I was having a discussion with a devoted pet owner shortly after she overheard a client in our clinic lobby say that she “spent $1000 to get her dog’s right knee fixed and she wasn’t going to spend anything on the left one.”
A devoted pet owner, we’ll call her “Frieda,” overheard, and was incredulous, saying that she would do almost anything for her pets, “but chemo,” she continued, “wouldn’t be fair to them because they don’t understand.”
It is a common mistake to think of cancer chemotherapy in terms of human treatment. It’s what we know. It’s what we see when we go to work, to the store, to church. We see bald men, women with wigs, children with no hair. We see burns from radiation.
We hear stories of (or have experienced with our own loved ones) vomiting, diarrhea, total loss of appetite, life-threatening infections. We hear stories of people who undergo horrible suffering because of their will to live.
We think that dog chemotherapy and cat chemotherapy must be the same.
Let’s look at what it is.
The root “chem” stems from the Greek word, chemeia, which has roots to alchemy, a Middle English word. In medieval times alchemists sought to transform base metals into precious ones, such as gold and silver. In chemotherapy, “chemo” is short for “chemical.”
“Therapy” comes from the Greek therapeia, meaning to cure or to heal.
Literally, then, chemotherapy is the use of any chemical element or compound for the treatment of a disease. The disease need not be cancer. Every time we take an antibiotic for a urinary tract infection or sinus infection, we are being administered chemotherapy.
Languages evolve, and usage defines definition. Today, the word chemotherapy is inextricably attached to the treatment of cancer in the layman’s mind.
The most important difference to understand between cancer chemotherapy for humans and cancer chemotherapy for domesticated animals is the goal of treatment.
People suffer many cancers that can be cured, permanently eliminated from the body. Humans also experience many cancers that can be controlled by medication, extending life expectancy even in the absence of a total cure.
Cancer in pets is different. There are some cancerous growths that can be cured with surgical excision. Some respond to radiation, never to return. Curative doses of chemotherapeutics, however, are rarely used in animals. Let’s look at the reasons:
- Pet owners and pet doctors have little tolerance for animal suffering. Agents (drugs) and doses of agents that cause severe weakness, vomiting and diarrhea are avoided.
- The human medical care system is well-equipped to provide nursing vigilance for the debilitated and incapacitated cancer patient. Usually, owners of pets provide all at-home aftercare, so dogs and cats simply are not allowed to become ill to a comparable level. Who could care for them, clean them and provide that level of nursing for the duration of their treatment?
- Cost. Out-of-pocket expenses can be high. Some pet health insurance policies do not provide coverage for cancer at all. Some companies may place limits on payments for cancer treatment. One factor to consider is treatment variables. Although each type of cancer is treated differently, there are protocols that cost a considerable amount, and there are those that are downright inexpensive. Of course, the more costly medications carry the best prognosis, but a shortage of funds doesn’t mean that treatment is out of the question.
- Quality of life. The philosophy of many board-certified veterinary oncologists is summarized in this statement by Dr. Elizabeth Kergosien of the MedVet Mandeville Medical & Cancer Centers for Pets, on chemotherapy, “Our goal is that the patient will not experience even one bad day.”
If your pet has cancer, remember that there is cure for some types of malignancies. If your pet’s doctor suggests chemotherapy, he can explain exactly what side effects to expect for the specific treatment(s) your dog or cat will have. Ultimately, you are in control, and you can determine the experience your pet will have, according to your tolerances.
Chemotherapy in pets is about buying time, and making that time be excellent quality time.
See you Monday, Dr. Randolph.