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Wilson's fibrosarcoma pathology report...long
29 March 2009
12:21 pm
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19 March 2009
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I finally got the report from Auburn….this is from Dr Henderson…the pathology report is kind of long too…I have it typed up if anyone would like for me to post it here.

When Wilson was at Auburn he had a 4 year student…she was wonderful….she is here in Mobile working with the vet that I was going to use for chemo….I called her and I will be taking Wilson to that vet on Tuesday for x-rays and will be talking to them more about this report since they are more informed about Canine Cancer….they have the same digital x-ray that Auburn has and my vet does not.

I will be calling Dr Henderson or sending a email to him to see if he got a 2nd opinion.

The final diagnosis is" Fibrosarcoma, intramedullary, femur

Recommendation: This is not a common biopsy report. Fibrosarcoma is most common in large (giant breed dogs) like Wilson and do not have the same early metastic risk as osteosarcoma. Unfortunately because there are fewer fibrosarcomas, we have less experience in their biological behavior. To quote VROM the current textbook on Clinical Oncology, "(amputation) may be curative, although metastatic potential may be considerable. "This is not very reassuring"

I have shared this pathology report with the VSSO (Veterinary Society of Surgical Oncologists) listserve this afternoon. The opinion will be that we should obtain a 2nd opionion on the pathology and begin chemotherapy in the interim if the thoracic radiographs remain clear of metastases.

This is my summary: We may have cured this neoplasm with amputation. If the owner is an optimist and wishes the least chance for medically induced disease, we should leave well enough alone. if a pessimistic approach is taken, that there is significant risk for metastasis (or that this is really varient of osteosarcoma), then there should be confirming clear chest x-rays and begin an administration of chemotherapy probably alternating doxoruicin and carbolatin for 4 to 6 doses (although some would choose one or the other of these drugs and be correct). cisplatin is another drug that could be included or substituted for the carboplatin.

I would like to give clear direction, but there is not a correct answer for Wilson. Often I am asked what I would do for my own pet in this situation. I would not give chemotherapy and just enjoy every day I am given. We are likely to outlive most of our pets and it is the living well that brings joy.

29 March 2009
2:55 pm
Here and Now

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While all the details can be overwhelming, we can never have to much information for those seking to find answers here. 

Some may find it useful, but I for one am totally with you about one thing. Living well is what brings the most joy, and that means not agonizing over treatment decisions and making decisions we – and our pups – are can be happy with. Thanks for the insight!

"Dogs are born with three legs and a spare."
— Jerry G. Dawg (10/98-10/08)
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31 March 2009
7:49 am
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19 March 2009
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Ok, I'm more confused then ever…this is what Dr Henderson just sent to me.

The original biopsy was the result of multiple pathologists opinion. I
will inquire if there can be any assistance from special stains.

Then in his report to me he said

I have shared this pathology report with the VSSO (Veterinary Society of Surgical Oncologists) listserve this afternoon. The opinion will be that we should obtain a 2nd opionion on the pathology and begin chemotherapy in the interim if the thoracic radiographs remain clear of metastases.  

Something is not right about all of this.  

Charlotte

(Wilson & Rocky)

31 March 2009
10:50 am
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Sounds to me like you've got some valuable input from pretty knowledgeable sources. Even if you do see it as contradictory to the original opinion.

Best wishes to you for weeding through all this and making the best decisions, for yourself and for your pup! Try to forget any negative feeling you may have about the past, and base your decisions on the information at hand.

"Dogs are born with three legs and a spare."
— Jerry G. Dawg (10/98-10/08)
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Have you started a Tripawds Blog yet?
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31 March 2009
2:27 pm
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11 February 2009
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Well, on the one hand you have to admire a medical professional who admits she doesn't have all the answers….!  (My ex was a radiologist, trust me I know about medical professionals who think they are super-beings…<roll eyes>)

It sounds to me like Dr Wilson is unsure of the path report and wants to get a repeat chest xray before recommending a treatment plan?

31 March 2009
11:04 pm

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22 August 2008
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Osteosarcoma is often mis-read as chondrosarcoma or fibrosarcoma on the path report because it can be very hard for the pathologist to be sure since some of these cells look similar under the scope.  Sometimes special stains can give you the cell line of origin.  The reason it is so important is that OSA is by far the most common type of bone cancer, and chemo has been proven to extend the life of most dogs with this type of tumor.  Unfortunately Goldens are a breed with a high incidence of cancer, so it sounds like your doctor is just being careful.

If it was my dog I would welcome a second or third opinion from other pathologists and do special stains if indicated.

Pam and Tazzie

1 April 2009
7:11 am
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19 March 2009
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Wilson's x-ray was clear[Image Can Not Be Found]

The vet I saw today read the report from Dr Henderson. He is like the others. He does not know anything about Fibro. He told me that if this was Oste..he would tell me to do chemo..cause he knows the chemo with Oste will give the pet more time. Fibro he could not tell me to do chemo….it's damn if you do and damn if you don't.

Wayne and I have some hard soul searching within our hearts to do right now.[Image Can Not Be Found]

I'm also going to start doing some leg work. I'm going to contact Dr Withrow of CSU. I looked him up last night on the web and read just about everything about him…top notch…plus the vet schools at Mississippi State and LSU. I'm going to get those 2nd opinions.

Charlotte

Wilson & Rocky

1 April 2009
3:41 pm

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I did some searching for you on VIN (Veterinary Info Network) and most oncologists concur that true fibrosarcoma of the bone is rare and often turns out to be fibroblastic osteosarcoma.  If the pathologist is sure of the diagnosis of fibrosarcoma then chemo should still be considered, as many of these do end up metastasizing.  The best protocol would be doxorubricin (Adriamycin) given every 2 weeks for 5 treatments.  This is also a good protocol for osteosarcoma, and most dogs tolerate the chemo very well.

I hope that you can find an answer but I would consider chemo either way!

Pam and Tazzie

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