In cancer, cells undergo a series of mutations leading to immortality. Cell division occurs uncontrolled, leading to tumor growth. In it’s final stages, cancer spreads throughout the body, ultimately leading to death of the host.
This leads me to think of cancer as the ultimate betrayal by one’s own body. Little can be done to reverse changes once they start, and treatments are designed to eradicate the aberrant cells, while sparing the healthy ones. All of this speaks to a complete lack of control over the disease process itself.
The lack of control extends to what owners feel once faced with a diagnosis of cancer for their pets. Some owners will feel guilty, wondering if they caused their pets cancer because of the type of diet they fed them, or the vaccines they chose to administer, or blame flea and tick medicine. Many want to know what can be done (beyond the surgical, radiation, chemotherapy, or immunotherapy recommendations I make) to slow the cancer progression or reverse the disease process now that it has started.
Some owners search for aspects they can control to help their pet battle their cancer, strengthen their immune system, and aid them through their more conventional treatments. I find the main thing owner’s feel they can control during this process is their pet’s diet and nutrition. They are generally helpless from stopping progressing of disease and they can’t prevent side effects from treatments, but they can control what their pet ingests and they can tangibly monitor things like body weight and the proverbial “ins and outs” of their pet.
The problem is the lack of evidence based information to suggest changing diet and/or adding supplements or nutriceuticals will make a difference in outcome. The other problem is adding too many variables into the “mix” can result in unexpected side effects where we can’t say for certain it’s the cancer, the treatment, or the new diet/supplement/vitamin/etc. causing the signs. The last problem with some of the nutritional aspects of treating cancer is they may work against the more conventional treatments (e.g. anti-oxidants may counteract the mechanism of action of some chemotherapeutics and radiation therapy). When I discuss these aspects with owners, I realize I’m taking away some of their hope and certainly some of their feelings regarding being able to actively change the progression of disease for their pets.
As an oncologist, I also feel the frustration of not being able control cancer. My concerns are different from the average pet owner though – I don’t spend as much time worrying about what caused the cancer to happen, but rather what can I do now to control the cancer from growing, spreading, and ultimately making that dog or cat not feel well. I’m trying to stay one step ahead of a disease we barely understand, and are continually discovering new things about.
It seems the only one in the scenario not concerned with controlling the situation is the actual patient. Cats and dogs diagnosed with cancer have no concept of their disease. They know no difference between today and tomorrow or next week or next summer. They have no desire to control their disease, and cannot comprehend words like “metastases” or “median survival times.”
Veterinary cancer patients live in the moment – enjoying each minute for what it brings. In most cases that is joy and happiness. In some cases it is illness from disease or from the treatment. But there is never resentment or anger, or concern for what the future may bring. They don’t have interest in learning what caused their disease, and it is their lack of understanding about their condition that makes their battle so bittersweet.
I think about the emotional aspects of cancer care a great deal, and I see firsthand the unique aspects related to veterinary oncology and the differences we face as compared to our human counterparts. The more I consider it, the more I think we have a lot to learn from animals and their approach to health and disease.
Yes, it would be great to have better control over our health or to better regulate for risk factors, or once diagnosed with a devastating disease such as cancer, be able to maintain power over progression. But wouldn’t it also be a beautiful thing to still enjoy each moment of each day for exactly what it’s worth rather than dwell on those things we cannot change?
Once again, I think animals have the upper hand in how they deal with cancer. Time and again, I seem to consistently learn more from them than any textbook or research article. Though I’m still compelled to conquer disease, I feel the need to give consideration to relinquishing some of the control for the sake of simply enjoying the opportunity to help our patients and use their “philosophies” as examples. Not an easy task given the field I’ve chosen to pursue, but I have some pretty good role models to look towards for help.