{"id":4760,"date":"2019-11-26T11:36:03","date_gmt":"2019-11-26T11:36:03","guid":{"rendered":"https:\/\/todaysveterinarynurse.com\/?post_type=articles&#038;p=4760"},"modified":"2022-02-02T15:33:08","modified_gmt":"2022-02-02T15:33:08","slug":"working-to-cure-cancer-in-animals","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/oncology\/working-to-cure-cancer-in-animals\/","title":{"rendered":"Working to Cure Cancer in Animals"},"content":{"rendered":"<p>Veterinary oncology research strives to advance the diagnosis and treatment of cancer in dogs, cats, and other species. Across the nation, veterinary schools and other institutions are conducting clinical studies on a variety of cancers, many of which hold promise for both animals and humans.<\/p>\n<p class=\"p1\"><span class=\"s1\">Approximately 1 in 4 dogs will, at some stage in their life, develop neoplasia, reports the American Veterinary Medical Association (AVMA).<sup>1<\/sup> Almost half of dogs over the age of 10 will develop cancer, says the AVMA. Dogs get cancer at roughly the same rate as humans, while there is less information about the rate of cancer in cats.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">At the forefront of oncology research are veterinary nurses, whose role encompasses everything from patient intake to the administration of experimental drugs to consoling clients whose pets have passed away by reminding them that their sacrifice could lead to a breakthrough that will benefit others in the future.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201c[Veterinary] nurses provide amazing care, and really advocate for their patients,\u201d observes Sarah Lahrman, RVT, oncology supervisor with the Purdue University Comparative Oncology Program. \u201cI think that\u2019s one of the most awesome things about this job.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">The scope of oncology research is broad. At Colorado State University College of Veterinary Medicine\u2019s Flint Animal Cancer Center (<\/span><a href=\"http:\/\/csuanimalcancercenter.org\/clinical-trials\"><span class=\"s2\">csuanimalcancercenter.org\/clinical-trials<\/span><\/a><span class=\"s1\">), an estimated 30 clinical studies are investigating experimental treatment modalities for lymphoma, soft tissue osteosarcoma, and other tumors. Some studies are designed to gauge a new treatment\u2019s efficacy and side effects, while others may determine the appropriate dose for a promising new compound, says clinical trials technician Kara Hall, CVT.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cThe studies at CSU change pretty consistently, depending on how many patients are needed,\u201d adds Hall\u2019s colleague, Lindsay Carroll, CVT, VTS (Oncology). \u201cWhen one study closes, new ones are opened. It keeps us busy.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">One large study ongoing at the University of Minnesota College of Veterinary Medicine\u2019s Clinical Investigations Center (<\/span><a href=\"http:\/\/vetmed.umn.edu\/centers-programs\/clinical-investigation-center\/current-clinical-trials\"><span class=\"s2\">vetmed.umn.edu\/centers-programs\/clinical-investigation-center\/current-clinical-trials<\/span><\/a><span class=\"s1\">) is looking into canine hemangiosarcoma, with an emphasis on splenic hemangiosarcoma, notes <\/span>research study technician specialist Amber Winter, CVT. The center has also performed clinical trials investigating<span class=\"s1\"> new treatments for canine B- and T-cell lymphoma, and feline squamous cell carcinoma. \u201cTargeted therapy is a big area of research here,\u201d Winter says.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Transitional cell carcinoma (TCC) and canine lymphoma are primary study subjects at the Purdue University Comparative Oncology Program (<\/span><a href=\"http:\/\/purdue.edu\/cancer-research\/index.php\"><span class=\"s2\">purdue.edu\/cancer-research\/index.php<\/span><\/a><span class=\"s1\">), reports Lahrman. Like many other institutions, Purdue is working on translational research in association with the National Institutes of Health, Johns Hopkins University, Duke University, and other institutions. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cHigh-grade transitional cell carcinoma in canines is very similar to high-grade TCC bladder cancer in humans,\u201d Lahrman explains. \u201cMuch of the work we have done regarding bladder cancer can be transcribed to human medicine. In fact, our work with the drug piroxicam for canine TCC helped the drug make its way into human medicine.\u201d<\/span><\/p>\n<h2>Comparative Oncology Research<\/h2>\n<p class=\"p1\"><span class=\"s1\">Purdue is one of many veterinary schools involved in comparative oncology, which evaluates animal cancer research to see if it can translate to human medicine. The Veterinary Health Center at the University of Missouri in Columbia, for example, is a member of the Comparative Oncology Trials Consortium (COTC), which comprises 22 sites nationwide. According to Deb Tate, RVT, VTS (Oncology), Clinical Trials Coordinator for Oncology Service at the University of Missouri (<\/span><a href=\"http:\/\/vhc.missouri.edu\/small-animal-hospital\/oncology\"><span class=\"s2\">vhc.missouri.edu\/small-animal-hospital\/oncology<\/span><\/a><span class=\"s1\">), canine osteosarcoma is the subject of a large COTC trial containing 3 arms: dogs that underwent standard of care (amputation followed by chemotherapy), dogs that received standard of care and a novel chemotherapeutic agent, and dogs that received standard of care and a listeria vaccine believed to stimulate the patient\u2019s immune system. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cImmunotherapy is a huge thing in cancer research right now,\u201d Tate reports. \u201cWe were recently involved in an immunotherapy study with ELIAS Animal Health in Olathe, Kansas. It was the first trial of its kind regarding osteosarcoma, and the enrolled patients have surpassed the median survival time of the dogs receiving standard of care, which is unheard of.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">It\u2019s important to note that these comparative oncology programs are not using companion animals specifically bred for the research; rather, pet owners are enrolling their pets in these clinical studies. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cThere has been renewed interest in studying tumors that spontaneously develop as a result of aging in companion animals (dogs mostly), because they share many characteristics with human cancers, such as histologic appearance; tumor genetics; biologic behavior; molecular targets; therapeutic response; and acquired resistance, recurrence, and metastasis,\u201d says Dr. Michael Kastan, executive director of the Duke Cancer Institute.<sup>2<\/sup><\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">The Canine Comparative Oncology and Genomics Consortium (<\/span><span class=\"s2\">ccogc.net<\/span><span class=\"s1\">), part of the NCI Center for Cancer Research, facilitates collaborations to study cancer in dogs. The Pfizer-CCOGC Biospecimen Repository has amassed 60,000 specimens from about 2000 canine patients with cancer of more than 100 breeds\u201452% male and 48% female. They include 7\u00a0types of cancer (osteosarcoma, lymphoma, melanoma, pulmonary tumors, mast cell tumors, soft-tissue sarcomas, and hemangiosarcomas) and 9 types of specimens, among them frozen tumor tissue, plasma, and normal tissue. The CCOGC has developed a mechanism to share reagents and resources as well as to develop a biospecimen repository, which is accessible to the public based on scientific merit.<sup>2<\/sup><\/span><\/p>\n<h2 class=\"p2\">The Role Veterinary Nurses Play<\/h2>\n<p class=\"p1\"><span class=\"s1\">The role of veterinary nurses and technicians in veterinary oncology research is all encompassing, and it\u2019s not hyperbole to say that such work would be next to impossible without their involvement. The veterinary nurses and technicians interviewed for this article collectively recited a lengthy list of responsibilities that included soliciting subjects for studies, patient intake, conducting histories and physicals, preparing subjects for biopsies and other procedures and assisting with same, collecting and processing tissue samples, administering experimental drugs, monitoring subjects and collecting data, ensuring data is correct and inputting data into the system, keeping clients apprised regarding their pets\u2019 status, consoling clients when their pets don\u2019t survive, and much more. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cI basically am the manager of the study I\u2019m helping the investigator with,\u201d says Winter. \u201cWhatever they need, I am there to help. I wear many hats, both administrative and clinical. The investigator will develop the protocol, present it to us, and we make sure it gets done the way they want it done.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Veterinary nurses also sometimes work with veterinary nursing students and DVM students as they rotate through their services. \u201cWe are involved in teaching them things like general history taking, blood draws, catheter placements, anesthesia, and setting up for biopsy procedures,\u201d notes Lahrman. \u201cThey may even be involved with our research patients.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Understandably, the relationship between veterinary nurses and study investigators is a tight one. \u201cWe get to know each other very well,\u201d Winter says. \u201cOnce an investigator starts a study, we are usually in contact with them on a daily basis. The relationship is different with each investigator. Some investigators are surprised at the scope of our capabilities.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Equally strong is the relationship between veterinary nurses and patient owners. Often, having a pet enrolled in a clinical study means the owner must visit the facility more frequently for appointments, which gives the support staff more opportunities to get to know them better. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cI spend a lot of time not only discussing what\u2019s going on with the patient, but how the owner is coping with having a pet with cancer,\u201d says Hall. \u201cI enjoy getting to know my clients and learning about their families and life outside the hospital.\u201d<\/span><\/p>\n<p class=\"p1\">Adds Carroll: \u201cKara and I are the frontline of our service,<span class=\"s1\"> so we are the first people our clients see and often the last they see as well. As we learn more about them, we establish a trust which helps ease the stress and pain of their animal going through cancer treatment.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Though they work jointly, Hall and Carroll tend to establish different relationships with their clients, Carroll says. \u201cKara, being a mom, likes to find out more about the client\u2019s family, how many kids they have, what they do,\u201d she explains. \u201cI am more about what they like to do when waiting around, or other animals in the house, or how long they have had their dog and how they found him or her.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Because of this close relationship, clients tend to lean hard on support staff, especially when difficulties arise. \u201cI am their constant,\u201d observes Tate. \u201cThe clients know that when they call here, they will always get me. We\u2019re the even keel of care, and the person they turn to when they have questions or concerns.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Cancer is a very common disease, so it\u2019s not unusual for clients and their pets to be on their journeys at the same time. Hall had a subject named Leo who was being treated for lymphoma while his owner was being treated for breast cancer. \u201cAt one time, they were receiving the same chemotherapy at the same time,\u201d Hall says. \u201cI always checked on [the owner] to see how she was feeling, listen to what she was going through, and be there for her regarding her concerns for Leo.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Lahrman recalls a Shih Tzu named Ellie Mae that was being treated for a nasal tumor, and whose owner shared with Lahrman her own cancer story. \u201cShe told me how Ellie had helped her get through her treatments, including long days of just laying in bed with Ellie at her side,\u201d Lahrman says. \u201cShe of course had concerns about side effects from Ellie\u2019s treatment since she knew how treatments has impacted her. She wanted to be there for Ellie like Ellie had been there for her. They had a very special bond.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\"><div class=\"su-quote su-quote-style-default\"><div class=\"su-quote-inner su-u-clearfix su-u-trim\">\u201cVeterinary oncology research provides an awesome opportunity to grow, not only as a [veterinary] nurse or technician, but as a person.\u201d<\/div><\/div><\/span><\/p>\n<h2 class=\"p2\">The Challenges and Rewards<\/h2>\n<p class=\"p1\"><span class=\"s1\">Working in veterinary oncology research can be challenging and wearing, but most veterinary nurses say they get a lot out of their involvement\u2014especially if cancer has touched them personally. Hall, for example, lost her aunt and grandfather to cancer, and is a cancer survivor herself. \u201cBeing a part of research that will help humans as well as pets is very satisfying,\u201d she says. \u201cI work with a fantastic team of people who have dedicated their lives to cancer research. I am honored to be a part of that team.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Others derive great personal satisfaction from being able to calm the often deep concerns of clients. Observes Winter, \u201cWhen a pet comes in with cancer, the news can be devastating for the owner. Being able to place their pet in a clinical trial gives them a glimmer of hope in their time of darkness. The most difficult part of my job is having to tell an owner that their pet isn\u2019t eligible.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">The emotional support aspect of her job also drives Tate. \u201cTheir animal has exhausted all of the conventional therapies, and the clinical trial is their last hope,\u201d she notes. \u201cSometimes things work, and sometimes they don\u2019t. The greatest upside for me is when we offer a therapy and it does work, and we have been able to fulfill the hope the client was looking for.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">There are, of course, challenges to the job, both emotional and otherwise. Foremost for many is having to euthanize patients and console their owners, especially if their relationship with the client has been long-term. \u201cYou always have to be cognizant that you don\u2019t become burned out, because it is a very emotional job,\u201d Tate says. \u201cYou get attached to your patients, and most of them eventually die. We see patients and clients weekly or monthly for a year or two, and suddenly the patient is no longer with us and the relationship ends. Sometimes that is really trying.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Equally difficult is knowing that a patient would benefit from participating in a clinical trial, but the client declines for financial or other reasons. \u201cThat can be frustrating because you know you can help the animal,\u201d Tate says. \u201cWe have to keep in mind that it\u2019s not that the owner has made the wrong decision; it may be the right decision for them and their family.\u201d <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Finding the time to do all that their job requires also can be difficult. \u201cEach trial has different requirements that must be done at each visit,\u201d Hall notes. \u201cWe may have 8 patients, each in a different trial in a day. We have to be extremely organized and efficient in order to get all of our work done in a timely manner.\u201d Detailed checklists help keep things running smoothly. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">And then there\u2019s the issue of funding\u2014or a lack of it. Carroll laments that unlike human medicine, veterinarians often don\u2019t receive the necessary grants from large companies needed to conduct state-of-the-art research. \u201cOur doctors may be working off a much smaller budget, and thus don\u2019t have all the bells and whistles they need or would like,\u201d Carroll says. \u201cHowever, I do believe that the research we are doing with what we have is still incredible and beneficial.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Yet, despite such challenges, most veterinary nurses in veterinary oncology research are enthusiastic about <\/span>their job, and encourage interested colleagues to consider<span class=\"s1\"> becoming involved. \u201cWhen I made the transition to the research side of things, I was able to develop a whole new perspective,\u201d Carroll says. \u201cI thought I knew a lot about oncology before, but this is a whole new world. I like being challenged, and this is one more way of doing that as we are constantly finishing and opening new trials, and they are all different.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Winter agrees, noting, \u201cVeterinary oncology research provides an awesome opportunity to grow, not only as a [veterinary] nurse or technician, but as a person. You see cancer treatments you have been working on go to market, and help patients. It\u2019s inspirational for me, and interested people who don\u2019t know much about oncology research should definitely look into it.\u201d <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Veterinary oncology research strives to advance the diagnosis and treatment of cancer in dogs, cats, and other species.<\/p>\n","protected":false},"author":1,"featured_media":4761,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":0,"footnotes":""},"categories":[144],"tags":[],"class_list":["post-4760","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-winter-2020","column-trends_in_veterinary_nursing","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 (Yoast SEO v27.4) - 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