It’s perhaps one of the ugliest tumors we see, a knobbly blackish gray multilobulated lump that looks something like the fungal outcroppings your neglected refrigerated foods might suffer. When melanoma masses get to breaking and bleeding they’re even less likely to compete against Miss Venezuela for the coveted sash and crown.
Last week I cut one of these bloody suckers out of a mixed-breed’s mouth down near the base of his tongue. The lump on the underlying mandibular bone led me to discuss the likelihood of a malignant melanoma diagnosis even before the pathologist had her way with the specimen of greedy cells.
A trio of X-rays later (along with a histopathology report in damning black and white) and it seemed fairly plain: A big tumor in the lungs along with a nasty tumor in the mouth tends to signal the spread of this cancer: now add “metastatic” to the diagnosis of malignant melanoma…bad.
After the owners of this unlucky nine year-old endured their grief sessions in the privacy of their home, it was time to get down to brass tacks. What’s next? What can we do…if anything?
One option had included radical surgery of the mouth with a procedure that would essentially remove half of his lower jaw (hemi-mandibulectomy), but the spread of the melanoma to the chest pretty much precluded that option (truth be told, the owners weren’t too upbeat on that approach anyway). And going into the chest to pull out a fist-sized hunk of blackish flesh seemed an even more unsavory (not to mention extremely temporary) way to curb this cancer’s relentless drive to consume my patient.
A phone consult with two internists and one oncologist later, we’d finally decided to take on the tumors with the much-touted melanoma vaccine.
Though the melanoma vaccine is only approved for use in dogs who suffer malignant melanomas of the as yet non-metastatic variety (i.e., the solitary, black toe mass), it has been used to halt the rapid spread of late-stage manifestations of this cancer.
Without the vaccine this little guy likely has less than a month to live. With $3,000 of melanoma vaccine therapy his owners can buy him six to seven months of comfortable “cure,” on average…and, of course, there are no guarantees.
The good news, and there is some, is that the vaccine has no side effects (that we know of). The application of this non-drug is blissfully painless and practically stressless…for the patient, that is. But for the rest of us?
It’s a tough choice, knowing that several paychecks will need to go to your dog’s last few months. The time bomb factor. The worry if you do. The guilt if you don’t. It’s enough to hope for a speedy end so these decisions can be denied their intrinsically agonizing nature.