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Cancer treatments and their prices   (2018)

8



When it comes to treating dogs with cancer, chemotherapy, radiation, and surgery are typically recommended, either alone or in combination. Veterinary medicine has made some recent strides in other treatments, such as immunotherapy or cell therapy, but these are less commonly used than the first-line treatments.

The course of your dog’s treatment will be determined by your veterinarian or veterinary oncologist, and will depend on the type of cancer, how far the cancer is advanced, as well as other factors. Whenever it is feasible, surgery to physically remove as much of the cancer as possible is usually part of the treatment. Surgery may be the only type of therapy that is recommended, or it will be performed before or after chemotherapy or radiation therapy.

Surgery

8.1

The physical removal of as much as possible of the cancer and if possible of existing metastasis.

However, approximately 70% of cancer patients already have advanced metastases at the time of diagnosis. This is the main reason why surgery alone is rarely effective at providing a cure for cancer. Nonetheless, surgery may provide a preventative approach to some forms of cancer as well as play a vital role for:


improving cure chances when combined with other forms of treatment such as radiation and/or chemotherapy,


2
reducing the tumor burden
for the purpose of relieving pain and removing obstructions that may interfere with normal organ functions,


3
removing secondary tumors
arising from metastases.


Possible complications in surgery

The risks associated with surgery increase with the age of the dog and are often associated with the dog’s general health. Mortalities resulting from surgery are most often associated with pulmonary blood clots (embolism), wound infection, blood loss, incomplete wound healing, pneumonia, cardiovascular collapse and abscess formation. Furthermore, cancer often causes a state of malnutrition in the dog which may further compromise the ability of the dog to recover from the trauma of surgery.

Approximate prize for a surgery: between 500.– and 3000.– SFr.
Approximate prizes by Animal Oncology and Imaging Center, Hünenberg, Switzerland)

Chemotherapy

8.2

Chemotherapy involves administering toxic drugs directly into a dog’s bloodstream through a vein (intravenously) or orally. These drugs target and kill rapidly-dividing cells, such as cancer cells. Unfortunately, current chemotherapeutic drugs cannot distinguish between cancer cells and other cells that normally reproduce rapidly. As a result, chemotherapy carries the risk of some side effects, including nausea, vomiting, diarrhoea, weakness, immunosuppression, and perhaps even death. 


Chemotherapy can be administered

  • Orally
  • Intravenously (injected into the bloodstream)
  • Subcutaneously (under the skin)
  • Intra-muscularly
  • Intra-tumorally (directly into a tumour)
  • Intra-cavitarily (into a body cavity).

Chemotherapy can be administered:

  • after a tumor is surgically removed in the hopes of killing the remaining or residual cancer cells;
  • prior to surgery to reduce the size of an existing tumor.

The majority of dogs treated with chemotherapy don’t suffer from serious side effects. Most dogs will not lose their fur during chemotherapy, however some breeds (those with continuously growing coats like Poodles and Old English Sheepdogs) will lose their hair, and might get naked. Your dog might also experience temporary diarrhoea or vomiting and have less of an appetite. Medication against these side effects will be administered. Bone marrow suppression is another long-term worry with chemotherapy treatments. These type of side-effect is very difficult and rarely treatable. That is why regular blood checks are needed. Approximately 80% of all dogs treated with chemotherapy do not experience any side effects. Dogs receive smaller doses and the drugs are administered in bigger intervals compared to humans. It is estimated that the chance of severe side effects is less than 5% of all pets receiving chemotherapy. With proper management, most animals recover uneventfully within a few days. After such an unpleasant event, the dose of the drug will further be reduced/adapted to your dog’s need. Quality of life during cancer treatment is the main goal in veterinary oncology.

Approximate prize for complete chemo-therapy: between 500.– and 5000.– SFr.
Approximate prizes by Animal Oncology and Imaging Center, Hünenberg, Switzerland)

Immunotherapy

8.3

Immunotherapy is a new treatment option for dogs with cancer. Cancer cells normally grow and spread because the immune system fails to recognize them as abnormal, allowing them to continue to metastasize. Immunotherapy is used to help the dog’s immune system recognize the cancer cells and attack them.

If the dog has a tumor that can be removed, a vaccine can be created for that patient. First the tumor is removed and shipped to a veterinary laboratory where the tumor and the cancerous cells are used to create a personalized vaccine that alerts the body to the fact that those specific cancer cells are harmful. The immune system then naturally starts killing the cancer cells and potentially helps prevent them from spreading further (metastases).

However, this type of treatment is not widely used yet and still a lot of research is needed before this technique can be recommended in the majority of cases.

The Animal Oncology and Imaging Center, Hünenberg, Switzerland doesn’t offer this type treatment.

Resource and further reading
→ Treat Cancer in Dogs with Immunotherapy

 

Stem cell therapy

8.4

This treatment so far is only available in the US.

The only indication for dogs is in the case of lymphoma, where no surgery is possible. After a total body radiation or chemo treatment to kill the cancerous cells, stem cells from a donor dog are intravenously administered. The hope is that the transplanted healthy cells spark new healthy cell growth.

A stem cell is a neutral cell that can become any type of cell, with the potential to regenerate tissue in a part of the body that has been damaged by disease, causing it to lose function.

Stem cell therapy for pets uses stem cells extracted either from your pet or from another animal of the same species. A veterinarian injects the stem cells intravenously.

Costs about US Dollars 30’000.–
The Animal Oncology and Imaging Center, Hünenberg, Switzerland doesn’t offer this type treatment. Only carried out by one institution worldwide, in the US:

Resource and further reading
→ Stem Cell Therapy for Cats and Dogs?

Radiotherapy

8.5

Depending upon the type of cancer and how it is affecting your dog, your vet may recommend radiation therapy rather than chemotherapy. 

Radiation therapy is a localized therapy, like surgery, and recommended in areas of the body where surgery is not feasible (eg. nasal cavity, brain, face) or where the surgeon does not get enough margins around the tumor or the tumor is too big for surgery. It can be directed directly to the affected area

Radiation produces a biological effect when it comes in contact with the cells in the dog's tissues. When radiation travels through these tissues, it causes an excitation of these cells that ultimately leads to biological damage of the cancer growth.

It’s often used for tumors that can’t be surgically removed because they’re too close to vital organs such as the heart or brain, or because the surgery carries too many risks for the dog. Whereas chemotherapy is a systemic treatment (once it is injected, it goes all throughout the body battling microscopic disease and also spreading to other locations), radiation is more localized, sparing normal tissues.

An effective radiation therapy is given more often in different schemes: either daily, two, three times a week or also once a week, with up to 20 daily treatments—so it may take up to three or four weeks in total. An individual treatment takes about an hour, and most of that time is spent waiting for the patient to become sleepy from the sedative, and then later to recover from the anaesthesia. The actual treatment itself only takes about 5-10 minutes.

Dogs are given a short general anaesthesia for radiation treatments, mainly to keep them still. There’s no direct pain from the radiation treatment itself, although some discomfort, skin problems, or fatigue may be associated with its effects.

If you live close to your treating oncologist, you might be able to bring your dog to its daily radiation treatments. If distance is an issue, your dog can be boarded during the week for treatments and be permitted to go home to recuperate over the weekend.

Approximate price for complete radiotherapy: 600 – 5’000.– SFr.
Prizes by: The Animal Oncology and Imaging Center, Hünenberg, Switzerland

Resource and further reading
→ What to Do When Your Dog is Diagnosed with Cancer: Treatment, Prognosis, and Costs

 

Hyperthermia

8.6

The mechanism involving damage to cancer cells through elevation of temperature, a process known as hyperthermia, is not fully understood. Heat exposure, however, does cause changes to proteins within the cells, thereby altering their ability to function. Therefore, it is believed that the killing of cells induced by hyperthermia may be a result of thermal effects on proteins.

The observation that high fevers in some human patients with cancer has resulted in subsequent disease remission led to the idea that elevation of the body temperature might provide a new treatment for this disease. Research into the use of hyperthermia for the clinical treatment of cancer has indicated that it is lethal to cells, causes tumour regression, increases the efficacy of radiation therapy and enhances the action of many anti-cancer drugs.

Local heating of tumours is typically accomplished by microwave radiation, infrared radiation, radiofrequency or ultrasound. The need for specialized equipment for the administration of hyperthermia is a limiting factor for its widespread use in veterinary medicine at present.

Many factors, including the nature and size of the tumour, will influence the success of hyperthermia in eradicating the entire malignant growth. Some cancer cells which are resistant to heat exposure may escape the lethal effects of hyperthermia. Therefore, as with other methods of treatment, hyperthermia is often used in combination with radiation or chemotherapy to increase overall treatment efficacy. In canine cancer, treatment with hyperthermia is most commonly administered in combination with radiation.

Hyperthermia is damaging to both cancer cells and normal cells. As such, the toxicity associated with hyperthermia may be significant.

The Animal Oncology and Imaging Center, Hünenberg, Switzerland doesn’t offer this type treatment.

Acupuncture as an adjunctive therapy

8.7

Current conventional treatment of cancer relies mainly on surgery, chemotherapy, radiation and attempts to boost immune function by immuno-therapy. Many of these treatments may induce severe adverse effects in the patient.

When properly used by people trained in the basic principles of traditional Chinese medicine (TCM), acupuncture has few if any negative effects.

Acupuncture is mostly used with the intention of aiding a pet to get through first-line treatments which often provoke symptoms such as fatigue, nausea, vomiting, dry mouth, and others that can be severe enough to require treatments to be discontinued. Acupuncture and Chinese herbal medicine are very effective at easing these symptoms, allowing a pet to finish its course of treatment.

As far as research goes, there have been no reputable studies done to observe the outcomes of cancer treatment using Chinese medicine only.

Chinese medicine is usually seen as an adjunctive therapy; one to be used in conjunction with more traditional treatments (for example, chemotherapy. If the pet’s owner decides to go through with traditional treatments, Chinese medicine can ease the side effects associated with chemotherapy and radiation, help make the pet feel more comfortable, and perhaps slow the progression of the disease, giving them more symptom-free time.

To bring most cancers under control – or ease the negative side effects of the cancer treatment - it usually takes 1-3 acupuncture sessions, at inter-session intervals of about 4 weeks, but treatment of very severe cancers may continue for 1-2 years.

Price per acupuncture session: For the first session Sfr. 165.–, all follow-up sessions Sfr. 120.–
Prices by Animal Clinic Ennetsee (ESK), Hünenberg, Switzerland

Resource and further reading
→ Clinical Results on Acupuncture in Cancer-Treatment
→ Acupuncture for dogs with cancer?
→ Part 3: Treating Cancer in the Canine

Nutrition

8.8

Symptoms of cancer include diminished appetite and food intake, progressive weight loss, and a number of metabolic abnormalities. Without the correction of their nutrition, many patients may succumb to severe physical exhaustion and eventual death. Therefore, attention must be devoted to ensuring that dogs afflicted with cancer receive palatable, highly digestible, and energy-dense diets that may enhance their overall quality of life, their life expectancy, and their ability to undergo aggressive therapy regimens (surgery, radiation or chemotherapy) for treatment of their disease. (see chapter 11)

Unfortunately, many of the dogs that are ill are unwilling or unable to eat for themselves. Therefore, hand feeding and in some cases, feeding tubes or catheters should be used to ensure adequate nutrition. The use of appetite stimulants, by causing an immediate increase in food intake following the administration of these drugs, does not appear to increase overall food intake over longer periods of time. Therefore, some veterinarian oncologists prefer to use feeding tubes or catheters that ensure increased food intake in lieu of appetite stimulants.

Resources and further reading:
http://www.petmd.com/dog/conditions/cancer/what-do-when-your-dog-diagnosed-cancer-treatment-prognosis-and-aftercare