During nearly every consultation, there comes a time where pet owners must make the decision whether to pursue chemotherapy or not. While a small number of people arrive assured that they will treat their pets, more frequently owners arrive with an open mind to the available options, searching for all possible choices before moving forward.
On rare occasions, at the onset of an appointment, an owner will inform me they have no intention of ever pursuing chemotherapy. I’m marginally astonished when faced with such assuredness, given I’m a veterinary oncologist and treating cancer is what I do for a living. With time, I’ve come to appreciate such an owner’s motivation for simply seeking my advice without intention to follow it.
Somewhere in the middle lie owners who initially decline therapy, but later change their minds and elect treatment.
Personal Experience Influences Decision
Most animals with cancer are diagnosed at relatively asymptomatic stages of disease. Owners are typically shocked if I tell them their otherwise happy and healthy dog or cat might only be expected to live a few weeks or months following a diagnosis of an aggressive cancer such as lymphoma or high-grade mast cell disease. Convincing that owner to pursue treatment is a challenge, until the pet’s health declines and the owner feels urgency to move forward out of desperation.
More often, owners digest the information I present to them and reverse their initial decision to not treat after learning the facts about chemotherapy. Their prior misconceptions may stem from personal experience with chemotherapy, or from observations of close friends or family members. Even an owner’s primary veterinarian can discourage meeting with an oncologist by perpetuating myths about cancer care in animals.
Of all the misunderstandings related to chemotherapy preventing owners from pursuing treatment, the biggest hurdle I face is communication with owners who are certain chemotherapy is guaranteed to make their pet sick.
Chemotherapy Side Effects and Quality of Life
The goal of veterinary oncology is to preserve quality of life for as long as possible while minimizing potential deleterious effects. Approximately 25% of all animals receiving chemotherapy will experience self-limiting side effects from chemotherapy. This generally entails mild gastrointestinal upset and/or lethargy that occurs during the first several days following treatment, and they only last for a day or so.
Adverse signs can usually be controlled using over the counter or prescription medications. Roughly 5% of chemotherapy patients will have severe side effects that require hospitalization. With appropriate management, the risk of these side effects causing the death is less than 1%.
If a patient experiences serious side effects, the prescribing oncologist will reduce future doses of chemotherapy to avoid similar complications in the future. Additionally, to help reduce the risk of complications in sick pets, every precaution is made to ensure they are strong enough to undergo treatment prior to instituting therapy.
The quality of life for animals receiving chemotherapy is excellent. Multiple studies indicate that the majority of owners are happy with their choice to pursue treatment for their companions and their outcomes and would elect to pursue treatment again if necessary.
Placing Your Trust in Medicine
For those owners who initially decline treatment, but then move ahead, experience tells me they would feel no different from those owners committed from the onset of diagnosis.
If you’re facing a diagnosis of cancer in your pet, you do not need to be absolutely positive you want to pursue treatment prior to speaking with an oncologist about your options. If you’re concerned chemotherapy will be “torture” for your animal, I can assure you this is untrue. No veterinary oncologist endures the rigors associated with their training and credentialing with the goal of imparting pain and suffering on their patients.
Veterinary oncologists are here to make your pet feel better from their disease and to know the appropriate and least impacting treatment for their situation. We’re not here to convince you to treat with chemotherapy. We’re here to provide the facts and allow you to consider what is most appropriate for your companion.
Even if it takes a little time for you to reach your decision, your oncologist will be there for you and your pet during your time of need.