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Metronomic chemotherapy
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Member Since:
15 April 2017
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14 May 2017 - 8:07 am
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Our 3 year old boy rocky had his back leg amputated may 2. He had surgery to remove a lump which they could not completely remove so they sent it away to pei to be tested, and it came back soft tissue sarcoma. The decision was made to remove his leg because we had tests and x rays on his chest and abdomen and blood work and nothing showed up anywhere else. Even when the leg was removed they sent it away and dissected it and checked the lymph nodes it didn't reach there. We were told he was cancer free. Before his results came back from the leg being sent away I had back up plans on what to do with whatever our outcome would be. I looked into metronomic chemotherapy for if just in case the cancer had spread and I was so happy to find out it didn't. Our vet originally wanted him to take piroxicam for so many weeks after and she didn't know what metronomic chemotherapy was until I brought up information on it and even a contact number for a vet oncologist that's specializes on it she's in New York. She never did call the other vet.  All of a sudden now she's saying she wants him to take metronomic chemotherapy and even said this is what we do after amputation for cancer. The thing is she didn't know what it was until I brought it to her attention. Keep in mind our vet clinic here is known for overcharging and doing unnessary tests to make the bill higher. But anyway my question is do you think metronomic chemotherapy should be used when they have gotten they are cancer free title? This was my back up plans for if the cancer had spread. If I hadn't brought up to sheets of paper about it he would have never been given it. He put in a hard week with recovery from the amputation but every day he seems better and better! I don't want to make him sick for 4 weeks with chemo if it's unnecessary.

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14 May 2017 - 8:25 am
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Unlike with humans, chemo RARELY ( and there is plenty of data to support this), rarely makes a dog sick (thank goodness). Additionally, although all the best tests in the world may show cancer free at this time, there is no test that reliably allows you to know about the spread of a micro disease. If you can afford it, and there are no complications, honestly, why not? It is just one more effective and well accepted practice to help on this journey. (Also, does sound as if your vet is willing to try this " new" concept: which has been widely accepted for awhile. Any chance you would be able to consult with a different and more up to date vet?) 

Minneapolis, MN
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14 May 2017 - 8:34 am
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Hi.  Was the STS staged at stage 1?  Did the lab report describe it as well contained?  STS is "typically" slow growing and less frequently metastasizes at least if caught early, but it does happen.  It seems like Rocky's was in a more visible spot than Pofi's which was never visible and hidden in his arm pit (brachial plexus), so he was misdiagnosed for at least a year and it had "destroyed" a lymph node. Subsequent tests on a near by lymph node showed no cancer, but I did lose him to recurrence in the spine 6 months later.  Pofi's was considered Stage 3.

Just laying out our circumstances for you for comparison and not trying to scare you.  You could have another vet read your pathology report to see what they are seeing that might have them recommend metronomic chemo.  Personally, I don't quite believe there is such a thing as a "cancer free" guarantee, but if they did stage the cancer as stage 1, meaning tumor was well contained, small, etc., it might not be something I would pursue.  But we did do it and it is relatively inexpensive compared to so many other cancer treatment therapies.  Pofi also had zero issue with the meds - no impact from the chemo.  He never seemed sick or ill or to feel poorly at all.  You can try it and see, too, if there is impact.

But I would really dig into the details of that pathology report and understand what they are saying about the state of the tumor.  IF it were considered stage 2, I would not hesitate to pursue metronomic chemo personally.

Piroxicam is part of metronomic chemo - is there any chance this is always what she was proposing, but just did not name it as such?  Tough decisions, I know, and I am glad for you it is likely Rocky's cancer was caught and removed early!  Glad he is doing well.

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His canine sister also succumbed to cancer on March 1, 2019 - we lavished her with our love in the interim, but life was never quite the same without her only real canine friend. Cliff kitty had to leave us, too, suddenly, in August 2019. Lucia kitty grieved all these losses, but helped us welcome two new Lurchers into our home and our lives, Shae and Barley.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation

Member Since:
15 April 2017
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14 May 2017 - 8:45 am
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charliebear said
Unlike with humans, chemo RARELY ( and there is plenty of data to support this), rarely makes a dog sick (thank goodness). Additionally, although all the best tests in the world may show cancer free at this time, there is no test that reliably allows you to know about the spread of a micro disease. If you can afford it, and there are no complications, honestly, why not? It is just one more effective and well accepted practice to help on this journey. (Also, does sound as if your vet is willing to try this " new" concept: which has been widely accepted for awhile. Any chance you would be able to consult with a different and more up to date vet?)   

I wish! that's why I contacted the vet in New York. There are no vet oncologists where I live. Out vet read the papers we give her about metronomic chemotherapy and looked into it herself after then she said he would have to be watched for 4 weeks and it would make him sick that's why we are second guessing it. 

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14 May 2017 - 8:52 am
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hester said
Hi.  Was the STS staged at stage 1?  Did the lab report describe it as well contained?  STS is "typically" slow growing and less frequently metastasizes at least if caught early, but it does happen.  It seems like Rocky's was in a more visible spot than Pofi's which was never visible and hidden in his arm pit (brachial plexus), so he was misdiagnosed for at least a year and it had "destroyed" a lymph node. Subsequent tests on a near by lymph node showed no cancer, but I did lose him to recurrence in the spine 6 months later.  Pofi's was considered Stage 3.

Just laying out our circumstances for you for comparison and not trying to scare you.  You could have another vet read your pathology report to see what they are seeing that might have them recommend metronomic chemo.  Personally, I don't quite believe there is such a thing as a "cancer free" guarantee, but if they did stage the cancer as stage 1, meaning tumor was well contained, small, etc., it might not be something I would pursue.  But we did do it and it is relatively inexpensive compared to so many other cancer treatment therapies.  Pofi also had zero issue with the meds - no impact from the chemo.  He never seemed sick or ill or to feel poorly at all.  You can try it and see, too, if there is impact.

But I would really dig into the details of that pathology report and understand what they are saying about the state of the tumor.  IF it were considered stage 2, I would not hesitate to pursue metronomic chemo personally.

Piroxicam is part of metronomic chemo - is there any chance this is always what she was proposing, but just did not name it as such?  Tough decisions, I know, and I am glad for you it is likely Rocky's cancer was caught and removed early!  Glad he is doing well.  

hester said
Hi.  Was the STS staged at stage 1?  Did the lab report describe it as well contained?  STS is "typically" slow growing and less frequently metastasizes at least if caught early, but it does happen.  It seems like Rocky's was in a more visible spot than Pofi's which was never visible and hidden in his arm pit (brachial plexus), so he was misdiagnosed for at least a year and it had "destroyed" a lymph node. Subsequent tests on a near by lymph node showed no cancer, but I did lose him to recurrence in the spine 6 months later.  Pofi's was considered Stage 3.

Just laying out our circumstances for you for comparison and not trying to scare you.  You could have another vet read your pathology report to see what they are seeing that might have them recommend metronomic chemo.  Personally, I don't quite believe there is such a thing as a "cancer free" guarantee, but if they did stage the cancer as stage 1, meaning tumor was well contained, small, etc., it might not be something I would pursue.  But we did do it and it is relatively inexpensive compared to so many other cancer treatment therapies.  Pofi also had zero issue with the meds - no impact from the chemo.  He never seemed sick or ill or to feel poorly at all.  You can try it and see, too, if there is impact.

But I would really dig into the details of that pathology report and understand what they are saying about the state of the tumor.  IF it were considered stage 2, I would not hesitate to pursue metronomic chemo personally.

Piroxicam is part of metronomic chemo - is there any chance this is always what she was proposing, but just did not name it as such?  Tough decisions, I know, and I am glad for you it is likely Rocky's cancer was caught and removed early!  Glad he is doing well.  

I have all the test results with me, There were no stages just said high grade soft tissue sarcoma no evidence of metastasis. He was misdiagnosed as well in November he had a small lump come out and they told us it was a cyst and not to worry about it so they give him metacam. They done a fine needle on it three times within a couple months and told us there was no cancer and still said it was a cyst. It kept getting bigger so we asked for it to be removed. Then we got the horrible c word once they done surgery 2 weeks later they removed his leg.

Minneapolis, MN
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14 May 2017 - 4:03 pm
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I'm realizing I said "Stage" when I meant "Grade".  So they did call out high grade rather than low grade, but no local metastases (lymph nodes).  I am guessing that is often classed as Grade 1- my understanding was there were three grades for STS, low grade means small and well encapsulated and very localized, but Grade 2 is high grade without the metastases and Pofi was at Grade 3.  Is there any verbiage about the type of STS?  All STS are in the connective tissues, but that could be muscle or derma or nerve.  Pofi's was a Nerve Sheath Tumor, specifically.

We can all only share our own experience and what we have done or think we might do.  Pofi had NO issue with low dose oral chemo and was on it for 5 months.  He did NOT do well with Piroxicam - that made him very ill.  We switched out Piroxicam for Rimadyl which is not the standard, but is still and NSAID. He never had a bad day because of Cytoxan  / Cyclophosphamide.  And I think it was about $60 a month from a compounding pharmacy.  It was worth it to me to be doing something to try to keep his cancer at bay.  But we did know we did not have clean margins and had local mets.  

Let me know if I can answer any questions you might have.

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His canine sister also succumbed to cancer on March 1, 2019 - we lavished her with our love in the interim, but life was never quite the same without her only real canine friend. Cliff kitty had to leave us, too, suddenly, in August 2019. Lucia kitty grieved all these losses, but helped us welcome two new Lurchers into our home and our lives, Shae and Barley.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation

Green Bay, WI


Member Since:
18 May 2014
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14 May 2017 - 5:47 pm
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Hi, and welcome...my Dobe had osteosarcoma, so we did traditional chemo, followed by metronomic therapy. Mostly because "it wouldn't hurt, and may do some good" - there really isn't literature supporting it benefits for OSA, but we wanted to explore every option. Nitro was on metronomics (cytoxan and piroxicam) for about 10 months before he developed cystitis - blood in his urine. I work in a hospital lab and was able to check his urine frequently, so I caught it early.  About this time he developed incontinence; there is some evidence that this could've been caused by the cytoxan, but we'll probably never know for sure, as he was 11 years old at the time and could've been due to old age. There is another chemo drug that can be used - Leukeran - that allegedly doesn't cause cystits, but it is a little more expensive. I'm not trying to alarm you, dogs really do handle chemo better than people; we have no regrets with the decisions we've made, and Nitro is almost 3 years post amp and doing well. Good luck as you move forward.

Paula and Nitro

Nitro 11 1/2  yr old Doberman; right front amp June 2014. Had 6 doses carboplatin, followed by metronomic therapy. Rocked it on 3 legs for over 3 years! My Warrior beat cancer, but couldn't beat old age. He crossed the Bridge peacefully on July 25, 2017, with dignity and on his terms.  Follow his blog entitled "Doberman's journey"

http://nitro.tripawds.com

"Be good, mama loves you".....run free my beautiful Warrior

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13 March 2010
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16 May 2017 - 9:43 pm
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My Travis Ray was just diagnosed with a grade 2 STS. This is also called intermediate grade. It is my understanding that a low grade would be the same as Grade 1 and a high grade tumor is the same as a Grade 3 tumor, same thing, different nomenclature. Grade 1 is the least aggressive and Grade 3 the most aggressive, with Grade 2 somewhere in between. I know my assessment contradicts Hester's but this is what I have been told and read? I am new to this, a few weeks ago I knew zero about STS and I am still in research mode and trying to wrap my head around it all. And Hester, you have been through all this so I am confused that we would have somewhat opposite information way-confused except I did read in the article below that there is not alot of standardization in how STS tumors are graded and otherwise defined ... isn't that just peachy?! 

I found a couple of good links on the subject  today: 

http://vetgirlo.....ion-blogs/

http://journals.....5810388820

I thought the first article was a good basic explanation of STS and potential treatments--she seems to think highly of metronomics as well smiley. The second is a bit to wade through but the bottom line is that STS are variable and there is not alot of data on treatment effectiveness for the most part--many studies are small or have other issues, nor is there necessarily standardization in how tumors are graded and described, or definitive knowledge of what factors lead to a better or worse prognosis, with the exception of a couple. The best studied treatment seems to be radiation therapy and it is by all accounts very effective but it seems like an awful lot for the dog to go through. I don't think Travis could tolerate it.  

We are in the process of deciding what treatment to pursue (if any!). So far we are tending towards metronomics or a form of chemo injected into the surgical site (no studies or data on this one--brand new!). I hope to post something more about our story and decision process with the different treatments we have been offered so far tomorrow! 

Hester and/or Paula, I don't get it, why do they give an NSAID with the chemo--do they somehow work together or is it to offset the effects of the chemo or.....?

Hang in there Donna!! Welcome to the club no one wants to join. The love, support, and educational resources you will find here help to make the whole thing bearable. Hope this helps a little.

xoxo,

Martha, Travis Ray, and the OP 

On The Road


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17 May 2017 - 8:22 am
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travisray said
I don't get it, why do they give an NSAID with the chemo--do they somehow work together or is it to offset the effects of the chemo or.....?

In several studies, the properties within NSAIDs are shown to have anti-tumour (anti-angiogenesis) properties that can help starve the blood supply of tumors.

I'm so bummed to hear about Travis. A cancer on the remaining limb of a Tripawd is that tough situation all of us dread. I'm so glad he bounced back from the tumor resection surgery though, what a pawesome and super healthy doggie! As I mentioned, it's proof that his body has what it takes to fight off recurrence.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

On The Road


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17 May 2017 - 8:30 am
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donna1123 said
But anyway my question is do you think metronomic chemotherapy should be used when they have gotten they are cancer free title? This was my back up plans for if the cancer had spread. If I hadn't brought up to sheets of paper about it he would have never been given it. He put in a hard week with recovery from the amputation but every day he seems better and better! I don't want to make him sick for 4 weeks with chemo if it's unnecessary.  

Metronomics is recommended as a preventive and sometimes as an alternative when traditional IV chemo isn't an option. Click on the links in posts about metronomics and you'll find tons of info. This is a daily (or every other day) pill form of chemo that you give at home, and come in for occasional check-ups to ensure your dog is tolerating the drugs.

I've never heard of it being administered for just four weeks, it's usually an ongoing preventive that goes on for as long as the dog will tolerate it, up to a couple of years in many cases. The only time I've heard of it making a cat or dog sick was in cases like Nitros, when he developed cystitis. It's rare, but it can happen. I've seen fewer side effects with it than traditional IV chemo. It didn't happen with our Jerry, he tolerated it very well.

It sounds like you're not comfortable with your vet delivering any form of chemo. If your vet is a general practice vet who is just now gaining experience in chemotherapy, you need to decide if you're comfortable with that. I personally would choose a board-certified oncologist who specializes in cancer care. You may want to see one for a second opinion. Ask your vet for a referral. If she's a good vet she will happily provide one.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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