Reproduced with kind permission by Shawn Messonnier, DVM

Chapter 1
Understanding the Holistic Approach to Treating Cancer

When treating a dog with cancer, owners truly have many options. The reason for the large number of options is that there is no one “best” treatment for every pet. I share the holistic belief that each pet is an individual, and must be treated as such. I discuss this philosophy with owners right from the start. What worked for the last dog I treated may not work for their pet. Additionally, each owner is unique and has different wants and a different budget for their pet’s medical care. Some owners want to do everything possible for their pet. Money is not an object, and they will often allow us to experiment and try quite a number of unique treatments. Others opt for a bit less, and may choose only surgery or one round of chemotherapy. Still others never want any conventional medications, but will only opt for natural therapies such as herbal therapy or homeopathy.

I should point out before proceeding that the truly holistic view, desired by most pet owners, involves looking at all options and choosing what works best with the fewest side effects. I’m a conventional doctor by training, and use many conventional therapies in my practice. Whenever appropriate, I like to integrate as many different therapies as possible, as the best results occur when conventional therapies are combined with complementary therapies. Chemotherapy, as used in veterinary medicine, is not as harmful as it is in people, and significant side effects are uncommon in pets. This is because maximum tolerated dosages are used in people, leading to complications in nearly every patient. For pets, most chemotherapy dosages are 10 to 20 percent lower than the maximum tolerable dosage, leading to fewer than 5 percent of treated pets having significant dose-limiting side effects such as bone marrow suppression (low white blood cell counts leading to increased risk of bacterial infection) or gastrointestinal upset (nausea, vomiting, or diarrhea).

The true goal of chemotherapy is to chemically reduce the burden of cancer and provide additional symptom-free quality of life. Having no evidence of cancer (by examination or X-ray evaluation) and no symptoms from cancer is called remission.

Once in remission, pets are prescribed supplements to help boost their immune system as well as counteract side effects of chemotherapy. In some cases chemotherapy may be the only treatment option, as the cancer patient may not be able or willing to take all of the recommended supplements. Some pets are easy to medicate and can take many herbal and homeopathic supplements several times a day, whereas others will never take anything by mouth, complicating our effort at developing the best treatment plan. The holistic approach simply means looking at all of the available treatment options and choosing what works best for each specific patient.

However, when trying to design the most natural and holistic treatment for the pet, it is wise to consider all options before settling on one particular therapy. The best treatment for many dogs with cancer is often a sensible combination of both conventional and complementary therapies. I believe that by combining and offering both conventional and complementary therapies to owners, I offer the best of both worlds. By knowing the pros and cons of both types of medical care, owners can work with me to pick the therapies that they are most comfortable with, and that are most beneficial to their pet.

Keep in mind, too, that “holistic” doesn’t necessarily mean “alternative.” A truly holistic approach tries to heal the entire pet, and not just treat symptoms. A truly holistic approach chooses what’s best for the pet, trying to give the pet relief while minimizing side effects. Conventional therapy can be a part of the holistic approach to the treatment of cancer if the goal is to help the pet become healthier and not just cover up symptoms or ignore the pet’s overall well being.

Combining conventional and complementary therapies is the best of both worlds.

Here’s an example of the harm that can come to a pet with a treatable cancer by refusing to be truly holistic and consider conventional chemotherapy. I once treated a friendly Shih Tzu named Radar with lymphosarcoma, a cancer that is very responsive to conventional chemotherapy with minimal side effects in most cases. In cases like this, I usually prescribe supplements and homeopathy to help boost a pet’s immune response to conventional therapy. Unfortunately, Radar’s owners were totally opposed to chemotherapy due to some unfounded fears that I could not overcome that he would suffer during chemotherapy. Despite two weeks of supplements and homeopathy, Radar rapidly worsened and was euthanized shortly thereafter. This case was frustrating, as I believe that Radar could have done quite well if only his owners had agreed to a quick round of chemotherapy in addition to other therapies. In this instance, homeopathy and other supplements did not have any chance of success against the aggressiveness of Radar’s cancer. The moral: whenever possible, don’t decline treatments that work without serious thought and rational judgments. Remember that for many pets with cancer, complementary therapies alone rarely achieve the same results as conventional therapies. It is best to use them as they are intended, to complement the conventional treatments for the pet with cancer.

On the flip side, there are problems with the strictly conventional approach of diagnosing and treating cancer. Often, by ignoring the holistic approach to treatment, we are treating the cancer and not the pet. As one of the contributors to this book, cancer specialist Dr. Kevin Hahn likes to point out, don’t forget that there is a pet attached to the tumor! The only way to win the war against cancer is to make the pet as healthy as possible while we’re treating the cancer. This may mean using supplements to support the liver, the gastrointestinal system, and any other organ or system of the body. Simply choosing conventional cancer therapies without regard for the overall health of the entire pet is not in the pet’s best interest. Nutritional support is important — we must provide the pet with the best diet possible (see chapter 7 for more on the best diet for a pet with cancer). Nutritional supplements may be useful to boost the immune system and help the pet recover its natural ability to fight cancer. Using complementary therapies such as glutamine supplementation may also reduce the side effects, such as vomiting or diarrhea, that may occur with some types of chemotherapy or radiation therapy.

Finally, I cannot stress enough the importance of a full diagnosis. Many doctors take a “wait and see” approach when an owner points out a suspicious lump on the pet. A diagnosis is often made by the doctor simply looking at and feeling the lump. Fatty tumor or cyst are terms often applied to these lesions. While it is true that most suspicious lumps are benign (non-cancerous) fatty tumors or cysts, some are malignant cancers. With rare exceptions (such as the commonly observed warts, technically called papillomas, usually seen in older dogs), no one can adequately diagnose a tumor simply by looking at it and feeling it. I have removed too many malignant cancers that were originally diagnosed as fatty tumors or cysts to know that full diagnostic testing is essential, usually by examining under the microscope the aspirate taken from a tumor with a tiny needle.

Not too long ago I made an initial diagnosis of an infected cyst on the abdomen of Lizzie, a five-year-old spayed female black Labrador retriever. At first I was not concerned about this lesion. However, when it didn’t get better after two weeks of topical antibiotic therapy, I suggested removal and biopsy. Imagine my surprise when this infected piece of skin was identified as a malignant mast cell tumor — a cancer notorious for looking like benign cysts and fatty tumors!

Thankfully I had removed the entire tumor with that surgery and no further treatment was needed for Lizzie. Because of this and other similar cases, I have become convinced that mast cell tumors can look like almost anything. (You’ll learn more about the ability of mast cell tumors to masquerade as benign fatty tumors and other lumps and bumps in chapter xx.)

Unless a lesion is an obvious old-age wart, I recommend removal and testing of all lesions. The lesson is simple: any lumps seen or felt under the skin or above the skin surface should be aspirated or in some way biopsied before a conclusive diagnosis of a benign fatty tumor or cyst is reached.

No one can adequately diagnose a tumor simply by looking at it and feeling it.

It is quite troubling that so many pets I see have not received a proper diagnosis. A good number of these pets have not had any diagnostic tests done. Yet often a simple aspirate of the lesion, radiograph (X-ray) of the abdomen when a suspicious mass is felt during examination, or blood test of a pet with unexplained clinical signs, such as lethargy and a lack of appetite, will reveal the cause of the pet’s problem. There is simply no excuse for failing to obtain a proper diagnosis. The bottom line is this: to prevent a misdiagnosis of the true cause of a pet’s lumps and bumps, we need proper diagnostic tests to make sure that our treatment choice is correct.

About the Author: Dr. Messonnier, a 1987 graduate of Texas A&M College of Veterinary Medicine, opened Paws & Claws Animal Hospital in 1991. His special interests include exotic pets, dermatology, and animal behavior.

Dr. Messonnier is a well-known speaker and author of several books. In addition to serving clients, he is a regular contributor to several veterinary journals, sits on the advisory board of the journal Veterinary Forum and regularly consults with veterinarians across the country and is a holistic pet columnist for Animal Wellness, Body + Soul, and Veterinary Forum.

He is the host of the weekly award-winning radio show, "Dr. Shawn-The Natural Vet", on Martha Stewart Radio, SIRIUS channel 112 on Tuesdays from 8:00 PM to 10:00 PM (EST) with a repeat on Saturday from 9:00 AM to 11:00 AM (EST). Please visit his website at www.petcarenaturally.com.