If you were diagnosed with cancer, to whom would you entrust your care?
The obvious answer is: an oncologist.
Most people understand an oncologist’s expertise in the diagnosis, treatment, and management of various cancers. Regardless of the expertise of the initial physician suspecting this dreaded disease, once cancer is on the radar the average person would be referred to, and actively seek consultation with, an oncologist.
Unfortunately, cancer is as common a disease in animals as it is in people. Approximately one in four dogs will develop this disease during their lifetime and more than half of animals over the age of 10 will be diagnosed with a tumor.
Statistics also tell us that two out of three American households own a pet, nine out of ten owners consider their pet part of their family, and over 75 percent of owners admit to talking to their pets as if they were “real” people. About 60 percent are comfortable referring to themselves as their pet’s “Mommy” or “Daddy,” and an additional 10 percent celebrate Mother’s Day and/or Father’s Day with their pets.
A quick summary of all these details tells us that 1) people understand the value of an oncologist for their own health care needs, 2) pets are more often than not considered a part of the household, and 3) cancer is a very common diagnosis in our furry family members.
So why am I, a board-certified veterinary oncologist, not completely booked with appointments every day? How do I explain the blank spaces in my schedule?
It’s frustrating for me to think about the disparity between what surveys and statistics tell us and what transpires in reality. It also affords me the chance to try to dispel some of the myths and misconceptions I think are (at least partially) responsible for the gap.
One major issue is the overriding, and incorrect, public perception that treating a pet’s cancer is akin to “torturing” them. I recognize the negative connotations associated with words like cancer, chemotherapy, and radiation therapy. I understand the gravity imparted by the diagnoses I deal with on a daily basis. I’m completely aware that my days are not filled with happy puppy and kitten visits or routine wellness exams.
However, I assure you that if I were to list the myriad of reasons why I selected veterinary oncology as my specialty, “a want and desire to torture animals and make them sick” would never even be on my radar.
I’m here to help pets with cancer live longer, happier lives. The treatments I prescribe have low side effect profiles and our patients are amongst the happiest and healthiest pets you will find in our waiting room. Many cancers are now managed as chronic diseases similar to diabetes or kidney failure. When it comes to cancer care for pets, the idea that I’m here to impart “torture” is absolutely absurd.
Likewise, I also struggle with primary care veterinarians who do not offer owners a referral or, worse yet, dissuade owners from pursuing consultation with an oncologist because they feel the option is inappropriate for the pet.
The numbers of vets who do not embrace specialty care or who adhere to the line of thinking that cancer is an untreatable condition in animals is remarkable. While I agree that it may not be the right choice for every pet or for every owner, the number of instances where oncological care can improve and extend a pet’s quality of life is no exaggeration.
Paradoxically, there are many general practitioner veterinarians who administer chemotherapy treatments without offering, or discouraging referral to, a specialist because they can treat cancer “equally” as well.
Though I understand the utility of such practice in areas where specialists are not available, I’ve encountered this practice in each area where I’ve worked, making it difficult to reconcile geography as the sole rationale.
In most of those cases, I’m told that owners are reluctant to pursue referral to an oncologist and choose to treat locally because of perception of increased expense. But experience tells me that in many instances the cost differential between my treatments and a primary care veterinarian’s is nominal.
Everything I’ve talked about thus far points toward an “outward” cause for my concerns. I’d be remiss not to look internally and ask what it is that I do or, conversely, don’t do, that contributes to a lack of referrals filling up my schedule.
Perhaps the most obvious answer is a lack of accessibility. I am one person, and I’m someone who values my personal time and quality of life outside of the clinic immensely. As such, although I work full time and make myself available as often as I can, I don’t see appointments on weekends or have late evening hours.
This means I’m not always available to see a case on a moment's notice or offer instant advice to a distraught owner. In a world where immediate gratification is the norm, the fact that I’m not always there for owners or veterinarians' questions has been called into question more than once during my career. Though I understand the hindrance, I must do what I can to maintain a semblance of normalcy in a profession where the expectation of doing so is far from ordinary.
I’ve mentioned a lot about statistics and odds, but what might be more important to note is that surveys also consistently tell us that owners of pets who elect to pursue advanced oncological care for their pets are happy with their decisions and would do so again in the future if faced with a similar decision.
With this information on board, I challenge owners, veterinarians, and specialists alike to keep the dialogue open and maintain our responsibility towards ensuring that we each work to support what is in the best interests of the animals we all love.
I’d bet if we did, there would never be a blank space in my schedule to speak of.
Dr. Joanne Intile