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Oncology

Advanced Treatment Modalities

Overview

It can feel scary to learn that your pet has been diagnosed with cancer, but it’s important to know that treatment options are available and they can improve quality and length of life, and in some cases offer a cure.

ONCOLOGY

The treatments used for cancer therapy in pets are very similar to those used in humans, including surgery, chemotherapy, and radiation therapy. It’s also comforting to know that the side effects of such treatments in pets, especially chemotherapy, are very different from those that humans experience. Although many of the drugs are the same, pets tend to respond well to therapy at the dosage and schedules used in veterinary oncology. Less than 20% of pets receiving chemotherapy show any clinical signs whatsoever, and most of those that do have minor symptoms that can be managed with medication. Our goal is quality of life above all else.

At Colorado Animal Specialty & Emergency (CASE), we offer surgical, immunotherapy, chemotherapy, and electrochemotherapy options under the guidance of a board-certified medical oncologist to target your pet’s cancer. We also have an assortment of clinical trials to aid in financial compensation as well as novel treatment options. Depending on your pet’s diagnosis, we may recommend any combination of these therapies to help get him or her back to living a comfortable life. We will always provide you with education and information you need to make an informed decision about your pet’s health, and will answer any questions you may have about your pet’s diagnosis. No matter what your time constraints or financial constraints we are here to help you through this uncertain time.

Perhaps the most important factor in successful cancer treatment is early detection, which is why it is important to keep close attention to your pet for early warning signs of cancer and to bring him or her to a family veterinarian for regular check-up examinations. Be sure to report any changes in your pet to his or her veterinarian and, if anything looks like it might be a sign of cancer, your veterinarian will recommend that your pet see a veterinary oncologist for further evaluation. From diagnosis to treatment and beyond, we are here to provide the support and care you and your pet need throughout his or her cancer recovery.

SURGICAL ONCOLOGY

Surgical intervention is sometimes needed to address cancer in pets.

This type of surgery takes a skilled and experienced hand. To improve health and quality of life for your pet, it is essential that the cancer is removed leaving the surrounding healthy tissue in-tact. Our board-certified surgeons have extensive training and experience in the surgical treatment of cancer, including one who completed a prestigious surgical oncology fellowship at CSU. That extra training goes a long way in tissue handling, and ability to complete difficulty surgeries successfully. This is known to directly translate into better outcomes. Our board-certified neurologist is even able to treat cancers of the brain and spine.

We also have technology available to assist in the diagnosis of cancer and to aid surgeons in tumor location. Our on-site CT machine is non-invasive and allows us to take cross-sectional X-ray image slices of the body, called computerized axial tomography (CAT) scans that provide a detailed picture of your pet for diagnosis.

Radiation Oncology

CASE offers cutting-edge technology as one of the few veterinary hospitals utilizing a Varian Halcyon linear accelerator. This allows for delivery of advanced radiation with extreme precision, resulting in decreased radiation to the adjacent normal tissues and less side effects while still delivering accurate doses of radiation to the tumor.

We offer Intensity modulated radiation therapy (IMRT), Volumetric arc therapy (VMAT), Stereotactic radiation therapy (SRT), and Stereotactic radiosurgery (SRS).

Types of Radiation Therapy

There are 2 main intents of radiation therapy: palliative and definitive.

Definitive intent radiation is utilized when there is a potential for long-term control of a tumor.

  • Finely fractionated radiation consists of delivery of small daily doses given Monday through Friday over 3-4 weeks.
  • Stereotactic radiation is another definitive methodology that is highly specialized and typically delivered over 1-5 closely scheduled treatments.     

Palliative radiation therapy consists of fewer larger doses (fractions) of radiation with the intent to alleviate pain and clinical signs associated with the tumor. Palliative radiation therapy is used to improve the patient’s quality of life and typically does not have long term control.

The exception is Coarse Fractionated radiation therapy. This therapy uses larger doses per fraction, as in palliative therapy, however the goal is definitive/long term control. There are certain tumors that respond better to this type of protocol such as melanoma.

Advanced Treatment Modalities

Intensity-Modulated Radiation Therapy is a sophisticated form radiation planning. IMRT can be used when delivering definitive (finely fractionated or stereotactic radiation therapy) or palliative intent radiation therapy. CASE is currently one of only two veterinary hospitals in Colorado to offer the treatment. IMRT allows for the radiation dose to conform to the shape of the tumor by modulating (adjusting) the intensity of the radiation beams. The individualized radiation plan utilizing IMRT is intended to maximize the dose delivered to the tumor while simultaneously protecting the surrounding normal tissue.

IMRT also improves the ability to conform the treatment to tumor shapes, for example when a tumor is wrapped around a vulnerable structure such as the spinal cord, a major organ, or blood vessel. The net effect is that radiation doses can be “wrapped” around tumors, or “painted” within tumors, far more precisely than was previously possible. Radiation therapy, including IMRT, stops cancer cells from dividing and growing, thus slowing or stopping tumor growth. Radiation therapy in general is often used in conjunction with surgery and/or chemotherapy.

Stereotactic radiation therapy (SRT) is a highly specialized form of radiation delivery that delivers 1-5 highly conformal doses of radiation to a tumor with submillimeter accuracy.

Multiple terms have been used for stereotactic-based radiation that includes stereotactic radiosurgery (SRS), stereotactic ablative radiation therapy (SABR), and stereotactic body radiation therapy (SBRT). In a purest sense, SRS is used when describing a single high dose of radiation delivered to a lesion in the brain. Stereotactic body radiation is used to describe when delivering high dose radiation over 1-5 treatments outside the brain. 

Image guided radiation therapy (IGRT) uses images of the patient at the time of treatment to determine the accuracy of setup so that corrections can be made in real time before the treatment is delivered. Our system uses cone beam-CT scans (CBCT) to confirm patient positioning to within millimeters of error.

Volumetric modulated Arc Therapy is an innovative form of intensity modulated radiation therapy (IMRT) that delivers precise continuous radiation in a single or multi-arc treatment to patient. With conventional IMRT techniques like step-and-shoot, the machine must make repeated stops and starts to treat the tumor from a number of different angles generally over 5-10 minutes. In comparison, VMAT can deliver the dose to the entire tumor in a 360-degree rotation, typically under two minutes.

Our Doctors

BROOKE FOWLER

DVM, MS, DACVIM (ONCOLOGY)

ANNIE GALLOWAY

DVM, MS, DACVIM (ONCOLOGY)

LYNDSAY KUBICEK

DVM, DACVR (Radiation Oncology)

CASSANDRA PRPICH

BVSC, MANZCVS (SAIM), DACVS-SA, ACVS FELLOW

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