Editorial October 1998 Issue

The Cancer Conundrum

How do you decide what treatment is best?

Cancer. There is no other word that strikes such fear into the heart. Partly because the disease is so often fatal, and partly because even the survivors end up experiencing so much pain and discomfort. The disease takes a tremendous toll on the patient, as well as his or her family and friends.

And as anyone who has heard a number of cancer stories knows, there are times when everything is used to treat the cancer – alternative and traditional medical remedies – and absolutely nothing seems to slow or stop the macabre march of the disease. At the other extreme, in other cases, some of the most ludicrous treatments imaginable seemingly cure the patient forever.

But while the majority of cancer patients, human and canine, probably receive medical care that falls somewhere in the middle of those two extremes, the uncertainty of the potentially fatal outcome weights every treatment decision.

So, as in so much of the game of life, there’s no right answer. Every person has to choose how they will treat their own (or their own dog’s) cancer. And there’s no way in advance to know whether you have chosen the correct remedies.

Informed, but personalized decisions
But, to be blunt, that’s life. If you think about it, you can never really know whether you did the “best” thing. Most of us just muddle through, educating ourselves about all the options, trusting our instincts, and, ultimately, accepting the results of our decisions with as much equanimity as possible, no matter what the outcome.

We are privileged to reap unlimited benefits from sharing our lives with our dogs. Balancing that transaction are the costs – financial and emotional – of our responsibility for making life-or-death decisions for our beloved canine companions. Determining how – and even whether – to treat a beloved dog with cancer can be just as difficult and heart-wrenching as it is for relatives of humans with cancer.

Nevertheless, we encourage you to embrace that responsibility yourself, rather than turning it over to your medical advisers, whether they are conventionally trained or alternative practitioners. Ask a lot of questions, and educate yourself as much as possible – about the side-effects of treatments, about the odds that a given remedy will improve or extend your dog’s life, the cost of the proposed treatments, and about the risks of not taking their recommended approach.

Make sure you communicate your concerns to all your medical advisors; the more they know about you and your dog, the better they can tailor their recommendations to your dog’s case. If, for instance, your dog panics when he is left with strangers, they might reconsider the wisdom of shipping him to a faraway university veterinary hospital for advanced treatments; the stress alone could have deleterious effects on his immune system.

Also, remember that doctors tend to advise taking the path they know best. Your knowledge, though it may not be as deep as theirs, may be wider.

A case in point is the author of this month’s Case History ("Buying Time to Spend Together"). When Di Rowling’s Belgian Shepherd, Jet, was diagnosed with fairly advanced bone cancer, her veterinarian felt there was little to be done but palliate Jet’s symptoms until his death (which he saw as inevitable and rapidly impending). Rowling quickly recovered from her initial despair, and consulted with two other experts – a veterinarian who uses unconventional nutritional supplements, and an experienced herbalist. Their treatments helped pull Jet back from the brink.

Rowling doesn’t imagine that she has “cured” Jet’s cancer forever; it may recur. For now, she’s thrilled to have bought some more time with her beloved friend.

-N.K.

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