Receiving a diagnosis of cancer can often be unexpected, and your primary care veterinarian may recommend referral to an oncology specialist. Friendship Oncology Specialists is here to help and provide state-of-the-art treatment options for pets with cancer. Recent advances in diagnostic and treatment capabilities have allowed for a more individualized approach to veterinary cancer care, leading to more successful outcomes.
The focus of FOS is to provide treatment options that meet the specific needs of each client whose pet has been diagnosed with cancer. These options may include conventional chemotherapy, new investigational therapies, and palliative or supportive care.
- Comprehensive consultation and examination – At the time of initial consultation, Dr. Mallett will perform an exam, discuss your pet’s diagnosis, and then make further recommendations regarding diagnostics and treatments as indicated. This initial discussion usually takes about 1 hour, although additional time may be needed if same-day diagnostics and/or treatments are pursued. All veterinary cancer treatment plans are customized to meet the needs and goals of the individual patient and family. A combination of different treatment types often provides the best chance for a good long-term outcome. Your pet should be present for the consultation and should be fasted after 10pm the night before (water and medications can be given as usual); please let us know if your pet is diabetic when the appointment is scheduled.
- Diagnostic tests for confirmation of diagnosis and cancer staging – If cancer is suspected, diagnostic recommendations may include lab work, x-rays, ultrasound, fine needle aspirates, biopsies, bone marrow aspirates and/or advanced imaging, such as CT or MRI. In veterinary medicine, cancers are generally grouped into 3 categories: 1) carcinomas (tumors derived from epithelial tissues), 2) sarcomas (tumors derived from connective tissues), and 3) round cell tumors (tumors derived from blood or immune cells). In addition to a definitive diagnosis, diagnostic tests may also provide a tumor “stage” and a tumor “grade” in some cases. “Stage” describes tumor size and where it has spread in the body. “Grade” describes what the cancer cells look like under a microscope following a biopsy. Staging and grading systems are different for different types of cancer. In most cases, lower stage and grade indicate a more favorable prognosis. After all of the pertinent results are obtained, the data points are integrated to provide comprehensive information regarding treatment options and prognosis. All cancers are not created equally; species, location, and diagnosis are very important to consider when determining a plan of action for an individual patient. Rates of growth and metastasis, response rates to various treatments, and prognoses can vary significantly based on these factors.
- Follow-up or recheck examination – If additional visits are recommended following the initial consultation, we offer two types of appointments: “rechecks” and “drop-offs.” Recheck appointments generally require around 1-2 hours from check-in to check-out. A member of our oncology team will come to the front lobby to greet you and bring your pet to the treatment area. Once treatment is complete, your pet will be promptly returned to you. Drop-off appointments are also offered for your convenience and to enhance our ability to schedule treatments. As with a recheck appointment, one of our team members will greet you in the front lobby and bring your pet to the treatment area. We will contact you once your pet is ready to go home. The length of time associated with a drop-off appointment may fluctuate and is dependent on the type of treatment or testing being administered.
- Chemotherapy – Chemotherapy is a systemic form of treatment that is given either orally or as an injection with the intent to kill rapidly dividing cancer cells. It can be used alone for cancers/tumors that affect multiple areas of the body, such as lymphoma, leukemia, and metastatic tumors, or it can be used in combination with surgery and/or radiation therapy to slow or stop localized tumors from spreading to other areas of the body when this is a concern. Different chemotherapy protocols are used for different types of cancer/tumors, and all are usually very well-tolerated.
- Targeted therapy – This is a new type of chemotherapy that acts selectively against molecular targets expressed by some tumors and can interfere with tumor growth and progression. The effect is different from the nonspecific destruction associated with traditional chemotherapy, which will kill any rapidly dividing cell population within the body (cancer cells and normal cells).
- Immunotherapy (including the Merial melanoma vaccine) – Immunotherapy is a medical treatment that induces, enhances, or suppresses an immune response. The goal of immunotherapy as a treatment for cancer is to stimulate the patient’s own immune system to reject and destroy tumor cells. Options for immunotherapy in veterinary oncology are currently very limited, but there is ongoing research in this area.
- Coordination for oncologic surgery – Surgery is the first step in treatment for many localized tumors, and it generally involves removal of the tumor itself plus a good margin of normal tissue around the tumor in order to prevent recurrence. Debulking is sometimes an option for large tumors or tumor in difficult locations in order to reduce the tumor to microscopic levels for improved success with follow-up treatment.
- Referral and coordination for radiation therapy – This is another form of localized therapy that uses high-energy radiation to kill cancer cells and improve quality of life. “Definitive” radiation therapy is generally used post-operatively for narrowly or incompletely removed tumors to help prevent recurrence, and a good long-term outcome is usually expected. “Palliative” radiation therapy is generally used for short-term pain control and relief from clinical signs when an incurable tumor is diagnosed.
- Clinical trials – Clinical trials evaluate the safety and effectiveness of new drugs and may offer a treatment option that potentially utilizes the newest medical research available. Some of these products are early in development, while others have been used in pets before. Details such as funding, the duration and intensity of the visit schedule, and potential side effects of the investigational product will vary from trial to trial.
- Management of treatment- and disease-related side effects/symptoms – Although the goal for all of our patients is to maintain a good quality of life throughout the treatment process, sometimes unexpected side effects and symptoms occur. Prescriptions for oral antinausea medications, antidiarrheal medications, antibiotics, and pain medications can be provided as needed. Sick or debilitated oncology patients should always be evaluated immediately through the Friendship Emergency & Critical Care (open 24/7), and hospitalized care for IV fluids and other more intensive supportive treatments can then be facilitated when appropriate.
- Hospice/palliative care – This is a type of medical care that provides relief from the symptoms, pain, and stress associated with cancer. The focus of this type of treatment is on improving quality of life and not on curing the cancer. Fluids, physical therapy, urinary bladder expression, and medications for pain, inflammation, and nausea are just some of the palliative measures that can be considered.
How to schedule:
Appointments must be made in advance and can be scheduled by calling directly at 202.567.2080. Currently, our office hours are Monday-Thursday from 8am-5pm. Phone consultations are not offered.
In addition to your visit(s) with Friendship Oncology Specialists, we recommend that you maintain your relationship with your primary care veterinarian for medical issues unrelated to cancer. All records from oncology will be shared with your veterinarian upon discharge. Please continue to administered monthly heartworm and flea preventatives, although we ask that you avoid giving or applying them within 24 hours of any chemotherapy treatment. Annual vaccines should be discussed with your veterinarian but avoided within 24 hours of any chemotherapy treatment. Regular vaccination for rabies is required by law.