Patient-Centered Oncology Care
The goal of IndyVet Oncology is to help families navigate a diagnosis of cancer and to recommend and administer therapy that provides excellent quality of life.
Patient Centered Care: Your pet’s quality of life is the most important factor in choosing the best course of treatment. The IndyVet oncology staff helps guide families through each step of the journey, from diagnosis through treatment. Therapeutic options and expected responses are considered in the formulation of the best individualized treatment plan.
Patients remaining comfortable, retaining a normal lifestyle, and being pain-free during treatment are priorities for the IndyVet oncology department. Our team provides innovative and progressive care to cancer patients and provides compassionate hospice and end-of-life care, when needed.
The purpose of IndyVet’s patient-centered care is to improve the quality of life of each patient, preserving the special bond between pets and their owners. This objective is best accomplished through a close partnership between IndyVet’s oncology team, the referring veterinarian, and the pet’s family. This close collaboration enables the best outcomes, and the IndyVet team is here 24/7/365 to help achieve them.
Oncology Therapy Philosophy
While few cancers are completely cured, many can be pushed into remission for various lengths of time. Success in veterinary oncology is measured in months to years, seldom in cures. Survival times of one year to a dog or cat would be similar to 5 to 7 years to a person. As we pursue cancer therapy in veterinary medicine, survival times and outcomes improve year by year.
Cancer is a complex disease that alters the body’s normal machinery. Various treatments are used alone, or in combination, depending on the situation being addressed. Multimodality therapy is an approach to cancer treatment that involves a combination of different types of therapy used together. Each patient’s treatment plan is customized and we work with you to determine the right therapy for your pet. At IndyVet, we utilize many different methods to diagnose and treat cancer in pets. Some of the methods used include:
- Comprehensive Examination – Examination remains the fundamental tool in describing and staging cancer. As treatment progresses, serial comprehensive examinations allow the oncology team to track treatment progress.
- Molecular Diagnostics
- Digital Radiography – Unlike traditional x-rays, digital radiography provides highly detailed images that can be modified or enhanced. The exceptional resolution of digital radiographs provides much greater ability to identify disease.
- Diagnostic Ultrasound – Ultrasound is a technique where sound waves are used to image soft tissues of the body. Different soft tissues absorb and reflect sound waves differently, giving them a different appearance. Ultrasound allows practitioners to see inside a solid organ, distinguishing changes within the tissue. The ability to distinguish changes inside a solid tissue organ (e.g., the liver), along with the ability to guide a biopsy needle into an abnormal area, enables targeted biopsies to be obtained. Precision biopsies enable the oncology team to diagnose cancers early.
- Endoscopy – Endoscopy is a procedure where a small camera is placed inside body cavities to observe tissues to identify disease. Biopsies taken during endoscopic exam enable the oncology team to diagnose cancer. Areas where endoscopy is used include the nasal cavity, gastrointestinal tract, urinary tract, thoracic cavity, and abdomen. Endoscopic examinations are minimally invasive and are frequently done on an outpatient basis.
- CT Scans – CT allows us to better diagnose and treat cancers in the brain, spinal cord, spine, abdomen, chest, and pelvis than ordinary x-ray. CT scans are much more sensitive in identifying cancer or spread of cancer to the lungs or other tissues. The extremely fast image acquisition and reconstructions allows us to perform studies requiring only sedation rather than anesthesia, which may be important in very sick patients.
- MRI – MRI is a safe and non-invasive imaging technique that enables cancers to be diagnosed accurately and rapidly. MRI provides excellent detail for pre-operative planning for surgical excision of tumors. IndyVet utilizes the Hallmarq PetVet 1.5T high field MRI specifically designed for veterinary use. The unique dual coil system of the PetVet MRI provides a significant boost in signal intensity across larger body regions allowing fast scan times, which is important in cancer patients. IndyVet is proud to be the first to have this superior veterinary MRI system in the Midwest.
- Histopathology – Histopathology is a technique where tissue biopsies are stained, sectioned, and viewed under a microscope by a pathologist to describe disease. Biopsy with histopathology is the method of diagnosing and differentiating cancers from other diseases.
- Bone Marrow Biopsy – Bone marrow biopsy is performed by placing a needle into a bone to extract marrow. This is done to diagnose various types of bone marrow cancer (leukemias). Extracted bone marrow is stained and viewed by a pathologist allowing description of the specific type of bone marrow cancer. Different types of bone marrow cancer require vastly different types of drugs for treatment.
Surgery has historically been the most common technique to treat cancer in companion animals and people. The best chance to achieve complete removal of cancer is during the first surgical procedure, best performed by surgeons with experience in surgical oncology. As the field of oncology has evolved, we have found that surgery can also be used as a secondary tool after a tumor has been reduced in size by chemotherapy or radiation. Surgery can also be used in a palliative setting to help achieve relief of clinical signs for a period of time.
Chemotherapy is drug therapy designed to kill or slow the growth of cancer cells. Many of the drugs used to treat cancer in pets are derived from natural substances found in plants, trees, or bacteria and are often the same drugs used in people. Chemotherapy is frequently used to treat cancer that has spread to other parts of the body, to treat cancer that cannot be treated with surgery or radiation therapy alone, or when it may enhance the effectiveness of other treatments.
The word chemotherapy often brings to mind images of patients sick in the hospital from side effects. For veterinary oncology, the goal of chemotherapy is very different in that it is designed to control or eliminate the cancer while still providing a high quality of life for your pet. Chemotherapy drugs are not ordinarily used to cure cancer, but rather to control it and to slow down the progression of the disease. Many chemotherapy protocols involve a series of treatments, followed by a period of careful monitoring of remission. Chemotherapy may be continued as long as it is controlling the cancer, but only as long as quality of life is maintained.
A bio-hazard containment hood and personal protective apparel is used to prepare chemotherapy drugs for use at IndyVet. Patients are administered chemotherapy medication in a separate room to assure that no accidental exposure occurs to other IndyVet patients or personnel.
Radiation therapy is the use of ionizing radiation to damage the DNA in tumor cells resulting in tumor cell death. Radiation therapy is effective against cancer cells that are rapidly dividing. Radiation therapy can be utilized in two ways: with curative intent or palliative (temporary relief) intent. Curative intent protocols are given over a 3-4 week period where a smaller dose of radiation is delivered each day. Palliative intent protocols are administered to relieve compromising symptoms and pain to improve quality of life. Palliative protocols are used when the patient has advanced cancer, metastasis, or some other condition that would limit life expectancy. These protocols vary and may involve weekly treatments or therapy over the course of a few days. While radiation therapy is not currently available on site at IndyVet Oncology, our oncology staff coordinates the utilization of radiation protocols when needed.
Targeted therapy is a form of chemotherapy that acts selectively against molecular targets expressed on the membrane of some tumors. Targeted therapy drugs interfere with tumor growth and progression. Targeted therapy is different from the non-specific destruction associated with traditional chemotherapy, which kills any rapidly dividing cell population in the body, whether cancerous or not.
Immunotherapy is a medical treatment that induces, enhances, or suppresses an immune response. The goal of immunotherapy in cancer treatment is to stimulate the patient’s immune system to reject and destroy tumor cells. Options for immunotherapy in veterinary oncology are currently very limited, but there is ongoing research that is very promising.
This type of treatment is focused on improving quality of life and not on curing cancer. Palliative and supportive care might include rehabilitation, pain management, nutritional support, and acupuncture, all of which are available at IndyVet.