Why Should I Consult an Oncologist?

Why Should I Consult an Oncologist?
By Emily J. Skovira, DVM, MS, Residency Trained in Internal Medicine
Dogwood Veterinary Internal Medicine

Cancer affects a significant number of dogs and cats; it is one of the leading causes of death in the aging pet population. As our understanding of cancer advances, we often are able to improve the length and quality of life for pets with cancer. Similar to the diagnosis of “infection” which is a very broad category of diseases, “cancer” is also a very broad category. While the term “cancer” is often associated with fear and a shortened lifespan, there are types of cancer that are associated with long term remission and some even with a cure. Treatment recommendations and prognosis is dependent on obtaining a specific diagnosis and often the grade of the tumor. Grade is a more objective evaluation of the observed behavior of the tumor and may provide more information on the expected disease progression and/or rate of progression. In addition, there are molecular tests available for several tumor types that can provide further information to direct treatment options and provide prognostic information.

Your pet’s primary veterinarian, internal medicine specialist, surgeon, or other specialist may recommend consultation with an oncologist. As an internist, it is not uncommon for people to tell me that if we obtain a diagnosis of cancer then they are not interested in treating their pet. The perception is that quality of life for a pet with cancer is poor and there is not much that can be done. This perception frequently does not correlate with reality. Treatment options may be divided by the goal of therapy including “definitive therapy”, where the goal is to eradicate the disease, or “palliative therapy”, where the goal is to improve the patient’s quality of life. A range of options are available including surgery, definitive chemotherapy, definitive radiation, palliative radiation, metronomic chemotherapy (small doses of chemotherapy given daily), and immunomodulatory therapy such as the melanoma vaccine, symptomatic therapy, and surveillance.

The majority of veterinary patients treated with chemotherapy do not experience the side effects that are common in humans receiving chemotherapy. The benefits of chemotherapy usually far outweigh the risk. The goal during treatment is for your pet to feel better or at least normal during treatment. In patients that develop side effects associated with chemotherapy, it may be possible to change the dose and/or type of chemotherapy or prescribe medications to manage the side effects.
A veterinary oncologist is a veterinarian that has done advanced training after becoming a veterinarian. Prior to obtaining board certification, the veterinary oncologist must pass a rigorous examination process to confirm that they have the knowledge required. The veterinary oncologist has extensive knowledge of treatment options available and a network of other oncologists with whom they may consult. Their knowledge of this topic far surpasses the knowledge of other veterinarians. Even if you do not think you are interested in pursuing therapy, I strongly recommend consulting with a veterinary oncologist so that you are fully informed regarding your pet’s prognosis and current treatment options including palliative care.