’t want to hear about how your bowel movements have been affected and how every stray hair now leaves you’re worried about the ones that remain.
Talk to another cancer patient, however, and you have someone who can relate and truly understand. They’ll share their experiences, assure you that what you’re going through is normal and help you find effective coping strategies. More than sympathy and prayers, you’ll get information that you can really use, and a friend who might even help you find some laughter in this difficult time.
The support groups can meet in person or they can be online. The method will depend on what works for you. Whether you are diagnosed with a common cancer such as breast cancer and chat online or going through a rare cancer like mesothelioma and meet in person, the therapeutic effect is the same: You won’t feel as alone anymore.
Support groups can also provide each other with valuable resources, referrals for doctors or tips on how to handle the debilitating exhaustion that sets in after treatments. Because these other people know exactly what you’re going through, they have a good idea of what you are looking for and can help you find it. They know which doctors have the best bedside manner and will share that information with you. They also know which clinics are using the most ground-breaking procedures for treatments and will guide you to that information, as well.
There is hope for anyone struggling with cancer. You don’t have to travel this road alone and you don’t have to isolate yourself to get away from the sympathetic glances that start to hurt as much as the diagnosis. As a survivor who lives in constant fear of a relapse, you can find comfort and relief in support groups. People in all stages of the process can find healing and help by sharing their stories and offering help to others. Find a support group today and get involved so you can say good-bye to the suffocating isolation.
By: David Haas
Sunday, September 18, 2011
To Chemo or Not to Chemo
It has been about a month since Cody's surgery. He is doing well. The incision is healed and his hair is almost totally grown back in. No more evidence of grey in the muzzle! I'm not sure what I saw before.
I've slowly been gathering information about what types of things I can do to help prevent this cancer from coming back. I'm speaking to 3 veterinary oncologists and you might be able to guess how that is going! Three opinions!! Well not that differing actually. They all recommend metronomic chemotherapy. This web site has a very good explanation of the process and the theory behind metronomic therapy http://www.veterinarycancer.com/metronomic_chemotherapy.html
Basically it is low doses of chemotherapy given over an extended period of time. This therapy is thought to reduce the toxicity of the chemotherapeutic drug and also to inhibit angiogenesis. What the heck is angiogenesis??? Just like it sounds folks, production of new blood vessels. Cancer needs blood to grow. Shut down that pathway - no cancer. There's a great talk by William Li on angiogenesis: http://www.ted.com/talks/william_li.html. Check it out.
The recommended protocol for metronomic therapy is typically a non-steroidal anti-inflammatory (NSAID) plus a chemotherapeutic agent. Two of the three oncologists I've spoken to have recommended I keep Cody on Previcox (that is the NSAID I'm giving him for his arthritis) and add in Cytoxan (also known as cyclophosphamide). If a dog is not already on a NSAID the drug of choice is piroxicam which has been studied extensively for its benefits in treating transitional cell carcinomas in dogs. I am assuming (I haven't asked the oncologist yet) that they have found that all NSAIDs seem to have similar effects on cancer and that is why it doesn't make a difference which NSAID you use.
Now Cytoxan can be a little scary. The drug can cause a hemorrhagic sterile cystitis and/or bone marrow suppression. To prevent the cystitis you basically need to get your dog to drink a lot of water and urinate a lot. Not usually an issue with Labradors, thank goodness! To monitor for bone marrow suppression it is wise to have a CBC (complete blood count) performed every 1-2 weeks. Humans taking this drug are likely to lose their hair. This can happen in dogs, especially those that have continuous hair growth (Poodles).
I'm going to dig around a bit more and I'll let you know what I decide. I guess my biggest fear as a pet owner is that if I don't do the metronomic chemotherapy and the cancer comes back will I be kicking myself and wishing I'd done it. If the cancer doesn't come back well then I'll be singing the praises of all the holistic therapies I've chosen. If the cancer comes back even with doing all of the above well then I guess at that point you just have to let nature take its course.
I've slowly been gathering information about what types of things I can do to help prevent this cancer from coming back. I'm speaking to 3 veterinary oncologists and you might be able to guess how that is going! Three opinions!! Well not that differing actually. They all recommend metronomic chemotherapy. This web site has a very good explanation of the process and the theory behind metronomic therapy http://www.veterinarycancer.com/metronomic_chemotherapy.html
Basically it is low doses of chemotherapy given over an extended period of time. This therapy is thought to reduce the toxicity of the chemotherapeutic drug and also to inhibit angiogenesis. What the heck is angiogenesis??? Just like it sounds folks, production of new blood vessels. Cancer needs blood to grow. Shut down that pathway - no cancer. There's a great talk by William Li on angiogenesis: http://www.ted.com/talks/william_li.html. Check it out.
The recommended protocol for metronomic therapy is typically a non-steroidal anti-inflammatory (NSAID) plus a chemotherapeutic agent. Two of the three oncologists I've spoken to have recommended I keep Cody on Previcox (that is the NSAID I'm giving him for his arthritis) and add in Cytoxan (also known as cyclophosphamide). If a dog is not already on a NSAID the drug of choice is piroxicam which has been studied extensively for its benefits in treating transitional cell carcinomas in dogs. I am assuming (I haven't asked the oncologist yet) that they have found that all NSAIDs seem to have similar effects on cancer and that is why it doesn't make a difference which NSAID you use.
Now Cytoxan can be a little scary. The drug can cause a hemorrhagic sterile cystitis and/or bone marrow suppression. To prevent the cystitis you basically need to get your dog to drink a lot of water and urinate a lot. Not usually an issue with Labradors, thank goodness! To monitor for bone marrow suppression it is wise to have a CBC (complete blood count) performed every 1-2 weeks. Humans taking this drug are likely to lose their hair. This can happen in dogs, especially those that have continuous hair growth (Poodles).
I'm going to dig around a bit more and I'll let you know what I decide. I guess my biggest fear as a pet owner is that if I don't do the metronomic chemotherapy and the cancer comes back will I be kicking myself and wishing I'd done it. If the cancer doesn't come back well then I'll be singing the praises of all the holistic therapies I've chosen. If the cancer comes back even with doing all of the above well then I guess at that point you just have to let nature take its course.
Thursday, August 25, 2011
Identification of the alien in Cody's chest
Well folks, the alien is out and the results are in! It is the best news we could have hoped for...at least for cancer. It is a "well differentiated papillary bronchogenic pulmonary adenocarcinoma, grade I, excision complete". The terms "well differentiated," "papillary," "bronchogenic," and "pulmonary" are descriptive terms. Read as: a protruding tumor of mature cells of the lung that orginates from the bronchi. Adenocarcinoma is a cancer of an epithelium that originates in glandular tissue. Tumor grading is a system used to classify cancer cells in terms of how abnormal they look under a microscope and how quickly the tumor is likely to grow and spread. Grade I tumor cells look almost normal and are less likely to spread. A complete excision means that the entire tumor was removed and did not appear to extend beyond the margins of the tissue that was sent to the lab.
There was also no evidence of cancer in the lymph node that was removed and sent to the lab. Good.
Better news would have been something totally benign like a granuloma, or abscess. But at least we are dealing with a cancer that has a lower probability of having spread. The oncologists have told me that we should always expect there to be some microscopic cancer cells lingering and therefore they do recommend chemotherapy.
At this point I am holding off on chemotherapy. I feel fairly confident that we got all of the tumor and that if there are stray cells floating around that we can deal with them another way. I've decided to investigate alternative therapies.
How is the dog? Cody is great! Back to urinating and defecating normally. Happy and really started driving me crazy about 10 days post-op asking to play with his ball. His incision is healing well. We just got a new 3B cold laser at our practice, so I've been using it to treat the surgical scar. The photo is from 13 days post-op and day 1 of laser treatment.
The long scar is the incision where they went into the chest. The 2 smaller parallel scars is where the chest tube was located.
I also noted grey hairs in Cody's muzzle for the first time today. Coincidence? Or is the grey the body's response to the recent stress (both from the cancer itself and the surgery). Humm...
There was also no evidence of cancer in the lymph node that was removed and sent to the lab. Good.
Better news would have been something totally benign like a granuloma, or abscess. But at least we are dealing with a cancer that has a lower probability of having spread. The oncologists have told me that we should always expect there to be some microscopic cancer cells lingering and therefore they do recommend chemotherapy.
At this point I am holding off on chemotherapy. I feel fairly confident that we got all of the tumor and that if there are stray cells floating around that we can deal with them another way. I've decided to investigate alternative therapies.
How is the dog? Cody is great! Back to urinating and defecating normally. Happy and really started driving me crazy about 10 days post-op asking to play with his ball. His incision is healing well. We just got a new 3B cold laser at our practice, so I've been using it to treat the surgical scar. The photo is from 13 days post-op and day 1 of laser treatment.
I also noted grey hairs in Cody's muzzle for the first time today. Coincidence? Or is the grey the body's response to the recent stress (both from the cancer itself and the surgery). Humm...
Saturday, August 13, 2011
How much?
Cody is home safe and sound. Our first night home was a little rough. Since IV fluids are standard procedure during and after surgery I expected Cody to have to pee, but holy urination Batman! He peed and peed and peed and dribbled and peed some more. Stop reading if you get grossed out easily...
I just couldn't say no to my boy on his first night home, so I allowed him to sleep with me. Oh joy...we both woke up in a puddle of urine. Now that's love for ya! I was very tired, exhausted actually from helping out a family member who is in the hospital (that's another story) so I pretty much slept through the enlarging wet spot. I did wake us both up twice to change bedding and go outside. The good thing is that he seemed happy and pain free the entire night.
Today he has continued to need to urinate very frequently. I'm starting to wonder if he might have a urinary tract infection from the urinary catheter that was placed while he was in the hospital. It is not uncommon for a UTI to develop after catheterization. I'm also wondering if it is not being caused by the pain medication (Tramadol) that he is on. We'll see how he does tonight.
Because you might be curious about what I paid for his surgery I'll share. The final bill came to $4122.51. That was with some pretty good discounts. So if one is not in the veterinary field and doesn't qualify for professional discounts you might expect to pay almost $5000 for this surgery. Yikes! That is significant. Now, I live in a somewhat affluent area in California and I sought out a surgeon and hospital that has a reputation for "gold standard" of care, so that may have been a factor in the final cost. I just wanted to share this number because many people do not realize that the cost to care for your best friend can hit the five grand mark pretty quickly. I recommend pet insurance folks. It might make a huge difference for your animal friend who relies on you to protect and care for them. Nothing is more sad to me as a veterinarian than owners who choose to euthanize based on finances. It is just wrong in my opinion. And this is just my opinion as a private person. As a veterinarian I have to walk a finer line and try to counsel my clients as best I can to help them make a decision that they can live with. I live by the old saying that you can't put a price on love, or is it life? Well both! My buddy has been by my side for 10 years and I've made a commitment to him so what the heck. It's only money right? You can't take it with you!
Future topic: poop and diet again! And watch for a post with the results of the histopathology...
Thanks for reading.
I just couldn't say no to my boy on his first night home, so I allowed him to sleep with me. Oh joy...we both woke up in a puddle of urine. Now that's love for ya! I was very tired, exhausted actually from helping out a family member who is in the hospital (that's another story) so I pretty much slept through the enlarging wet spot. I did wake us both up twice to change bedding and go outside. The good thing is that he seemed happy and pain free the entire night.
Today he has continued to need to urinate very frequently. I'm starting to wonder if he might have a urinary tract infection from the urinary catheter that was placed while he was in the hospital. It is not uncommon for a UTI to develop after catheterization. I'm also wondering if it is not being caused by the pain medication (Tramadol) that he is on. We'll see how he does tonight.
Because you might be curious about what I paid for his surgery I'll share. The final bill came to $4122.51. That was with some pretty good discounts. So if one is not in the veterinary field and doesn't qualify for professional discounts you might expect to pay almost $5000 for this surgery. Yikes! That is significant. Now, I live in a somewhat affluent area in California and I sought out a surgeon and hospital that has a reputation for "gold standard" of care, so that may have been a factor in the final cost. I just wanted to share this number because many people do not realize that the cost to care for your best friend can hit the five grand mark pretty quickly. I recommend pet insurance folks. It might make a huge difference for your animal friend who relies on you to protect and care for them. Nothing is more sad to me as a veterinarian than owners who choose to euthanize based on finances. It is just wrong in my opinion. And this is just my opinion as a private person. As a veterinarian I have to walk a finer line and try to counsel my clients as best I can to help them make a decision that they can live with. I live by the old saying that you can't put a price on love, or is it life? Well both! My buddy has been by my side for 10 years and I've made a commitment to him so what the heck. It's only money right? You can't take it with you!
Future topic: poop and diet again! And watch for a post with the results of the histopathology...
Thanks for reading.
Thursday, August 11, 2011
Post Op Update
As far as lung tumors go Cody's was text book perfect - exactly what a surgeon would want to work with. Everything went well in surgery. Cody was a rockstar anesthesia patient; meaning all his vitals (temperature, blood pressure, heart rate, etc.) stayed within the parameters one would want while under anesthesia. His tumor was very well circumscribed (sort of encapsulated; think of a billiard ball) and very distal (at the far end of the lung); two factors that help with removal. The closer the tumor is to the hilus (think of the hilus as the "top" of the lungs - the place where everything starts branching) the harder it is to remove. Cody's tumor was in the right caudal lung lobe far away from the hilus. The surgeon removed the entire lung lobe. Lucky for Cody he's still got two lobes on the right side. All in all he really didn't loose much lung capacity.
The surgeon had a hard time finding the lymph node because it was small. This is a good thing. She did find it eventually, removed it and reported to me that it was about the size of a bean. This is promising. We're hoping that a small lymph node is consistent with no cancer in that lymph node. Cross your fingers.
The entire lobe plus lymph node have been sent to the laboratory. Now we wait on the results.
Cody had a chest tube in after surgery. The tube is placed into the chest cavity to help remove air that gets into the chest cavity during surgery. After closing up the chest all the air that got in while the chest was open needs to be removed to create negative pressure so that the lungs work properly. When there is air outside the lungs it prevents the lungs from expanding...or otherwise known in lay terms as a collapsed lung. The tube stays in place over night and air is sucked out of the chest periodically. When no more air comes out of the tube it is removed. Cody's tube was removed this afternoon. When I visited he had the tube out and was comfortable. He got a little excited and whiny when he saw me, so we didn't visit long. He needs his rest. He's got his octopus friend to keep him company and I'm comforted knowing he is in good hands. He may be able to go home tomorrow.
The surgeon had a hard time finding the lymph node because it was small. This is a good thing. She did find it eventually, removed it and reported to me that it was about the size of a bean. This is promising. We're hoping that a small lymph node is consistent with no cancer in that lymph node. Cross your fingers.
The entire lobe plus lymph node have been sent to the laboratory. Now we wait on the results.
Cody had a chest tube in after surgery. The tube is placed into the chest cavity to help remove air that gets into the chest cavity during surgery. After closing up the chest all the air that got in while the chest was open needs to be removed to create negative pressure so that the lungs work properly. When there is air outside the lungs it prevents the lungs from expanding...or otherwise known in lay terms as a collapsed lung. The tube stays in place over night and air is sucked out of the chest periodically. When no more air comes out of the tube it is removed. Cody's tube was removed this afternoon. When I visited he had the tube out and was comfortable. He got a little excited and whiny when he saw me, so we didn't visit long. He needs his rest. He's got his octopus friend to keep him company and I'm comforted knowing he is in good hands. He may be able to go home tomorrow.
Tuesday, August 9, 2011
Thoracotomy
Tomorrow is the big day. Surgery - a thoracotomy.
Thank you again Wikipedia.
The surgery was supposed to be today, but it was rescheduled so that all the best nurses would be on the case. It is a big deal. Part of what makes it a big deal is that when you go into the chest you have to ventilate that patient because they can't breath on their own. This either requires a special machine or it requires a person manually squeezing a bag that looks a little like a black whoopee cushion. That person doing the breathing for the animal has to pay close attention to how much and how fast they are breathing for the animal. It is all about end title volume... or about how well you are able to oxygenate the patient. There is a measurement called the SPO2 which you can think of as the percentage of blood being oxygenated. The goal is to have that number at or higher than 97%. It kinda sucks to be the person ventilating the patient...no stress there, you're only breathing for the patient. Luckily there are machines that do the job quite well.
Another scary aspect of this surgery is the potential pain factor. The surgeon will be going in from the side. She'll have to spread the ribs apart and work down in a hole, so-to-speak. There will be excellent pain control before, during and after the surgery. He'll be on a Fentanyl drip. Fentanyl is 100 times more potent than morphine. Cody should be in la-la land and feelin' no pain.
The surgeon will remove the lung lobe and the entire mass will be submitted to the lab for analysis. There is still a remote chance it will be something benign, but probably not. Hopefully the surgeon will be able to remove the lymph nodes as well. Those will also be sent to the lab to look for evidence of spread of the cancer into those lymph nodes. If the cancer is in the nodes, then we most likely have a slam dunk decision about chemo - do it. If not in the lymph nodes, then I'll have to ponder it a bit... and of course get more advice from my oncologist friends.
Wish us well. Pray. Cross fingers and/or do whatever you do to send good vibes.
Thanks for your support.
Thoracotomy is an incision into the pleural space of the chest.[1] It is performed by a surgeon, and, rarely, by emergency physicians, to gain access to the thoracic organs, most commonly the heart, the lungs, the esophagus or thoracic aorta, or for access to the anterior spine such as is necessary for access to tumors in the spine.
Thoracotomy is a major surgical maneuver—the first step in many thoracic surgeries including lobectomy or pneumonectomy for lung cancer—and as such requires general anesthesia withendotracheal tube insertion and mechanical ventilation.
Thoracotomies are thought to be one of the hardest surgical incisions to deal with post-op, because they are extremely painful and the pain can prevent the patient from breathing effectively, leading toatelectasis or pneumonia.Thank you again Wikipedia.
The surgery was supposed to be today, but it was rescheduled so that all the best nurses would be on the case. It is a big deal. Part of what makes it a big deal is that when you go into the chest you have to ventilate that patient because they can't breath on their own. This either requires a special machine or it requires a person manually squeezing a bag that looks a little like a black whoopee cushion. That person doing the breathing for the animal has to pay close attention to how much and how fast they are breathing for the animal. It is all about end title volume... or about how well you are able to oxygenate the patient. There is a measurement called the SPO2 which you can think of as the percentage of blood being oxygenated. The goal is to have that number at or higher than 97%. It kinda sucks to be the person ventilating the patient...no stress there, you're only breathing for the patient. Luckily there are machines that do the job quite well.
Another scary aspect of this surgery is the potential pain factor. The surgeon will be going in from the side. She'll have to spread the ribs apart and work down in a hole, so-to-speak. There will be excellent pain control before, during and after the surgery. He'll be on a Fentanyl drip. Fentanyl is 100 times more potent than morphine. Cody should be in la-la land and feelin' no pain.
The surgeon will remove the lung lobe and the entire mass will be submitted to the lab for analysis. There is still a remote chance it will be something benign, but probably not. Hopefully the surgeon will be able to remove the lymph nodes as well. Those will also be sent to the lab to look for evidence of spread of the cancer into those lymph nodes. If the cancer is in the nodes, then we most likely have a slam dunk decision about chemo - do it. If not in the lymph nodes, then I'll have to ponder it a bit... and of course get more advice from my oncologist friends.
Wish us well. Pray. Cross fingers and/or do whatever you do to send good vibes.
Thanks for your support.
Tuesday, August 2, 2011
Off to Surgery
Well, the decision has been made - we're going to surgery. A week from tonight. A week from tonight I'll be home worrying that he's ok. I've done my home work. I've found an excellent surgeon. We'll take out the alien and send it to the lab and find out without a doubt what exactly Cody has been growing.
I'm undecided about chemotherapy at this point. It will depend on the histopathology of the tumor. All my sources tell me that we assume that even after removing the tumor there are microscopic tumor cells floating around that we need to zap with chemo. We'll see.
We're pooped. Cody wore me out playing today. At least we got that going for us.
I'm undecided about chemotherapy at this point. It will depend on the histopathology of the tumor. All my sources tell me that we assume that even after removing the tumor there are microscopic tumor cells floating around that we need to zap with chemo. We'll see.
We're pooped. Cody wore me out playing today. At least we got that going for us.
Friday, July 29, 2011
Diagnosis: The Big C.
Because I'm a veterinarian I can expedite some of the steps to getting a diagnosis of a problem, but just like any pet owner I can't necessarily expedite the emotional processing of the information.
The feelings come in waves from denial to acceptance to grieving. There's a feeling of something being stolen from me; a betrayal. This was not the plan. Cody was supposed to get stem cell therapy for his arthritis and live to be 16 years old. Now that is not possible because stem cell therapy is contraindicated in patients with cancer (can make the cancer grow).
On July 25th the radiologist performed a fine needle aspirate (FNA) of the mass. Since the tumor is big and is located right up against the body wall, this was a relatively easy procedure. Cody was heavily sedated and a large gauge needle was inserted into the tumor from the outside of his chest. Several small core samples were obtained and shipped off to the lab for histopathology.
I got the results on the 27th. The pathologist's diagnosis is papillary bronchogenic pulmonary adenocarcinoma. Well, this was the expected diagnosis because this type of tumor is the most common primary lung tumor in dogs. As I collect the cold hard facts from reliable sources the reality of the situation is sinking in. According the the numbers, the best case scenario is that Cody will be with me another 494 days, or approximately 16 & 1/2 months after surgery and chemotherapy.
There are a number of factors to consider that help to stage the cancer. Cody appears to be a T1 which means there is only the 1 solitary tumor. There's no evidence of metastasis either to other lung lobes or to lymph nodes (that was determined with the CT scan and an abdominal ultrasound). These tumors are also graded as well, moderately or poor differentiated. A T1, well differentiated tumor has the best prognosis.
I'm polling my co-workers and others in the business to find a surgeon. There is a surgeon about 45 minutes away who comes highly recommended. I will contact her this next week to talk about surgery. I'm fairly certain I will proceed with surgery. I'm not sure about chemotherapy. If I do nothing eventually the tumor will cause fluid to develop around Cody's lungs making it very hard for him to breath. It is hard to say when that might happen. These tumors grow slowly and according the the oncologist some dogs live another 1-2 years even without doing anything.
The feelings come in waves from denial to acceptance to grieving. There's a feeling of something being stolen from me; a betrayal. This was not the plan. Cody was supposed to get stem cell therapy for his arthritis and live to be 16 years old. Now that is not possible because stem cell therapy is contraindicated in patients with cancer (can make the cancer grow).
On July 25th the radiologist performed a fine needle aspirate (FNA) of the mass. Since the tumor is big and is located right up against the body wall, this was a relatively easy procedure. Cody was heavily sedated and a large gauge needle was inserted into the tumor from the outside of his chest. Several small core samples were obtained and shipped off to the lab for histopathology.
I got the results on the 27th. The pathologist's diagnosis is papillary bronchogenic pulmonary adenocarcinoma. Well, this was the expected diagnosis because this type of tumor is the most common primary lung tumor in dogs. As I collect the cold hard facts from reliable sources the reality of the situation is sinking in. According the the numbers, the best case scenario is that Cody will be with me another 494 days, or approximately 16 & 1/2 months after surgery and chemotherapy.
There are a number of factors to consider that help to stage the cancer. Cody appears to be a T1 which means there is only the 1 solitary tumor. There's no evidence of metastasis either to other lung lobes or to lymph nodes (that was determined with the CT scan and an abdominal ultrasound). These tumors are also graded as well, moderately or poor differentiated. A T1, well differentiated tumor has the best prognosis.
I'm polling my co-workers and others in the business to find a surgeon. There is a surgeon about 45 minutes away who comes highly recommended. I will contact her this next week to talk about surgery. I'm fairly certain I will proceed with surgery. I'm not sure about chemotherapy. If I do nothing eventually the tumor will cause fluid to develop around Cody's lungs making it very hard for him to breath. It is hard to say when that might happen. These tumors grow slowly and according the the oncologist some dogs live another 1-2 years even without doing anything.
Monday, July 25, 2011
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