Neuse River Golden Retiever Rescue
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The disease who must not be named

by User Not Found | Apr 13, 2014

The “c” word, Cancer.  Yep I said it.  It’s scary, but not because it casts evil spells like Vold---I mean He Who Must Not Be Named.  It’s because it has been known to break our hearts, our human-loving and canine-loving hearts.  Some stories are inspirational and empowering and others are unfair and devastating, but it’s not something that’s going away any time soon.  So you can call it the “c” word and be afraid of it or you can arm yourself with knowledge and be the story of positivity and grace, no matter how it ends. 

Part of the reason cancer is so scary is because of all the terminology associated with it.  It’s like reading a book in another language on survival while you’re stuck in the woods with nothing but the clothes on your back.  But if you know the language, you can make smart decisions and that’s more than half the battle.  So let’s talk about some basics before we dive further into the specifics of types of cancer.  Being able to ask the right questions when you need to be a medical advocate for yourself or for your canine companion gives you the upper-hand.  And who doesn’t feel powerful and confident with that kind of power?

There are a million different types of cancer, ok maybe not a million, but too many to count.  However, the basics are the same.

Say your vet tells you, your dog has been diagnosed with connective tissue cancer.  You don’t hear a word they say after that statement, your mind is racing.  Inevitably you end up late in the night laying awake thinking about it so you go straight to Google and search for connective tissue cancer.  You find some vague, completely unhelpful information.  Now, let’s say you are able to maintain your composure and you ask the doc, what is connective tissue cancer and he says “Chondrosarcoma”.  You may recognize “Chondro” because you’ve seen it on Glucosamine bottles, Chondrotin.  “Chondro” means cartilage and “sarc” means connective or soft tissue and “oma” means mass or tumor.  Chondrosarcoma is a cancer or the connective tissue that is found between the bones and joints.  This doesn’t change your sleepless and late night date with Google, but you’d be amazed at the way better quality of information you get by searching for “Chondrosarcoma” vs. “connective tissue cancer.”  The reason is because most people can only process information like this, and rightly so, in basic terms.  And that’s ok, but that’s also not the information you want to base your dog’s life decisions on.  The folks who study these kind of tumors for a living (aka nerdy scientists), will be using the word Chondrosarcoma.  What’s my point?  There are some scary dog owners posting things on the internet.  Don’t believe me?  Google “dog with diarrhea” and you’ll see the first results pop up as discussion boards from people chatting with each other.   Read those and you’ll see things like “my dog has had diarrhea for two weeks, I can’t afford to take him to the vet, what can I do” and then answers like “give him chicken and rice”.  These things make my toes curl.  NO DOG SHOULD HAVE DIARRHEA FOR TWO WEEKS!  If they have, no amount of chicken and rice is going to fix your dog!  So be careful out there!

But how do we get to this point?  It’s not always so easy to just walk in to the vet and walk out with a diagnosis (although that seems to be loads easier at the vet than at the human hospital)!  It may start with a lump or bump you find on your dog while combing, bathing or petting them.  The next step is usually a visit to the vet.  In most cases your vet will want to do what’s called a Fine Needle Aspirate or FNA.  This involves taking an empty syringe and needle and “poking” the lump several times in several different places.  The needle is very small so it does not require sedation, but may require a strong vet tech, depending on the dog’s ‘squirmy-ness’.  The vet will push the contents of the syringe out on to a slide or two and will sometimes stain it to look at the cells.  Ideally they can tell what kind of cells they are, whether they are dividing and whether or not they are growing where they should be.  However, veterinarians have only a small amount of experience looking at cells.  If they aren’t confident about it, they should advise that it be sent off for a pathologist to examine.  If a vet “makes a guess,” take it with a grain of salt until you get a pathologist’s opinion.  Be careful with FNA information.  Remember this is only a very small sample of cells.  They may appear normal and no cause for concern, but if you want the best outcome, it’s important to keep your eye on that lump for any changes, like growth or appearance.  If it morphs?  Get it checked again.

A more invasive procedure is called a punch biopsy.  This procedure involves removing a chunk, about the size of a pencil eraser, from the tumor.  The good part about these particular samples is that they are bigger and get a more comprehensive assessment of the tumor make-up, however they are more invasive and involve sedation and sometimes stitches to close the hole that is left.

If the pathologist and your vet determine that these samples are made up of cells that are out of control, after all that is the definition of cancer, they may recommend removal of the tumor.  Should we freak out now?  Hang in there guys, believe it or not, we still don’t have enough information.  After surgery, the tumor is sent to the pathologist who can tell you if the tumor has been completely removed, usually with certainty, the type of tumor and how aggressive the tumor is. This is all really good information, because this tells us the tumor is likely or not likely to come back, i.e. if cancer cells were left behind and tells us how likely the tumor is to have metastasized or will recur, life expectancy, whether further treatment is necessary, etc.  That’s a lot of good information!

A pathologist report can be confusing; it contains a lot of description about the cells that they are looking at, the surrounding tissue and things like shapes, sizes, colors, etc.  But there are some important pieces to make sure you ask your vet about.   

  1. Margins—this is how the pathologist describes the edges of the tumor.  Ideally, the edges of the tumor should contain healthy looking cells.  The pathologist can tell you how many centimeters or millimeters of healthy tissue surround the tumor or if there are “dirty” margins, or some places it appears the edges contain cancer cells.  The goal is clean margins because this means that the tumor has been “completely” removed thus drastically reducing the likely-hood of the cancer recurring in that location or worse, metastasizing (spreading).  However, this is never a guarantee because with cancer, it just takes one cell to move and take up residence somewhere else…..just one little microscopic cell.  The best case scenario is that when a tumor is removed, it is completely removed.  And your best shot for completely removing a tumor is to get it on the first try.  If you go in to that surgery knowing what you are dealing with, you are far more likely to have a better outcome long-term. 
  2. Mitotic index—think waaaaaaaaaay back to your high school biology.  Remember the word mitosis?  It basically describes the cells dividing, so when the pathologist talks about the mitotic figures, he or she is talking about the rate at which the cells are dividing.  In order to standardize it a bit, they refer to it as mitotic figures per high power field, which is just a fancy way of saying which lens they are looking thru the microscope with.  Wow that was a lot of high school biology.  Simply, it tells you how rapidly or slowly the cells are dividing.  Obviously in this case, we would want it to be as slowly as possible, meaning the tumor is not as aggressive.  The pathologist uses this number to “grade” the tumor.
  3. Grading the tumor—depending on the type of tumor, there is an accepted scale.  Some are numbers, like 1, 2, 3 and some are descriptions, like low or high.  The higher the number, the more aggressive the tumor and obviously low grade tumors are not as aggressive as high grade tumors.

Still not time to freak out.  Our dogs are individuals and as much as we’d like to make blanket statements to make the world easier to understand, we can’t do that.  Each dog is an individual and their medical decisions have to be treated as such.  An eleven year old dog with soft tissue sarcoma cannot be treated like a two year old with osteosarcoma, but both diseases are cancer.  Get your information first, then make decisions.  Use your friends, your family and your local rescues.  Chances are, someone’s been there and they can help.

The hope is that you will never need this information, but in reality each and every one of us knows someone who is affected by cancer.  So instead of running away, let’s face our fear and fight it with the knowledge to make the best quality of life decisions we can for our pets.  They can’t speak for themselves and we have to be their medical advocates.  Information is hopeful and empowering.  Refer back to this blog often and in the coming weeks, we’ll be sharing some of the rescue dogs who have tackled cancer.  

Neuse River Golden Retiever Rescue
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