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Information provided by Earl F. Calfee, III (Trey), DVM, MS, DAVS, Colorado State University Surgical Oncology Fellow, Diplomate American College of Veterinary Surgeons at Nashville Veterinary Specialists
Appropriate treatment of surgical oncology patients is complicated by the broad variety of cancer presentations, the multitude of organ systems involved, the potential for concurrent medical conditions, the state of current advanced diagnostics, the potential for multimodality therapy, the overwhelming information available about animal cancer and the variability in owners’ desires and abilities to treat various cancer conditions. Now more than ever, veterinarians have to stay abreast of the current state of veterinary oncology.
It is essential to take appropriate first steps in the diagnostic approach and treatment of cancer patients. Inappropriate decisions in the beginning can eliminate the possibility of curative treatments in the future. It is helpful to divide cancers into simple and complicated categories.
“Simple” cancers are clearly demarcated, small and superficially located within a core body region. Neoplasms that are located peripherally and clearly require amputation are also “simple.” “Complex” cancers have local factors that lead to problems with tissue healing or are located in deep tissue planes or regions of essential anatomy.
Pretreatment biopsy is often indicated with “complex” neoplasms. A biopsy prior to definitive treatment is indicated when the type and extent of treatment would be significantly altered by knowing the tumor type, when the tumor is in a difficult location for surgical reconstruction or when knowledge of the specific tumor type would change an owner’s willingness to treat.
Pretreatment biopsy is NOT warranted when knowledge of tumor type would not change the surgical therapy or when the biopsy procedure is as dangerous or as difficult as the definitive treatment.
Many options are available. It is our obligation to appropriately direct owners through this complicated decision-making process of animal cancer treatment.