Surgery is one of the most commonly used techniques to treat pet cancer. The best chance to achieve complete surgical removal of cancer is during the first surgical procedure. In many cases, surgery is best performed by a surgeon with experience in surgical oncology. A surgical oncologist is often board certified by the American College of Veterinary Surgery and 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, criticalists, 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 PET/ MRI, CT, and Ultrasound to determine the size of the tumor(s) and to plan resection. Surgery can also include specialized surgical techniques such as thoracoscopy, laparoscopy, endoscopy, and other interventional procedures such as palliative stenting.
What is the goal of surgery?
The purpose of surgery is to control or eliminate the 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. A cure is not always possible, and one of the most difficult decisions in surgical oncology is the decision not to perform surgery.
What are the common reasons for surgery in the treatment of pet cancer?
The following are the most common indications for surgery:
- To diagnose
- To cure the pet cancer patient
- To provide pain relief or improved function for the pet patient
- To de-bulk the tumor
Surgery for diagnosis of cancer in pets
Commonly referred to as a biopsy, this is one of the essential steps in management of the pet cancer patient. In this surgery, a section of tumor is removed to be analyzed under a microscope by a pathologist to establish a diagnosis. Information about tumor grade can be obtained from larger biopsy samples that may influence the type of surgery recommended as well as patient prognosis.
Surgery for cure
This generally refers to the first surgery performed to remove the tumor with complete margins. This is often confirmed by a pathology report that offers microscopic (histological) evidence that the tumor was removed and encased by a cuff of normal healthy tissue and that no cancer was left behind. Even when local control is achieved by surgery, some patients may require other treatments such as chemotherapy to prolong survival, depending on the biologic behavior of a specific type of cancer.
Palliative surgery is a surgery 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 removal of a mass that is bleeding or infected or amputation of a limb for pain relief after a pathologic bone fracture.
Debulking surgery, otherwise known as marginal resection, is incomplete removal of a tumor to enhance the efficacy of other treatment modalities such as chemotherapy, or radiation therapy.
Flint Animal Cancer Center Surgical Oncology
The Flint Animal Cancer Center oncology service includes four surgical oncology faculty and two surgical oncology fellows. They work with a team of medical and radiation oncologists and veterinary technicians to determine the best treatment plan for each pet cancer patient. Over the last four decades, Flint Animal Cancer Center surgeons have pioneered several procedures, including limb spare and oral/facial reconstruction. Today, these techniques are common practice around the world. Faculty continue to pursue new and better options for pet cancer patients and are exploring areas such as 3D-printed limb spare implants and the use of stem cells for muscle regeneration following surgery.