Dear Doctor: Should a Dog Diagnosed with Cancer be seeing a Veterinary Oncologist?
Q My dog has just been diagnosed with a mast cell tumor, which my vet said is cancerous. She also said the cancer is a grade 2, meaning not as good as a grade 1 but still better than a grade 3, which she says does not respond well to treatment. She says the treatment plan should include surgery to remove the mass plus radiation. My question is, should I be taking my dog to a specialist at this point, or can her regular vet handle the treatment?
St. Paul, Minnesota
Dear Ms. Rossi,
A The answer to this question needs to be taken on a case-by-case basis. Some primary care veterinarians feel very comfortable — and are very competent — at handling certain types of cancer treatment. But not all cancers require the same kinds of treatment, and it also depends on the location and extent of the tumor.
Dealing with a mast cell tumor has a number of components. A grade 2, which your dog has, calls for surgical removal, occasionally followed by radiation therapy. Because mast cell tumors are notorious for invading nearby tissue, a two-centimeter margin around the cancer is usually recommended. That can be tricky if the cancer is in a location where a two-centimeter margin is difficult to impossible to achieve. This can be the case in areas where there’s very little adjacent tissue to allow closure of the wound, such as a paw.
Thus, depending on your veterinarian’s surgical skills and experience, she may or may not be the right person to excise the tumor. A good vet will be honest with you about the limits of her expertise. You can also ask how many removals of mast cell tumors she has performed and whether any of the tumors were at the same spot as on your dog, and how the operations went.
You’ll want to know, too, whether radiation therapy is available in your area. While some general practice veterinarians are equipped to administer chemotherapy, few if any offer radiation therapy, which is pretty much limited to referral multi-specialty centers. Then, too, a board-certified veterinary oncologist is going to have gone through rigorous training and sat for exams that a primary care vet will not have undergone.
If you have a good relationship with your vet and there’s a feeling of trust between the two of you (which there should be), the answer on who should be treating your dog for her particular cancer should become clear pretty easily.