{"id":29643,"date":"2023-09-01T14:25:31","date_gmt":"2023-09-01T14:25:31","guid":{"rendered":"https:\/\/todaysveterinarynurse.com\/?p=29643"},"modified":"2024-02-04T13:33:04","modified_gmt":"2024-02-04T13:33:04","slug":"exposing-medical-oncology-myths-for-the-veterinary-professional","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/oncology\/exposing-medical-oncology-myths-for-the-veterinary-professional\/","title":{"rendered":"Exposing Medical Oncology Myths for the Veterinary Professional"},"content":{"rendered":"<div class=\"su-note\"  style=\"border-color:#d8d8d8;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><div class=\"su-note-inner su-u-clearfix su-u-trim\" style=\"background-color:#f2f2f2;border-color:#ffffff;color:#333333;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><b>Abstract<\/b><\/p>\n<p class=\"p1\">Human and veterinary oncology share many similarities, which could lead to misconceptions when veterinary clients learn their pet has been diagnosed with cancer and begins undergoing treatment. This article will expose common myths surrounding cancer care for canine and feline patients by introducing the truth to those who may be unfamiliar with veterinary oncology. Knowing the facts will help veterinary nurses best prepare clients with reasonable expectations, allowing them to make a well-informed decision for their pet\u2019s care.<\/p>\n<p><b>Take-Home Points <\/b><\/p>\n<ul>\n<li class=\"p1\">Veterinary oncology specializes in the diagnosis, treatment, and management of cancers, tumors, masses, and secondary signs of cancer or cancer treatment.<\/li>\n<li class=\"p1\">Once a patient receives a cancer diagnosis, it is the veterinary nurse\u2019s job to make sure clients know there are always treatment options.<\/li>\n<li class=\"p1\">IV chemotherapy is not the only treatment option.<\/li>\n<li class=\"p1\">Side effects in pets are not the same as those in humans receiving chemotherapy.<\/li>\n<li class=\"p1\">Veterinary oncology patients are not radioactive and can be around the family.<\/li>\n<li class=\"p1\">The No. 1 goal of veterinary oncology treatment is quality of life.<\/li>\n<\/ul>\n<\/div><\/div>\n<p class=\"p1\"><span class=\"s1\">M<\/span><span class=\"s1\">any people know someone who has gone through cancer treatment or have personally experienced it. Therefore, it\u2019s understandable that veterinary clients may make an assumption that a pet will share <\/span>the same experiences as a human cancer patient. However, this is the first of various misunderstandings of veterinary oncology.<\/p>\n<p class=\"p2\"><span class=\"s1\">In a recent VCA Pet CancerCare Alliance survey, more than half (59%) of participants did not believe their pet would develop cancer, although 90% recognized that cancer occurs in cats and dogs.<sup>1<\/sup> Respondents were then asked to imagine their pet was diagnosed with cancer. Most participants (74%) responded that they would do everything they could so their pet would be comfortable, but only 35% indicated they would adhere to their veterinarian\u2019s plan.<sup>1<\/sup> These numbers do not seem to favor veterinary oncology. Why is that? This survey exposed a few common myths<sup>1<\/sup>:<\/span><\/p>\n<ul>\n<li class=\"p3\"><span class=\"s1\">66% believed cancer therapy is cost-prohibitive.<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">45% felt treatment would cause pain.<\/span><\/li>\n<li class=\"p4\"><span class=\"s1\">43% believed treatment would cause adverse effects.<\/span><\/li>\n<\/ul>\n<p class=\"p2\"><span class=\"s1\">This article will expose and address these and other prevailing myths surrounding cancer care for canine and feline patients.<\/span><\/p>\n<h2 class=\"p5\">Myth #1: \u201cVeterinary Oncology\u201d\u2014I Didn\u2019t Know That Was a Thing.<\/h2>\n<p class=\"p2\"><span class=\"s1\">Veterinary oncology is a branch of medicine that specializes in the diagnosis, treatment, and management of cancers, tumors, masses, and secondary signs of cancer or cancer treatment in animals. The veterinary oncology team typically consists of an internal medicine diplomate specializing in oncology and an oncology veterinary technician specialist. See <\/span><span class=\"s2\"><b>ADDITIONAL RESOURCES<\/b><\/span><span class=\"s1\"> for more information.<\/span><\/p>\n<h3 class=\"p6\">What Does It Take to Become a Diplomate in Medical Oncology?<\/h3>\n<ul>\n<li class=\"p3\"><span class=\"s1\">Be a graduate of a college or school of veterinary medicine that is accredited by the AVMA or be legally qualified to practice veterinary medicine<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">Satisfactorily complete a 1-year rotating internship in veterinary medicine and surgery or have undertaken an equivalent broad-based clinical experience<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">Complete an American College of Veterinary Internal Medicine (ACVIM)\u2013approved (3- to 5-year) residency training program in the oncology specialty<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">Pass the ACVIM general examination<\/span><\/li>\n<li class=\"p4\"><span class=\"s1\">Pass the ACVIM oncology specialty examination<\/span><\/li>\n<\/ul>\n<h3>What Does It Take to Become a Veterinary Technician Specialist in Oncology?<\/h3>\n<ul>\n<li class=\"p3\"><span class=\"s1\">A minimum of 3 years and\u00a06000 hours as a credentialed veterinary technician in the field of internal medicine with a minimum of 4500 contact hours in oncology (must be completed within 5 years before applying for VTS certification in oncology)<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">At least 40 hours of oncology continuing education<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">3 potential oncology examination questions that showcase your advanced knowledge<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">2 letters of recommendation\u00a0from a VTS member of the Academy of Internal Medicine for Veterinary Technicians or a diplomate of the ACVIM<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">75% mastery of the 36 advanced skills<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">50 to 75 detailed case logs demonstrating what you did to master the advanced skills<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">4 in-depth case reports explaining the \u201cwhy<i>\u201d<\/i> of each case<\/span><\/li>\n<li class=\"p4\"><span class=\"s1\">Following the acceptance of the application, pass a 200-question, 4-hour examination<\/span><\/li>\n<\/ul>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">Additional Resources<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">\n<ul>\n<li>Academy of Internal Medicine for Veterinary Technicians. Oncology members.<br \/>\n<a href=\"http:\/\/aimvt.com\/oncology-members.html\" target=\"_blank\" rel=\"noopener\">aimvt.com\/oncology-members.html<\/a><\/li>\n<li>American College of Veterinary Radiology. Find a specialist.<br \/>\n<a href=\"http:\/\/acvr.org\/find-a-specialist\" target=\"_blank\" rel=\"noopener\">acvr.org\/find-a-specialist<\/a><\/li>\n<li>VetSpecialists.com. Find a specialist.<br \/>\n<a href=\"http:\/\/vetspecialists.com\/find-a-specialist\" target=\"_blank\" rel=\"noopener\">vetspecialists.com\/find-a-specialist<\/a><\/div><\/div><\/li>\n<\/ul>\n<h2>Myth #2: What\u2019s the Point? Cancer Is a Death Sentence.<\/h2>\n<p class=\"p2\"><span class=\"s1\">A veterinary patient has no idea they have cancer, but the family does.<i> <\/i>Once the family can fully appreciate the cancer type, <a href=\"https:\/\/todaysveterinarynurse.com\/oncology\/veterinary-cancer-staging\/\" target=\"_blank\" rel=\"noopener\">staging process<\/a>, treatment options, prognosis, at-home care, and <a href=\"https:\/\/todaysveterinarynurse.com\/oncology\/chemotherapy-induced-side-effects-prevention-and-treatment\/\" target=\"_blank\" rel=\"noopener\">side effects<\/a>, then they can make a well-rounded decision (<\/span><span class=\"s2\"><b>TABLE\u00a01<\/b><\/span><span class=\"s1\">).<\/span><\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter wp-image-29648\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table1.png\" alt=\"\" width=\"1037\" height=\"1382\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table1.png 2135w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table1-225x300.png 225w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table1-768x1024.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table1-1152x1536.png 1152w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table1-1536x2048.png 1536w\" sizes=\"(max-width: 1037px) 100vw, 1037px\" \/><\/p>\n<p class=\"p2\"><span class=\"s1\">There are always treatment options, and it is the veterinary nurse\u2019s job to make sure clients know that. Once a patient receives a cancer diagnosis, clients should be given a referral and encouraged to meet with an expert. It is the duty of the specialist and their highly trained team to deliver all treatment options before implementing a reasonable treatment plan. It is true that some cancers carry a poorer prognosis than others, but some are also curable.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Medical advancements are happening every day. For instance, cancers such as splenic hemangiosarcoma have always carried a negative association and poor prognosis. In the author\u2019s practice, postsplenectomy combined with a multimodal approach of doxorubicin, dacarbazine,<sup>3<\/sup> and polysaccharopeptide<sup>4<\/sup> has yielded significantly higher survival times of 3+ years versus 6 to 8 months with the standard protocol of surgery and single-agent doxorubicin (<\/span><span class=\"s2\"><b>TABLE 2<\/b><\/span><span class=\"s1\">).<br \/>\n<img decoding=\"async\" class=\"aligncenter wp-image-29649\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table2.png\" alt=\"\" width=\"1042\" height=\"279\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table2.png 2018w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table2-300x80.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table2-1024x274.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table2-768x206.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table2-1536x411.png 1536w\" sizes=\"(max-width: 1042px) 100vw, 1042px\" \/><br \/>\n<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Every oncologist practices a little differently. Some may approach treatment more aggressively and are open to <a href=\"https:\/\/todaysveterinarypractice.com\/pharmacology\/new-cancer-treatments-for-dogs\/\" target=\"_blank\" rel=\"noopener\">new protocols and experimenting with drug combinations<\/a>, whereas others may start conservatively and try dose escalation using gold standard protocols. There is no right or wrong treatment approach, but it\u2019s important that pet owners understand that there are always options to explore with their veterinary oncology team.<\/span><\/p>\n<h2 class=\"p5\">Myth #3: Pets With Cancer Have a Poor Quality of Life.<\/h2>\n<p class=\"p7\"><span class=\"s1\">Common initial thoughts from clients when their pet receives a cancer diagnosis include:<\/span><\/p>\n<ul>\n<li class=\"p3\"><span class=\"s1\">\u201cMy pet is too old for treatment.\u201d<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">\u201cThey will be hospitalized\/sick all the time.\u201d<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">\u201cThey will be skin and bones and lose all their fur.\u201d<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">\u201cI won\u2019t put my pet through treatment after knowing what it did to my family member\/self.\u201d<\/span><\/li>\n<li class=\"p4\"><span class=\"s1\">\u201cThe doctor I go to had a bad experience with an oncology case and won\u2019t refer because of that.\u201d<\/span><\/li>\n<\/ul>\n<p><span class=\"s1\">The No. 1 goal of veterinary oncology treatment is quality of life. Age is never used as a diagnostic tool, provided the patient does not have additional life-threatening comorbidities. If there are none, there is no medical reason why a senior or geriatric patient cannot undergo individualized treatment.<\/span><\/p>\n<h3 class=\"p6\">Dosing<\/h3>\n<p class=\"p2\"><span class=\"s1\">Many of the same human antineoplastic agents are used in veterinary oncology, with the main distinction being the vastly different dosing and frequency of the drugs. Extensive data have been studied to allow veterinary oncology to deliver the maximum tolerated dosage that will result in the fewest adverse effects. For example, what a human with non-Hodgkin lymphoma will be treated with in 1\u00a0treatment, a veterinary oncology lymphoma patient will receive over 1 month when using the same drugs.<\/span><\/p>\n<h3 class=\"p6\">Side Effects<\/h3>\n<p class=\"p2\"><span class=\"s1\">The treatment should never be worse than the disease. For this reason, veterinary oncology patients can achieve an excellent quality of life. They tolerate chemotherapy incredibly well and experience significantly fewer adverse effects, if any at all, than human oncology patients.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Cancer cells are unpredictable and are constantly changing and dividing. Chemotherapy targets and kills rapidly dividing cells. Most chemotherapy drugs are unable to differentiate between killing cancer cells and normal cells\/bone marrow. This is the reason that acute general side effects may occur in some patients.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Approximately 15% to 30% of patients treated with a chemotherapy agent will experience a minor adverse effect during treatment (<\/span><span class=\"s2\"><b>TABLE 3<\/b><\/span><span class=\"s1\">).<sup>5<\/sup> About 5% of patients may require hospitalization and supportive care for moderate side effects, and less than 1% may have severe or fatal side effects.<sup>5<\/sup> If an adverse effect is going to occur, it generally ranges from 2 to 5 days post-treatment and may last for 1 to 2\u00a0days.<sup>5<\/sup> <\/span><\/p>\n<p><img decoding=\"async\" class=\"aligncenter wp-image-29650\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table3.png\" alt=\"\" width=\"1034\" height=\"397\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table3.png 2029w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table3-300x115.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table3-1024x393.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table3-768x294.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table3-1536x589.png 1536w\" sizes=\"(max-width: 1034px) 100vw, 1034px\" \/><\/p>\n<p class=\"p2\"><span class=\"s1\">The most common adverse effects in veterinary patients include nausea, vomiting, diarrhea, decreased appetite, and a decreased energy level.<sup>5<\/sup> Most veterinary teams will send patients home after the first chemotherapy visit with some variation of an antinausea\/antivomiting medication and an antidiarrheal.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Hair loss is a widely recognized adverse effect in human oncology patients. Most veterinary oncology patients will not experience hair loss, but this is observed in \u201cgrooming patients.\u201d This category of patients has a rapid hair growth rate, and cancer targets rapidly dividing cells. Hair growth is slowed or stopped and the hair becomes brittle, breaks off, or greatly thins out. Commonly affected locations include pressure point areas, such as the posterior aspect of the front limbs, anterior aspect of the rear limbs, pinnae, muzzle, and tail. In the author\u2019s experience, hair growth will return within approximately 1 to 2 months after treatment has been completed.<\/span><\/p>\n<p class=\"p8\"><b>Pro Tips:<\/b><\/p>\n<ul>\n<li class=\"p3\"><span class=\"s1\">Clients should be instructed to give the antinausea medication if there is any variation in a patient\u2019s appetite. Dogs will continue to eat, even when nauseated. Nausea is easier to control than anorexia.<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">Avoid starting drugs that aren\u2019t needed. Clients should be advised to only start the prescribed antidiarrheal medication if there have been<br \/>\n2 episodes of loss of form to the stool or diarrhea within a 24-hour period. More times than not, 1 episode is an isolated incident and transient.<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">To minimize the chance of food aversion in oncology patients, medications should be given separately from the patient\u2019s normal diet and mealtime.<\/span><\/li>\n<li class=\"p4\"><span class=\"s1\">A \u201csympathy diet\u201d is when a patient has learned that if they do not eat their food and hold out, they will end up receiving \u201cpeople food.\u201d There is often a misconception that because the pet has cancer, they can have what they want. However, a food change is not necessary and maintaining the patient on a well-balanced diet is the best proven nutritional route.<sup>8<\/sup><\/span><\/li>\n<\/ul>\n<h2 class=\"p5\">Myth #4: Treatment Is Too Expensive\/Hard.<\/h2>\n<p class=\"p7\"><span class=\"s1\">Client hesitations that veterinary oncology professionals often hear include:<\/span><\/p>\n<ul>\n<li class=\"p3\"><span class=\"s1\">\u201cI can\u2019t afford that.\u201d<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">\u201cTreatment will take too much time\/effort\/travel.\u201d<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">\u201cI\u2019m not putting my pet through IV treatment.\u201d<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">\u201cI\u2019m weighing the options (treatment versus no treatment).\u201d<\/span><\/li>\n<li class=\"p4\"><span class=\"s1\">\u201cThere isn\u2019t a veterinary oncology hospital close to me.\u201d<\/span><\/li>\n<\/ul>\n<h3 class=\"p6\">Cost<\/h3>\n<p class=\"p2\"><span class=\"s1\">Treatment cost can vary from state to state and often depends on whether the hospital is private, corporate, or a university. No single practice is necessarily better than another, but different practices may offer different services. <\/span><span class=\"s2\"><b>TABLE 4<\/b><\/span><span class=\"s1\"> shows an average cost range for clients for several commonly used drugs for an approximately 25-kg (55-lb) pet.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-29651\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table4.png\" alt=\"\" width=\"1025\" height=\"320\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table4.png 2044w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table4-300x94.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table4-1024x320.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table4-768x240.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table4-1536x479.png 1536w\" sizes=\"(max-width: 1025px) 100vw, 1025px\" \/><\/p>\n<p class=\"p2\"><span class=\"s1\">It is important to remind clients that if they have <a href=\"https:\/\/todaysveterinarypractice.com\/practice-management\/how-does-pet-insurance-fit-into-the-access-to-care-conversation\/\" target=\"_blank\" rel=\"noopener\">pet insurance<\/a> prior to the cancer diagnosis, chemotherapy and other treatments are likely covered. <\/span><\/p>\n<h3 class=\"p6\">Frequency<\/h3>\n<p class=\"p2\"><span class=\"s1\">The frequency of visits will vary depending on the treatment protocol. For example, the gold standard for treating B\u00a0cell multicentric lymphoma is the CHOP (cyclophosphamide, doxorubicin, vincristine, predniso[lo]ne) protocol, where patients are seen weekly for 16 to 25 weeks.<sup>9,10<\/sup> Visits for single-agent protocols are typically every 3 to 4 weeks, with a complete blood count (CBC) recheck approximately 7\u00a0to 14 days post treatment. Metronomic protocols can start with rechecks every month, transitioning to every other month.<sup>11<\/sup> Melanoma vaccines can vary from 1 to 2\u00a0weeks, then every 6 months.<sup>12<\/sup><\/span><\/p>\n<h3 class=\"p6\">Location<\/h3>\n<p class=\"p2\"><span class=\"s1\">Veterinary oncology is a growing specialty. There are private veterinary oncology practices and universities throughout most of the United States. In some locations, seeking specialty care still may involve considerable travel. However, most oncologists are willing to speak with the referral partner to discuss the case, along with an initial telehealth appointment. Depending on the nature of the treatment, some therapies may be able to be <a href=\"https:\/\/todaysveterinarypractice.com\/oncology\/monitoring-of-chemotherapy-patients-in-general-practice\/\" target=\"_blank\" rel=\"noopener\">offered at the general practice<\/a>. While a variety of treatment options are commonly provided, travel and cost for the owner always need to be considered when aiding clients in the best options for them and their pet. Veterinary nurses are in the position to spend quality 1-on-1 time with clients, educating them about these options and offering advice throughout the process. <\/span><\/p>\n<h3 class=\"p6\">Treatment Types and Clinical Signs<\/h3>\n<p class=\"p2\"><span class=\"s1\">If clients are hesitant to pursue cancer treatment due to misconceptions surrounding IV chemotherapy in human oncology patients, veterinary nurses should assure them that there are a variety of veterinary cancer modalities available (<\/span><span class=\"s2\"><b>TABLE 5<\/b><\/span><span class=\"s1\">).<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-29652\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table5.png\" alt=\"\" width=\"1036\" height=\"937\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table5.png 2039w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table5-300x271.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table5-1024x927.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table5-768x695.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2023\/09\/Wesolowski_TVNFall23_OncologyMyths_Table5-1536x1390.png 1536w\" sizes=\"(max-width: 1036px) 100vw, 1036px\" \/><\/p>\n<p class=\"p2\"><span class=\"s1\">Humans undergoing chemotherapy often have serious adverse effects because their goal of treatment is to cure the cancer, causing complete immune suppression (or even bone marrow ablation in blood cancers), whereas in veterinary oncology, the goal is to extend the pets\u2019 quality of life for as long as possible. Chemotherapy targets rapidly dividing cells (e.g., bone marrow, cancer cells, hair follicles, gastrointestinal tract); thus, possibly causing clinical signs including bone marrow suppression, coat changes, diarrhea, nausea, and vomiting. However, since dose ranges used in veterinary oncology are lower than those typically used in human oncology, bone marrow suppression lowers the immune system just enough to allow the body to fight the cancer without the severity of adverse effects that occurs in human cancer patients. Each patient\u2019s bone marrow sensitivity will vary. Closely monitoring a patient\u2019s CBC before each treatment is vital to ensuring their neutrophil count has not dropped lower than 1 K\/\u00b5L, when the body has a greater likelihood of being compromised by an infection or even sepsis.<sup>14<\/sup><\/span><\/p>\n<p class=\"p7\"><span class=\"s1\">Cancer itself can cause clinical signs, and certain types of cancer can cause far more serious clinical signs compared to chemotherapy:<\/span><\/p>\n<ul>\n<li class=\"p3\"><span class=\"s1\">Many cancers may be associated with certain paraneoplastic syndromes (PNSs), including cancer <a href=\"https:\/\/todaysveterinarypractice.com\/nutrition\/nutrition-for-small-animal-cancer-patients\/\" target=\"_blank\" rel=\"noopener\">anorexia and cachexia<\/a>.<sup>15<\/sup><\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">High-grade mast cell tumor, if left untreated, can ultimately result in degranulation, gastrointestinal ulceration (including the possibility of perforation),<sup>16<\/sup> and death.<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">Lymphomas, anal sac adenocarcinoma, parathyroid tumors, multiple myeloma, mammary adenocarcinoma, and melanoma are all associated with hypercalcemia of malignancy.<sup>17<\/sup><\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">Insulinoma, lung tumors, and mammary tumors, among others, can all cause peripheral neuropathy.<sup>18<\/sup><\/span><\/li>\n<li class=\"p4\"><span class=\"s1\">Due to their location (space occupying), some tumors will cause major quality-of-life challenges and severe effects, such as brain tumors potentially causing seizures or blindness, anal sac tumors causing urinary and\/or fecal obstruction, and thoracic or heart base masses causing effusion accumulation.<\/span><\/li>\n<\/ul>\n<p class=\"p2\"><span class=\"s1\">Oncologists are specifically trained to identify and successfully treat the tumor, which then leads to the disappearance of PNSs and cancer-related effects.<\/span><\/p>\n<h2 class=\"p5\">Myth #5: The Patient Can\u2019t Be Around the Family.<\/h2>\n<p class=\"p2\"><span class=\"s1\">Clients may think that having a pet on chemotherapy means the pet will be highly immunocompromised or radioactive. The fact is that veterinary oncology patients are not radioactive. They will excrete metabolites in their urine, feces, or saliva, depending on which drug(s) they are receiving. Unless a family member is immunocompromised, there is no reason they should be separated from their pet. It is also not necessary to separate pets in multipet households.<\/span><\/p>\n<p class=\"p7\"><span class=\"s1\">Advise clients of the following precautions:<\/span><\/p>\n<ul>\n<li class=\"p3\"><span class=\"s1\">Follow proper hand washing protocols.<\/span><\/li>\n<li class=\"p3\"><span class=\"s1\">Wear nitrile gloves while handling urine or feces during the first 72 hours (5 days for rabacfosadine) after treatment.<\/span>\n<ul>\n<li class=\"p10\"><span class=\"s1\">Do not use spray nozzle cleaning agents as they can aerosolize the metabolites in the excrement if residue was missed during the initial cleaning stage.<\/span><\/li>\n<li class=\"p10\"><span class=\"s1\">Double-bag all excrement, gloves, and potty pads used before placing them in the regular trash.<\/span><\/li>\n<li class=\"p10\"><span class=\"s1\">Change the litter box daily for 72 hours after chemotherapy administration.<\/span><\/li>\n<li class=\"p10\"><span class=\"s1\">Avoid inhaling dust from the litter box.<\/span><\/li>\n<li class=\"p10\"><span class=\"s1\">Consider using litter box liners to help decrease the potential of exposure to metabolites in the excrement since no scooping is required with liners.<\/span><\/li>\n<\/ul>\n<\/li>\n<li class=\"p4\"><span class=\"s1\">Encourage owners to relieve their pet in an area that receives sunlight; sunlight is believed to inactivate chemotherapy in the urine\/feces.<sup>19<\/sup><\/span><\/li>\n<\/ul>\n<h2 class=\"p5\">Myth #6: Treatment Is Painful, Stressful, and Scary.<\/h2>\n<p class=\"p2\"><span class=\"s1\">Another goal among veterinary oncology is building a stress-free, welcoming, and comfortable environment. Most patients visit on a weekly basis, and every attempt is made to have their experience remain fun and positive. Treats, toys, music, diffusers, holiday lights, and cat towers\/houses can be employed. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Smaller-gauge IV catheters are used, and especially nervous patients may get a lidocaine gel block prior to placement or mild sedation with gabapentin and trazodone.<\/span><\/p>\n<p class=\"p8\"><b>Pro Tips:<\/b><\/p>\n<ul>\n<li class=\"p3\"><span class=\"s1\">If referring an already anxious pet, the veterinarian may prescribe a gabapentin\/trazodone protocol to be administered before the next visit.<\/span><\/li>\n<li class=\"p4\"><span class=\"s1\">Remind owners to keep their pet\u2019s routine as normal and consistent as possible, which will aid the pet\u2019s quality of life as well as the owner\u2019s.<\/span><\/li>\n<\/ul>\n<h2>Summary<\/h2>\n<p class=\"p2\"><span class=\"s1\">Veterinary oncology is a dynamic and vast specialty with a variety of treatment options. Veterinary nurses are in the important position of educating clients on the realities of veterinary oncology care and empowering owners with the proper knowledge and resources that will provide their pet with the best quality of life possible.<\/span><\/p>\n<p class=\"p8\"><b>Pro Tip:<\/b><\/p>\n<ul>\n<li class=\"p4\"><span class=\"s1\">The internet should <i>never<\/i> replace the veterinary care team. Remind pet owners to always reach out\u2014we are experts for a reason!<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Veterinary nurses are in the important position of educating clients on the realities of veterinary oncology care and empowering owners with the proper knowledge and resources that will provide their pet with the best quality of life possible.<\/p>\n","protected":false},"author":236,"featured_media":29647,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":0,"footnotes":""},"categories":[241],"tags":[145],"class_list":["post-29643","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fall-2023","tag-peer-reviewed","column-features","clinical_topics-oncology"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 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