Hemangiosarcoma---HELP!

[dorimama]

Well that's certainly a hopeful report, probably the best you can get for a confirmed hermangiosarcoma. I'm so glad that Cyrus is doing well and that you have found a vet that you trust and that cares so much about Cyrus! I know that that alone will make a huge difference in his and your recovery.
Just as and FYI and my personal opinion - I have seen quite a few histology reports including ones for suspected hermangiosarcomas and what I found is that pathologists tend to be very frank about the prognosis of the disease. If it's really bad news they'll tell you and if it's not that bad they'll tell you as well...There's no beating around the bush and to me the report you got for Cyrus sounds very encouraging! To me it sounds like what the pathologist is saying is that he/she found some cancerous cells but also found many more healthy cells in the tumour...

Anyways, I wish Cyrus a speedy recovery and another successful surgery. I also hope that all remaining tests come back cancer free and you can finally stop worrying about the prognosis of his young life. I hope that you can at least take comfort in the fact that Cyrus is very young so he will be able to withstand much more then our older companions are able to and therefore will hopefully have many more options to beat this disease available to him.

 

[joeys mom]

Many thoughts, prayers and healing vibes to Cyrus.

 

[tasham]

Thanks for the info dorimama. It's good to hear that your opinion of how pathologists work and word things. Makes me feel better actually.

I got a hold of the actual report. The prognosis on the actual report is "Guarded." I guess that's better than "Poor". I'm in the human medical field and know a little about prognoses and know that if it says "poor" that's not good, and "guarded" means kinda in between good and bad, so I'll take that over a "poor" diagnosis any day. We'll see what the oncologist says tomorrow when we talk to her. I'm still very nervous about putting him on chemo, but I believe this will be our best chance to get this disease and stop it.....assuming it shows no signs of metastasis on the tests we'll be running.

 

[SweetCody]

Just caught this as I don't come to the health forums often. I have no experiance or advice for you but I do have many prayers being sent your and Cyrus's way. Sending out lots of healing vibes to beat that cancer and to continue feeling good. So sorry you are having to go through this.

 

[dorimama]

Hi Tasham...Guarded as far as I know is saying that while he is ok now, precautions should be taken to ensure that he remains ok in the future, (basically saying he is not out of the woods yet). Vets typically use that term for pets that are stable at the moment but for which they cannot predict whether or not they will remain that way. There is definitely still hope that the disease will not return but steps need to be taken to improve those chances. Like you said, it's definitely a better prognosis then poor, in which case there is little hope of the disease not returning/speading even with treatment.

Seeing an oncologist is definitely the right step for your little guy. I work at an animal hospital and we occasionally do chemo therapy...from what I've seen chemo does not affect dogs the same way as it affects humans. Generally speaking, dogs seem unaffected by the drugs and although they may experience some side effects (like diarrhea and vomiting), they are easily controlled. A few years ago we treated a 6 year old Nova Scotia Duck Toller Retriever that was diagnosed with lymphoma. He underwent chemo therapy for 6 months and then went into remission. Honestly, you would never have even known that he was undergoing chemo therapy...he actually gained energy and vitality as he underwent treatment and his vomiting and signs of illness (lethargy, swollen lymph nodes) disappeared. I'm not saying that this is the case for every dog but hopefully it will make you feel a bit better about starting Cyrus on chemo if the oncologist recommends that course of action.

 

[tasham]

I talked to the oncologist on the phone last night for quite a while. She got the results on the 2nd pathology report and we discussed what, if anything, changes as far as recommended treatment. She still suggests going in and taking additional tissue in that area to be absolutely sure we got it all, even though it was very well differentiated. She says we'd want all the tissue from the next surgery to come back completely disease free. Because the margins were just a little thin, she is saying that being extra cautious and getting more out would be her first line of treatment. Next we will do baseline ultrasound and chest x-rays to make sure it hasn't spread. If those come back clear, then the next decision on whether to do chemo is kind of where it falls for us to decide.

I'm really struggling with the decision on doing chemo or not. She has said that of course if we want to be very aggressive with treatment and throw everything we can at this, then surgery and chemo is the best option. But she says we don't know for sure if he needs it or if the surgery alone has taken the cancer out of his body and that is all the treatment he needs. If we do chemo and the cancer doesn't come back it could be because the chemo actually did kill it or it could be that the chemo was a nonfactor and it wasn't going to come back in Cyrus anyway. There's no way to tell. She's very honest and open and explains everything very well, but she's also saying she can't tell us for sure what course of treatment we need to do because it is harder to predict the course of the disease in a young dog.

The pathologist did feel that the tumor was of lower malignancy potential and felt it was possibly a lower risk for metastasis. She said that with this pathologist, who she had very wonderful things to say about and that she really values and trusts this pathologist's diagnoses, that she tells it like it is and is very good at predicting disease progress. So she said that this report made her feel like this could possibly be a less aggressive hemangiosarcoma....at least the tumor sample. Of course, who knows if the cancer is hiding somewhere else in his body and is being aggressive somewhere it hasn't manifested itself yet.

So our dilemma is do we put Cyrus through chemo just to make sure we give him every fighting chance to beat this? Chemo has risks. Heart failure is a low risk, but it scares me to death. Do we wait and watch and see how he does over the next few months with surgery alone? Problem is that if we wait and it does metastasize, then we missed a great opportunity which is right now when the cancer is less invasive in his body (assuming all his tests come back clear which we haven't done yet). If it has spread, then chemo is still effective, but it will be a harder fight. I'll never forgive myself if I miss a chance and it does come back and ends up being a poor prognosis later. What if we do chemo and Cyrus does get heart failure? Then I'd probably never forgive myself for doing that to him.

So sorry for the long post. I'm just putting all the thoughts that I have been wrestling with out there. This is such a hard decision. I just don't know exactly what to do. We don't have to make that decision right now. For now, we are startting wtih going back in for more surgery. Then that has to heal for about 2 weeks before chemo would be started anyway, so we have some time to decide on this, but ugh, this is probably the toughest choice I've had to make. Again, sorry for rambling and for the long post. I appreciate everyone's input and thoughts through all of this!

 

[dorimama]

Oh boy, that is a very tough decision. I would have a hard time making it as well. As I mentioned in a previous post, as far as I know dogs do not have the same issues with chemo that humans face (Severe nausea, anemia, hair loss etc). Sure there are risks with chemo as there are with every drug; however, Cyrus is a young healthy dog so the risks should (theoretically) be much lower for him then if he were an older dog. I know there is a small risk of heart failure but at the same time isn't the risk of the cancer returning much greater by comparison? It's easy to beat yourself up over these things but if you do that you'll never make a decision. Keep in mind that you are doing what you feel is best for Cyrus and therefore no matter what you choose you are making the best decision you can for him. If things go wrong, it's not because you are a bad owner but because that is how it was meant to be.

What did the oncologist recommend as the course of action? If you're really worried about heart failure with chemo are there no extra precautions you could take to ensure it doesn't happen in the process (like extra monitoring)?

What course of action did the pathologist recommend? If you don't know, it might be worthwhile to have your oncologist speak with her.

Honestly, you know your dog best and no matter what anyone else suggests it's your decision to make. No choice is wrong in the matter...you are doing as much as you can and it is completely understandable that you don't want to put Cyrus through more then you have to.

Good luck and keep us posted on your decision! Sending lots if healing vibes and thoughts towards Cyrus especially as he undergoes sugery.

 

[tasham]

Cyrus got his ultrasound and chest x-rays last week. They checked for any signs of internal spreading. There were no visible signs, so that was a huge relief. He then went in last week for his 2nd surgery to remove additional tissue in that area where the tumor was. We got the lab results back on that and it was all clear and free of any cancerous cells. Another huge relief.

My vet said that he felt that was all we needed to do. He says the oncologist also feels that surgery should be enough with Cyrus. They've both kept the option of chemo out there though. The oncologist initially went over all of our options for treatment, chemo being one of them. She has, however, never said "I suggest chemo" or anything like that. She even said at one point that if Cyrus was her dog, she was not sure if she would do chemo or not. She has said also, however, that doing chemo is not the wrong thing to do either. She said it just really comes down to how aggressive we want to be with treatment and how comfortable we are with the risks that come along with it.

I've done a lot of research on hemangiosarcoma, and really I'm probably the one who's been pushing the idea of chemo more than either doctor, even though they've both said it is definitely an option and definitely would be a treatment course they'd be fine doing if we want to do that, but neither one has specifically said or tried to urge us to do chemo with a strong opinion, so I'm really confused. I just don't want to miss the best opportunity to beat this while it's "weakest" in his body. At the same time, I keep telling myself to trust the doctors and that if they really thought chemo was needed, they'd tell me. I know doctors have to be extremely careful in what they say. I know they can't guarantee me that doing X treatment will beat this or doing Y treatment will not, etc. I guess I just want someone to come in and tell me exactly what to do, but I know that's not going to happen. No one can tell me the exact treatment that will be the best for him.

At this point, we're now leaning slightly towards not doing chemo....just based on the fact that the doctors aren't pushing it too much.

I have a question for any of you who have been through this cancer, did the doctors tell you specifically that they did or did not recommend chemo or did the just give you the options and tell you to decide?

 

[kelseighgirl]

We were dealing with a Mast Cell Tumor and the internal medicine dr. had stated that the surgeon may have wanted to do a round of chemo before the surgery and a round after. Once we met with the surgeon he said that he didnt feel in our case that was going to be necessary so I didnt push the issue. Although it has been said that dogs do much better with chemo than humans do ( on a daily basis) I was very nervous about what effects there may have been down the road. I have heard of other boxers coming out on top with a clean bill of health from the cancer and than months down the road passing away from the effects of the chemo. I just dont think, in my honest opinion and for what I would do for my baby, that I would go the chemo route...especially if it were going to be a long term thing (meaning weeks of it). I just dont think I am comfortable pumping my dog full of such harsh chemicals. But that is just how I feel in my heart.
You have to do what you feel is right in your heart for your baby. There is no right or wrong here because lets be honest...whatever decision you make you are making in the best interest of your baby. Its not like if you do or if you dont you didnt have the best intentions. So please dont beat yourself up with the decision that you make. Either way you take a chance with you decision. With cancer being so unpredictable you just hope and pray at the end of the day that the cancer goes along with the decision that you make.

Sending tons of hugs and healing vibes your way.
You are a good mom and you will make the right decision for your baby.

 

[Bruisersmomi]

Such good news!, still sending lots of Boxer vibes for Cyrus to have a speedy recovery