I’m seated across from one of my favorite owners and her endearing 9-year-old Lhasa Apso, Sparky. I’m reviewing Sparky’s medical record, determining when he’s due for repeat chest x-rays to make sure his there’s no evidence of his cancer resurfacing. Sparky is customarily unimpressed, making no attempt to stifle an uninterested yawn. Mrs. Baker, Sparky’s owner, patiently awaits my decision.
Sparky was diagnosed with a form of skin cancer that was removed about eight months ago. Since recovering from the operation, I see him every month for routine examinations. Though his type of cancer wouldn’t typically spread to distant sites in the body, the probability is not zero, therefore routine monitoring is important.
“It looks like we last checked for spread of his tumor about three months ago. This would be a good time to see if anything has changed. We could perform the x-rays today, or during his check up next month,” I say.
“Let’s do the x-rays now,” Mrs. Baker states emphatically.
I’m grateful for her dedication to Sparky’s care. One of the biggest struggles I have with owners of pets with cancer is relaying the importance of monitoring for recurrence or spread of disease.
As I’m finishing up with writing my notes about the checkup, Mrs. Baker casually adds, “You know, they found another lump and I need to go for more testing.” My pen stutter-steps along the page as I immediately look up, unable to find the words to express my concern.
I knew Mrs. Baker was previously diagnosed with breast cancer over 30 years ago. We had discussed her disease numerous times over the course of Sparky’s visits. She’d told me all about the invasive surgery she underwent and the subsequent six weeks of daily radiation therapy she’d endured.
I heard details of the horrendous long-term side effects she had from her treatments, including persistent lack of sensation along the right side of her chest, a chronic cough, and an intolerance to strenuous activity.
I knew she was as diligent monitoring her own health as she was about her dog’s. She underwent regular mammograms and CT scans and previously always received encouraging news that her cancer was non-existent.
However, over three decades after her initial diagnosis and treatment, she’d developed not only one but two new tumors. One in each breast. Her treatment would be a double mastectomy followed by chemotherapy. Her prognosis was unknown, but the initial biopsies suggested the two tumors were not related to each other and were each likely aggressive.
In some cases, owners of animals with cancer who are diagnosed with cancer themselves are reluctant to pursue treatment for their pets. Their own experiences negatively influence their perception of what their companion would experience.
While there are many similarities between a diagnosis of cancer in animals and people, and the drugs I prescribe are the same used to treat humans with cancer, the dosages are lower and the interval between treatments is extended so as to avoid side effects in pets. This conservative plan of action affords a much lower cure rate for most veterinary cancers. However, we consider this an acceptable consequence because animals with cancer experience an exceptionally low rate of treatment related complications.
More frequently, I encounter owners such as Mrs. Baker, who search for options for their pets on par with what they’ve experienced themselves. I don’t have to go into the details of chemotherapy, or the importance of staging tests or monitoring with cancer survivors. They are already acutely aware of which information is crucial for making optimal decisions about their animal’s care.
While I’m prepared for discussing cancer care in animals, I lack confidence in my capabilities for providing the same support for the human beings attached to those pets facing a similar diagnosis. I’m humbled and honored when owners of pets with cancer open up to me about their own diagnosis. Whether doing so helps them to better understand their pet’s diagnosis, or simply provides them with a sounding board to express their own concerns and fears, I’m appreciative of their disclosure.
I was thrilled to let Mrs. Baker know Sparky’s x-rays turned out to be clear. We spent several additional minutes discussing how happy we were with how well he was doing and joking about his propensity to ingest acorns before she could pry them from his tiny, genetically stunted jaws. We concluded the appointment as we always do, with a quick hug and a few parting sentiments about Sparky’s cuteness, and with me letting her know I looked forward to seeing the both of them next month.
As Mrs. Baker and Sparky exited the hospital, given the recent news regarding her health, I felt just a tiny bit guilty knowing I’d be happier to see her rather than him at their next visit.