Oncologic Surgery

ONCOLOGIC SURGERY

Surgery is often an integral part of the treatment of pet cancer. The first procedure to remove a cancer is typically the best chance to achieve complete removal. In many cases, surgery is best performed by a board-certified surgeon with experience in surgical oncology. A board-certified has advanced training and current knowledge of tumor biology and, importantly, the role of surgery in the treatment of cancer. Surgeons do not act in isolation, however, and ideally are part of a comprehensive team of medical oncologists, pathologists, radiologists, and certified veterinary technicians.

Prior to recommending surgery, knowledge of tumor type and an associated prognosis is necessary. Bloodwork and other biological samples may be required as well as advanced diagnostic imaging such as CT or ultrasound to determine the size of the tumor(s) and any spread of the tumor and biopsies to determine the type and aggressiveness of the tumor. Surgery can also include specialized surgical techniques such as thoracoscopy, laparoscopy, endoscopy, and other interventional procedures such as palliative stenting.

Book an Appointment

WHEN IS SURGERY PART OF MY PETS CANCER JOURNEY

The purpose of surgery when treating cancer is to control or eliminate local cancer in an attempt to improve the quality of the patient’s life. Successful surgical removal of localized cancer cures more pet cancer patients than any other form of treatment. But a cure may not always be possible, and one of the most difficult decisions in surgical oncology is the decision not to perform surgery. Communication between the pet owner and the surgeon is critical to ensure that the level of surgery aligns with the owner’s goals.

SURGERY GOALS

Diagnosis

Commonly referred to as a biopsy, this is a crucial step in decision-making for pet cancer. In this surgery, a section of the tumor is removed to be analyzed under a microscope by a pathologist to establish a diagnosis. This may be a smaller “core” sample or a larger piece or wedge of the tumor. Information about tumor grade can be obtained from larger biopsy samples that may influence the type of surgery recommended as well as the prognosis.

Cure

This generally refers to the surgery performed to remove the tumor with complete margins. “Margins” are borders or layers of cancer-free tissue on all sides of the tumor. A pathologist will confirm that no cancer was left behind. Even when local control is achieved by surgery, some patients may require other treatments (e.g. chemotherapy, immunotherapy, radiation) to prolong survival, depending on the biological behavior of a specific type of cancer.

Palliation

Palliative surgery is a surgery or procedure that attempts to improve the quality of the patient’s life (pain relief or improved function or esthetics) but not necessarily prolongs the patient’s life. Examples of palliative surgery would be the removal of a mass that is bleeding or infected, amputation of a limb for pain relief after a pathologic bone fracture, or infusing a bone with surgical cement to prevent a fracture. Cancer will likely grow back or spread, but the patient can have longer survival than they otherwise would have had.

Debulking

Debulking surgery, otherwise known as marginal resection, is a planned “incomplete” removal of a tumor or mass to enhance the efficacy of other treatment modalities such as chemotherapy, or radiation therapy.

ONCOLOGIC PROCEDURES PERFORMED
AT VSC INCLUDE:

Skin tumors

Skin flaps and reconstructive surgery
Skin grafting
Advanced wound care
Mastectomies
Anal sacculectomy and rectal tumor excision

Abdominal Tumors

Organ biopsies (laparoscopic and mini-laparotomy)
Splenectomy (laparoscopic and laparotomy)
Adrenalectomies
Liver lobectomies and biopsies
Stomach and bowel resections
Laparoscopic and open lymph node excision/biopsies
Laparoscopic and open partial pancreatectomies

Thoracic tumors

Thoracic biopsies and procedures (open thoracotomy and thoracoscopy)
Lung lobectomy
Thoracoscopic lymph node biopsies
Thymectomy
Chest wall resections and reconstructions
Pericardectomy (open and thoracoscopic)

Bone Tumors

Bone biopsies
Cementoplasty
Amputation
Hemipelvectomies

Head and Oral tumors

Tonsillectomy
Mandibulectomy
Maxillectomy
Glossectomy
Enucleations
Salivary gland resection

WHAT HAPPENS AFTER SURGERY

After a pet has surgery to remove a tumor (i.e. the physical cancer), the tissues will be sent to a laboratory to analyze the tumor cells and the surrounding tissues. The pathologist will classify the tumor grade to indicate the aggressiveness of the cancer cells. This information helps your surgeon or oncologist determine a prognosis and decide on additional or long-term therapy. The pathologist will evaluate the tumor “margin”. A margin is normal-appearing tissue that is adjacent to the tumor on all sides; there are various recommendations for margins based on studies of the cancer. Many cancers can have microscopic extensions (like roots growing in soil). In order to limit the cancer’s ability to grow back, all of the cancer “roots” must be removed. Cancers that have “clean margins” means there is no evidence of cancer cells at the edges of the removed tissue; “dirty margins” indicates that cancer cells were left behind which could regrow.

There may be additional therapy needed after the tumor is removed. Your surgeon may recommend chemotherapy (traditional vs mutation-based), radiation therapy, or immunotherapy (targeted antibody-based therapy). There may be a need for future monitoring of the area with ultrasound, CT, or blood work. Your primary veterinarian or oncologist will also likely be involved in this process.

NOVEL CANCER THERAPIES

People get mammograms, colonoscopies, and other cancer screening tests to help detect cancer early. Now, dogs have OncoK9, a cancer screening test developed just for them, ushering in a new era of preventive care for pets.

Learn More...

Torigen utilizes immunotherapy to combat the cancer cells left behind or elsewhere in the body. The cancer tissue is used to create a vaccine to help the body’s immune system find the cancer cells and slow their growth.

Learn More...

FidoCure looks for targeted cancer therapies after surgery by examining the specific DNA mutations that resulted in a cancer forming. This service does not require additional samples or preparation, the company will get the necessary information to develop the chemotherapy protocol for your pet.

Learn More...

END OF LIFE DECISIONS

Pets hold an important part in our lives. The diagnosis of malignant cancer is difficult to process for many owners and it is easy to slip into feelings of despair and anguish. There are numerous resources available to help owners decide when their pet’s disease has progressed to the point where compassionate euthanasia should be considered. Not all pets take the same path through their cancer journey and knowing the signs to look for can help owners cope with the stress and grief. We have provided a link to a site with multiple resources for owners experiencing the loss or eminent loss of a pet.

Learn more...