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Chaos in the world brings uneasiness, but it also allows the opportunity for creativity and growth.
– Tom Barrett  
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  Volume No. 17 Issue No. 7 July 2020  

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Dr. Jim Humphries

  Cancer terms defined
  By Dr. Jim Humphries
  Veterinarian

   Because my specialty practice is now focused on end-of-life issues, we see a lot of cancer. Cancer of all types accounts for about 70 percent of our cases. Cancer diagnosis and treatment is its own specialty, called oncology, and it is a complex specialty. I want to help make it a bit more understandable.
   
   First, let me point out that not all cancer is fatal. Several types of cancer are survivable; of course, early detection is the key in getting good help. If you see a lump or a growth, please have it seen. That is the SSDS principle; if you see something, do something. Many of these growths are not cancer (benign) but many are and the longer they remain, the more likely they are spreading their cancerous cells throughout the body. If you see a lump, have it evaluated. A simple exam by a good veterinarian is inexpensive and valuable
   
   When you hear the word “cancer” coming from your veterinarian, it’s much like hearing it coming from your own doctor. There is an empty hole that forms in your chest because you may be facing an end-of-life decision right then or perhaps in the next few weeks or months. Either way, it’s an overwhelming feeling that your wonderful pet friend will likely be facing a long and expensive ordeal — or might even die.
   
   There is so much to this topic; I’d like to cover one aspect this month, which focuses on the meaning of special cancer words. If you or a family member has experienced this with your own health, you are likely familiar with some of these. If not, this is a good thing to know.
   
   The language of cancer
   Sarcoma, carcinoma and round cell tumor: Microscopically, oncologists group tumors into three main families: sarcoma, carcinoma and round cell tumors. A sarcoma is a type of cancer that starts in tissues like bone or muscle. Soft tissue sarcomas can develop in tissues like fat, muscle, nerves, fibrous tissues, blood vessels or deep skin tissues. Carcinoma is the most common type of cancer, and it begins in the tissue that lines internal organs, such as the liver or kidneys. Round cell tumors get their name from the way the nucleus appears under the microscope. In dogs, they are often skin tumors; and, while they can be aggressive and malignant, if caught early, they are easily removed surgically —and that is often curative.
   
   Median survival time: After you get a cancer diagnosis, your next question is likely how long will my pet live? This important question can only be answered from knowing how thousands of other pets did after their diagnosis. To do this, we look at data. The term “median” represents the midpoint of the data. If we say the median survival time (MST) is 12 months, this means that 50 percent of all pets with this cancer will live more than 12 months — half will not survive that length of time.
   
   Prognostic factors: Prognostic means predicting or forecasting. An experienced oncologist is pretty good at predicting the outcome of cancer cases, but sometimes the tumor does not follow the rules and they can be way off base. Prognostic factors are characteristics about your pet’s tumor that will affect how well your pet will respond to treatment. Both grade and stage will come into play here
   
   Grade: A pathologist looks at the tumor biopsy microscopically and decides the cell type and “grade.” This is determined by the number of dividing tumor cells seen in the biopsy, the degree of abnormal structures and if the cells are invasive to other tissues. A higher grade typically means a worse prognosis and perhaps a need for more intensive or multiple treatments.
   
   Stage: This is a description of how widespread the cancer is. This determination is usually made by an evaluation of the entire pet using a physical examination, blood tests, X-rays, ultrasound or advanced imaging. In all tumors, the highest stage is given when the tumor has spread widely throughout the body. Of course, a tumor with a high stage carries a worse prognosis.
   
   Aggressive: This term is used for both the disease and the treatment. When used to describe a tumor, it means the tumor is likely to spread rapidly or recur quickly despite treatment. When it is used to describe a treatment, though, it means we take every possible step to aggressively fight the cancer.
   
   Complete remission: These are the two words every pet owner wants to hear. Complete remission, or no evidence of disease, means we cannot find any clinical evidence of the tumor remaining in your pet. Great news! This is usually based on a physical examination, blood tests, X-rays and ultrasound or advanced imaging. If you and your pet are lucky, the tumor will stay away forever.
   
   In our practice, we see a great deal of cancer that is usually life ending. Take the lumps and bumps seriously and get them evaluated. We’ll talk about causes and prevention in a future column.
Dr. Jim Humphries is a veterinarian in Colorado Springs and serves as a visiting professor at the College of Veterinary Medicine at Texas A&M University. His specialty practice provides hospice and end-of-life care for pets. He lives in Falcon with his wife, horses and Great Danes. www.HomeWithDignity.com
  
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