To start the new year off right, we spoke with Dr. Kendra Pope and Dr. Trina Hazzah, two of the four (you read that right!) integrative veterinary oncologists in the U.S. to get their take on dog cancer treatments now… and things they are excited about for the future.
I’ve got the highlights of our conversation for you here, or you can listen to the full conversation through the Dog Cancer Answers podcast.
An Integrative Approach
Many dog lovers have long wondered when dog cancer treatment will embrace a more integrative approach.
According to Dr. Pope and Dr. Hazzah, the time is now!
General practice vets and conventional veterinary oncologists are becoming more and more interested in integrative and holistic treatment options to help their patients. In fact, Dr. Hazzah and Dr. Pope have been invited to participate in a panel discussion at an oncology conference this coming fall.
The time for an integrative approach to dog cancer treatment is now!
Some integrative options have already worked their way into standard cancer care:
Yunnan baiyao, a proprietary herbal remedy from the Yunnan province of China, is now frequently recommended for dogs with hemangiosarcoma to prevent or limit bleeds. The increased acceptance of Yunnan baiyao is partly thanks to clinical trials done by the University of Florida.
Mushroom polysaccharopeptide products such as Im-Yunity (c) are often used to support the immune system in cancer patients. The increased acceptance of Im-Yunity is partly thanks to clinical trials done by the University of Pennsylvania.
The goal of using these and other integrative dog cancer treatments is to improve quality of life. Some therapies target cancer directly, while others can work together with conventional treatments to support your dog’s body and health.
Clinical Trials for Holistic Treatments
Vets like data.
And that’s a good thing! You don’t want to spend time and money on a treatment that doesn’t work.
One of the best ways to evaluate a treatment, to make sure that it works and is safe, and determine the ideal dosage is to do research studies and clinical trials.
Things that work great to kill cancer cells in a test tube don’t always translate to working in a real dog body. Clinical trials are a great place to see how well something works in real dogs.
We already know that clinical trials are an important step in bringing pharmaceuticals to market. Applying that template to herbals and other holistic treatments is a great way to help vets see the value of these therapies and also standardize dosing.
The catch, of course, is that clinical trials are expensive.
Why Clinical Trials are Expensive
Dr. Pope explains that designing a high-quality clinical trial for an herbal remedy is not as simple as designing a trial for a pharmaceutical drug. There are a couple reasons for this:
- Drugs usually consist of one compound doing one thing, while herbs are made up of many compounds that work together.
- The goal of many integrative treatments is to improve quality of life, which can be more challenging to evaluate than survival time.
- Herbs occur naturally, so they aren’t as attractive financially.
- Some high-interest remedies, such as cannabis, have legal complications that still need to be worked out.
- The concentration of plant compounds can vary by location and growing conditions.
But there is progress! Dr. Pope loves using herbs to treat her cancer patients and is actively working on clinical trials to show other vets and oncologists just what these treatments can do.
While herbal clinical trials are unlikely to be funded by big drug companies, funding is available from the National Institute of Health. Trials can also be publicly funded by dog lovers.
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Holistic Dog Cancer Treatments
The beauty of an integrative approach to dog cancer treatment is that it considers treatment options from both sides of the aisle.
Dr. Pope mentions that conventional treatments, such as chemotherapy, radiation, and surgery, are often valuable for life-saving measures for sick dogs with cancer. Herbs don’t work overnight – they need time.
Where she and Dr. Hazzah find the more holistic dog cancer treatments shine is in the long game. These therapies provide improved quality of life and help to keep patients happy and healthy longer.
The Whole Picture… Or Rather Whole Plant!
While an herb is a single plant, that plant is made up of lots of different compounds.
For example, Dr. Hazzah mentions that cannabis has over 750 compounds. And while some of those compounds have shown promise on their own, botanicals often have an additive effect where multiple compounds work together to get better results than each of them alone.
So in order to truly evaluate botanical therapies, the entire plant needs to be used and studied.
This of course makes clinical trials more difficult to design.
But in the meantime, it is important to remember that real-world evidence has value too. Many herbal remedies have been around for centuries, and things that don’t work usually don’t stick around.
Genetic Testing and Dog Cancer
One thing that Dr. Hazzah is very excited about for the future is genetic testing.
Her dream is to be able to customize treatment to both the individual patient and that patient’s individual tumor. Genetic tests can reveal mutations that might impact which treatments will work best, or what weaknesses that patient has that need to be supported.
We are already starting to see customized medicine entering the veterinary field. Companies like FidoCure make treatment recommendations based off of genetic testing, and the melanoma vaccine is made specifically for your dog’s tumor.
“I think as things get more precise there’s going to be points where we’re not going to have to do CTs and MRIs and, and x-rays every three months, we’re going to be able to do a blood test and be able to figure out, if there’s cancer recurrence, where it is in the body.”
~ Dr. Trina Hazzah
Many of these options can be expensive, at least up front. But knowing the best treatment plan from the start can be more cost-effective in the long run.
“How do you compare shooting in the dark versus knowing what you’re really needing to attack?,” says Dr. Hazzah. “From a diagnostic perspective, I think as things get more precise there’s going to be points where we’re not going to have to do CTs and MRIs and, and x-rays every three months, we’re going to be able to do a blood test and be able to figure out, if there’s cancer recurrence, where it is in the body.”
It Takes Time
The embrace of integrative dog cancer treatments isn’t going to happen overnight.
Dr. Pope says that studies have shown that, on average, it takes 17 years of research to change clinical practice.
What does this mean? It means that it takes time to convince people that trying something new is worth the risk and really will work better than a preexisting treatment.
The current inundation of vets everywhere exacerbates this problem. If a vet is exhausted from trying to keep up with a huge caseload, he or she is less likely to be spending time learning about new options.
If a vet is exhausted from trying to keep up with a huge caseload, he or she is less likely to be spending time learning about new options.
This can feel frustrating. But the bright side is that this tendency prevents vets from jumping to new treatments willy-nilly without considering them carefully first… which could cause your dog to miss out on a proven treatment.
While we let integrative vets like Dr. Hazzah and Dr. Pope work their magic and educate their peers, you and your dog can still benefit from emerging therapies.
Consider consulting with a holistic veterinarian or oncologist to work with your conventional vet as a team, or ask about clinical trials that your dog might get to participate in.
Find a Vet Who Shares Your Values
Dr. Hazzah and Dr. Pope both emphasize the importance of having a veterinary team that you trust and that shares your values.
Depending on your personality, you might want to dive in and tackle cancer aggressively, or you might prefer a more palliative approach. It is important that your vet and/or oncologist knows your goals for your dog, and that you have a similar intensity.
When it comes to choosing a veterinary care team, trust your gut!
Consulting with an integrative veterinary oncologist is easier said than done because there are only four of them in the U.S. But there are many more holistic vets, and you can likely find one in your area who can work together with your regular vet to come up with the right balance of treatment options for you and your dog.
And if something doesn’t feel right, trust your gut, Dr. Hazzah advises. You are your dog’s best advocate, so your comfort with their care is important.
You can read the full transcript of the conversation on the Dog Cancer Answers page.
Paws and wags,