SARCOMAS AND THEIR TREATMENT

Sarcomas  are a common tumor type for both cats and dogs, and are generally considered to be aggressive malignancies.

From an integrative perspective, we believe that most sarcomas develop in response to chronic inflammation.  This can be local—as with the sarcomas that cats can develop at the site of a skin puncture—or distant inflammation, as with chronic dental disease.

In general, early sarcomas appear as simple thickening of the skin, which then progresses to ulceration (ie, a non-healing wound).  These ulcers and localized swelling gradually increase over time..

Once we find a suspicious lesion, the best way to make a diagnosis is to do a “fine needle aspirate”, where we stick a small needle into the mass and aspirate, or suck back, some of the cells within the bump.  We then look at those cells under the microscope, and in many cases can make a diagnosis within the clinic.  If there is any question, we always recommend sending the microscope slide off for histopathologic exam by a pathology specialist.

Once diagnosed, the primary form of initial treatment for sarcomas is their surgical removal.  Because sarcomas develop by growing roots, we always try to get a margin of at least two centimeters  around and under the mass.    If a sarcoma progresses on the lower limb, it may necessitate amputation in an effort to prevent spread.

The early excision of these masses is very important when you realize that they have a tendency to spread locally by forming invasive roots, very similar to the roots of a tree.   These roots can sometimes extend several inches away from the visible mass.  Sarcomas in general are not metastatic—in other words, they usually do not spread to distant sites via the blood or lymphatic systems.   However,  local recurrence rates after surgery are high due to the widespread tumor roots.

 

Once excised, we always recommend the histopathologic exam of your pet’s tumor for specific diagnosis, staging purposes, and to evaluate incisional margins.  This biopsy will enable us to offer you the most detailed guidance in the form of treatment and prognosis.

Along with surgery, there are four other forms of treatment for sarcomas.

First, from an integrative approach, our goal is to mellow the immune system.  We do this by trying to avoid allergies, minimize inflammatory disease like dental problems or arthritis, and by minimizing vaccines.

Secondly, we can use natural supplements to help reduce inflammation throughout the body.  These include…..

-omega 3 fatty acids in fish oil (50 mg per lb body weight per day)

-curcumin (the dosage depends upon the purity of your product—we carry Transcend, the most

bioavailable form of curcumin on the market)

 

-Undenatured type 2 collagen to reduce arthritic inflammation

-mushroom therapy to reduce systemic inflammation (shitake and turkey tail)

-decaffeinated green tea at a dose of 20 mg per lb body weight with food

We also use Chinese herbal mixtures to help reduce inflammation and directly fight tumor growth.

Traditional chemotherapy, which consists of “maximally tolerated doses” of drugs usually given as injections, is usually not a great approach to the treatment of sarcomas.   Just as with human patients, traditional chemotherapy also creates a myriad of side effects.  For this reason we generally recommend against its use.

However, there is increasing interest in the use of metronomic chemotherapy, which consists of very small doses of chemotherapy given at home in pill form.   This is generally well tolerated, and most patients show no ill effects at all.  The most commonly prescribed drugs for this purpose are cyclophosphamide and a NSAID pain reliever such as piroxicam or Deramax.   Our goal with metronomic treatment is NOT tumor eradication, but rather to slow tumor growth by reducing root formation and the blood supply to the tumor, while still maintaining an excellent quality of life.

Another approach to therapy consists of localized radiation treatment delivered to the specific tumor site.  Unfortunately, this generally requires repeated trips to the Bay or LA areas and repeated anesthetic procedures, so it is not without nuisance.  However, localized radiation therapy can be very effective in minimizing tumor growth and in some instances may be curative.   We can recommend pet cancer specialists that could help you in this journey if you wish.

And the most important part of all?  We’ll help you however we can.