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Soft Tissue Sarcoma...final diagnosis?
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Forum Posts: 37
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10 November 2011 - 11:39 am
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Charlie was diagnosed with a soft tissue sarcoma and had his right front leg amputated 10/31/11.  It has been a roller coaster but, Charlie is a champ and is doing well overall.  We go back for suture removal 11/14/11. 

We have understood that under the diagnosis:  soft tissue sarcoma, there are a number of possibilities:  hystiocytic sarcoma, nerve sheath tumor, fibrosarcoma, etc.  From being on tripawds, I have seen other dogs with the diagnosis soft tissue sarcoma that have had amputations.  However, it seems that many of you received final diagnoses after the amputation that narrowed things down from that general diagnosis and resulted in a need for further treatment, i.e. chemotherapy.  His mass was intertwined through his right front wrist and was really through the tendons, etc.  If they had his whole leg and could have really gone through the whole mass, they may have gotten more information.  Am I right?

We have been anxiously waiting a diagnosis from Charlie's amputated limb and when we asked about the pathology, she explained to us that his limb was discarded and “she felt” that we would get no further information if we had submitted his limb. 

We naturally are extremely upset as that was not her call and were even quoted for the pathology in the estimate.  She is telling us that we never would have gotten any more information and suggested putting him on chemotherapy if we wanted to. 

We would never put Charlie on chemotherapy if it was not necessary.  We are very upset and are looking for some kind of confirmation that supports either our thinking that we could have gotten more information or to find out if she is correct.

Now, we'll never know.  His leg was creamated after the sugery.  Please help us find an answer. 

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10 November 2011 - 11:42 am
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Maybe I posted this information in the wrong forum?

Edmond, Oklahoma
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10 November 2011 - 12:16 pm
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We never had a  satisfactory/final diagnosis– first, we did an MRI and  the radiologist diagnosed Scout with possible synovial cell sarcoma.  Then we did a bone biopsy, and the diagnosis was probable histiocytic sarcoma.  The “final” diagnosis on the amputated limb was  a “poorly differentiated sarcoma”.  I was so frustrated not to have a concrete diagnosis, but the surgeon said it didn't matter in terms of treatment– in terms of chemo, you treat all sarcomas the same– you might want to see if your vet agrees.  Still, it was so frustrating– I like answers.  I am sorry that you did not have the opportunity to do the pathology on the amputated limb, but in our case, the final diagnosis was still not an answer.  By the way, I am so glad Charlie is doing so well– he's a good looking boy.

Scout: January 31, 2002 to November 7, 2011

Scout's diagnosis was "poorly differentiated sarcoma"; amputation 1/11/2011.  Scout enjoyed 9 fantastic years on 4 legs and 9 glorious months on 3 legs.  If love alone could have saved you…

knoxville, tn
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10 November 2011 - 12:37 pm
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gayle's tumor was also in her right front wrist.  when our vet did the exploratory biopsy (we were hoping it was a mass that could be removed) i was by her side and saw what a tangled mess the cancer was.  it was twined around ligaments, nerves and vessels, and would have been impossible to remove.  the pathology report we got back from the UT vet school was also 'soft tissue sarcoma”, with no more specification…they did say it was grade III and recommended chemo to perhaps a 60% chance of living an additional year (wow were those guys pulling # out of their butts…..).  i don't know if these tumors are too hard to 'tie down' or what, i remember that maggie in maine is also STS and they could never give her a definitive diagnosis of the type either.

stop beating yourself up over something that you can't change, sounds like they screwed up, but you can't fix that now.  as for chemo, we did five rounds of doxorubicin (every three weeks) and although it was a little rough on her GI system, gayle got through it like a champ.  we are glad we did the chemo, we think it helped gayle.  you'll make the right decision, based on the info you have for charlie.  as long as you are basing your decision on the love you share with charlie, you will always make the right decision.

let us know if we can give you any other info or be of further help…this is scary stuff we know.

charon & gayle

Life is good, so very, very good!!! Gayle enjoyed each and every moment of each and every wonderful day (naps included).  She left this world December 12, 2011 – off on a new adventure.

Love Never Ends

http://etgayle

The Rainbow Bridge



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10 November 2011 - 2:07 pm
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Yay Charley! First of all, it's GREAT to hear that you are doing well.

I agree with Charon & Gayle…what's done is done. Yes, I agree they really messed up. According to Dr. Demian Dressler of The Dog Cancer Survival Guide, “the prognosis for STS tumors is variable, depending upon the tumor type, location, stage, grade and rate of cell division.” I'm not a vet, but it sounds to me like putting him on chemo will be a shot in the dark without the pathology report. I'm sorry. You may want to get a second opinion by a board-certified onco vet. The good news is that lots of dogs with STS have done quite well, both with and without chemo.

With cancer, we learn that every day is a gift not to be wasted. I know it's hard not to be upset, but look at Charlie…he's not! Try to Be More Dog and live each moment for the precious gift that it is. {{{{{hugs}}}}}

It's better to hop on three legs than to limp on four.™
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Chicago, IL
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10 November 2011 - 7:57 pm
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We had a devil of a time getting a diagnosis for Tate, did the aspirate, did the surgical.  Both inconclusive, probable synovial cell sarcoma.  They analyzed the amputated leg and it came back probable histiocytic sarcoma.  So it is difficult but I disagree that they would get no further information.  Sounds like she is covering up a mistake. 

I agree with Jerry, see if you can find another oncologist.  Our guy knew what it was the first time he examined Tate (could have saved a bundle if we had listened to him!)  Maybe you will be able to find someone that can make a reasonably certain diagnosis based on Charlie's file.

Regardless, glad to hear Charlie is doing well!

Jan & Tate

http://tate.tripawds.com/
August 16, 2006 to November 28, 2011
TATE ~ Forever in our hearts.

Georgia
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10 November 2011 - 9:59 pm
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Is the vet who did the surgery an oncologist or a family vet (or something else).  Personally I would be PISSED about the vet not doing the pathology without first discussing it with you.  But like the others have said, what's done is done, so now time to move on.  If I were in your shoes, I would ask your current vet to fill an oncologist in on everything that is known and then I'd swap to seeing the new oncologist.  I don't think I'd continue with the current vet after that because at least in our experience we WERE able to get a diagnosis from a sample (though we got it from a surgical biopsy done before amputation) and it made a huge difference in how we have treated Spencer's cancer.

 

For us, our family vet went in the morning after we found the tumor and checked to see if he possibly could remove it (he couldn't) and then took a sample for biopsy.  We got the results of a grade 3 fibrosarcoma a few days later.  His leg was amputated 1 week after we found the tumor.  Our vet started talking with an oncologist in the Atlanta area then; but we had decided to do the amputation ASAP due to how aggressive the tumor was.  After the amputation the leg was not sent off for further pathology because the tumor was so large that our family vet said that it would be almost impossible to know 100% if we had clean margins.  he did go in and look at it himself and said that the tumor was encapsulated in a membrane and the membrane did seem intact.  So we are optimistic that he got clean margins.

 

The oncologist that looked at Spencer's records recommended chemo.  We ended up going to see him and he explained that if Spencer's tumor had been a grade 1 or 2 that we could assume that the amputation was a curative surgery; but with a grade 3 we had to assume it had spread at a cellular level, so chemo was strongly recommended.  

 

Spencer has done really well with the chemo.  Today was his 9th treatment.  He is going to have 15 total.  Originally it was going to be 12 weeks, 3 week cycles with Adria and Cytoxan on week 1 and Vincristine on weeks 2 and 3.  15 weeks is normally the recommendation; but adria can cause heart issues that dobermans are already more prone to, so they didn't want him doing more than four doses of the adria.  But, after some weakness issues 2 weeks into the chemo, we had a cardio workup done and it turns out that Spencer has a heart that isn't fully functioning.  So we swapped meds and bumped to 15 weeks.  Spencer has had a few issues of an upset stomach and today he seems more tired than normal; but in general he has been doing great.  I guess I'll never know if the cancer isn't back yet because of the chemo, or if it simply wasn't going to come back.  But what I do know is that he is doing great.  He is alive almost 3 months after finding the tumor and so far at least seems to be cancer free.  

 

I'm not going to lie though, the chemo has been/is going to be EXPENSIVE.  each week with vincristine is $175, each week with the mitox is about $390 (includes 2 weeks of antibiotics for each of those treatments).  If we had been able to do the adria/cytoxan it would have been a little less expensive.  All told we will have spent nearly $4,000 on the chemo, plus the $300 – $400 for the original surgery for the biopsy, plus about $1,000 for the amputation surgery, plus about $800 for an ER visit then a cardio workup.way-confused  (not to mention ANOTHER surgery and lots of meds because he got MRSA !)  

 

So it is important to take into consideration the expense.  And today I talked to our oncologist about Spencer's longterm prognosis.  They only give him 50/50 odds on an “apparent cure”.  I do know that the original tumor initially grew from nothing that you could see at.all to the size of a jumbo egg in less than 2 months.  And here we are almost 3 months post amputation, 9 weeks into chemo, and there is no sign of a tumor yet.  I really do feel that the chemo has at a minimum bought us time, if not a cure.

 

Good luck!!!

Jac and Angel Spencer.  Spencer was 5.25 years old. He fought a grade 3 fibrosarcoma, started on his shoulder.  Left front leg amputated in August 2011.  15 weeks of chemo finished 12/22/11 (mytox and adria).  Lung mets found on x-rays 12/28/11.  Started carboplatin 1/6/12. Went to Heaven on 2/27/12. I miss him like crazy every day.  See his blog here:  http://spencer.tripawds.com/

Morgantown, WV
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10 November 2011 - 10:38 pm
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I posted a little of this in your other thread…

I agree that it is pretty damn asinine of the vet to charge you for the histopath and then not do it.  She is seriously slacking in her duties as an animal health care professional.  As a vet tech student, stuff like this really angers me; I know there are bad vets out there and I pray I never end up working for one.  evil

Add Katy to the list of those who didn't have a definitive diagnosis before amputation.  My professor was the first vet who saw her, and according to the x-rays we took at school he thought it was osteosarcoma.  It wasn't until like a month later that a radiologist pretty much ruled osteosarc out because she didn't see any actual destruction of the bone.  That's when my vet said it was a soft tissue sarcoma, most likely a liposarcoma; there was a big aggressive lipoma kind of half buried in the muscle and it was apparently wreaking havoc with the tissue in there as well as bone (her ulna specifically).  He wants clear answers almost as much as I do.  We briefly discussed exploratory surgery to remove the lipoma and any suspicious tissue, but in the end decided it would be too traumatic given the location of the tumor, and if it turned out to be liposarcoma we'd amputate the limb anyway, so hey.  We started way back in the beginning with an aspirate (came back clear, lots of normal-looking fat cells and some bone cells indicating new growth) and then a biopsy (took 2 samples of bone and one of soft tissue, no neoplastic tissue noted BUT the histopathologist said that the bulk of osteosarcomas was reactive tissue just like the samples and multiple biopsies would be needed for a definitive diagnosis-no way was I putting Katy through that).  Taking her leg off and sending it out is pretty much our big chance for some real answers; if there's any kind of cancer anywhere in that leg, they better not miss it!

As far as chemo, I don't think we're planning on it.  Katy's almost 9, and given what I've read about liposarcoma (it's locally aggressive and VERY slow to spread, compared to other sarcs), I'm thinking the amputation will be enough.  She'll live out the rest of her years as a very happy healthy Tripawd; she'll be as comfy as we can make her for as long as possible.  🙂

I'm Crystal, but you can call me Katymom.  :)  I'm Triproud of my Tripawd!

Katy Sue Sarcopski – born approx 2/03, found "the lump" 9/7/11, suspected soft tissue sarcoma (most likely liposarcoma) 10/11, became a Tripawd 11/1/11, official diagnosis of infiltrating lipoma 11/23/11

Follow her "tail" at katydidit.tripawds.com!

Portage Lake, Maine
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11 November 2011 - 10:07 am
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Hi there,

Glad your boy is doing well with recovery!!!  Keep on going up and up!

Yes, Charon is right.  My dog, Maggie, also was diagnosed with STS – and never found out which type even after many special stains done.  BTW, they never sent out her entire leg to do so either.  But it was weeks, stain after stain, never an answer.  Some ruled out but never an actual type of STS diagnosed.  Like Jerry said, “shot in dark” was the words my Vet used if we did chemo on Maggie.  Because we didn't know exactly what type of STS AND because Maggie was so sick after surgery for 2 weeks, she felt chemo would be a “shot in the dark”.  I opted out of  chemo and my Vet actually recommended against me doing it.  She is treated with homeopathy daily by Dr. Charles Loops in NC, instead.  There are several dogs here that I know of that are also treated by Dr. Loops – Eisen and Roxy off the top of my head.

Seems alot of these cancers never get pinpointed down exactly frown

Tracy, Maggie's Mom

Maggie was amputated for soft tissue sarcoma 10-20-09

Maggie lost her battle with kidney disease on 8-24-13

http://maggie.t.....t-24-2013/

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1 December 2011 - 9:01 pm
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I'm a bit late on the bandwagon here, but my Chloe was diagnosed with a type of STS known as spindle cell sarcoma, a rare type of STS.  From my understanding of different STSs (from her vet) is that there are so many kinds, not always “common” and therefore can be hard to diagnose.  I got a diagnosis, but I also was told that since spindle cell sarcoma is “rare”, if I opted for a limb saving procedure i.e. chemo or radiation, that it may not be very effective against the tumor/cancer.  More studies are needed.  So I opted for amputation (since her tumor was on her left hind “calf”), up to the hip in hopes that they “got it all”.  Her tumor was also very entwined within the tendons, muscle… so pure tumor removal wasn't an option.

It's unfortunate that your vet didn't consider doing a biopsy of a nearby lymphnode to see if they were 'positive' (indicating they are fighting something) to see if it had at least spread beyond the tumor site.  Chloe's vet did this for lymphnodes in her knee and that came back negative for cancer, meaning no spread beyond site!

During my first year as a tripawd owner I worried that maybe something had secretely spread, but I decided I would rather spend every moment treasuring the time I do have with her and just hope for the best.  We are now 15 months cancer free and still going strong!  We wish you the same!!!

-Nicole and Chloe

Chloe became a rear amp tripawd on 7-29-10. Another tumor was removed on front leg 2-20-14. Found 3rd tumor on neck 2-2015, but she's still kicking cancer's butt at age 14. Chloe's blog

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