I had the privilege of meeting recently with a group of veterinary oncologists and technicians at the Cornell University College of Veterinary Medicine.
Veterinary oncologists diagnose and treat cancers in dogs and cats. Just as in humans, cancer care in animals may involve surgery, chemotherapy, and radiation therapy.
What struck me first was that these vets and techs were such nice people. That’s a trait they share in common with oncology professionals who work with humans. I think that individuals drawn to oncology tend to be unusually warm-hearted and caring. They have to be because they work with people in the most stressful of situations.
Oncology is also an intellectually challenging field because cancer is so complex. A treatment that works for one individual may not work for another individual with seemingly the exact same cancer.
Oncologists who treat people have to understand different cancers and individual variation, but at least they’re dealing with a single species. Oncologists who treat animals have all kinds of tails thumping in their waiting rooms.
The biggest difference, of course, is that treatment decisions are made not by the patient (i.e., the pet), but by the pet owner.
In humans, treatment decisions are so much easier when the patient clearly states his or her wishes. If the patient can’t or won’t be clear as to what they want, the family generally steps in, but this can be fraught with miscommunication and misunderstandings. Is the decision best for the patient, or for the family? It gets confusing and often stressful.
In the vet world, the pet owner is always the communicator and decision-maker. Understanding what your pet wants isn’t necessarily obvious. And pet-owners can struggle in deciding what’s in their own best interests.
Special mention should be made of the vet technicians who work in oncology. In human oncology, patients (and family members) often talk more comfortably and at greater length with the nurses and radiation therapists than with the doctors. The same can be true in veterinary oncology. The techs are often there with the pet owner when the vet leaves the room. They listen, answer questions and provide an extra dose of kindness when it’s most needed.
The financial considerations in vet oncology are more explicit than with humans where cancer treatment is largely covered by insurance, and the rules and fine-print of that insurance are so complicated that no one seems to fully understand them. If your dog has cancer, the finances are clear. The vet might say, “Treating your dog’s cancer will cost $5,000.” Since there’s no insurance, that money will come from the owner’s pocket.
Some owners feel badly that they can’t afford the cost and have to forego treatment. Other owners feel guilty spending money on a pet that likely wouldn’t live too many years longer even without having cancer.
If curative treatment is unaffordable or not pursued for whatever reason, veterinary oncologists are also expert in providing palliative care which focuses on symptom control and maintaining the pet’s quality of life. This kind of care is far less expensive because it doesn’t require costly drugs or high-tech equipment.
The most poignant situations are those in which both the pet and the pet-owner have cancer. The emotional overtones are everywhere. If the pet dies, is the pet-owner next? Or, if the owner dies, who will care for the pet?
None of this is simple. It seems that everything we know about cancer is complicated – the disease itself and the emotional entanglements that come with it. I now know that this is as true for veterinary oncologists as it is for human oncologists. And I’m comforted in knowing that veterinary oncologists and techs are as kind and as smart as their human oncology counterparts.
Published with permission of the Ithaca Journal.
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