Dear Dr. Thompson: Our 7-year-old boxer developed some large lumps under his chin and wasn’t eating well. We took him in and he was diagnosed with lymphoma. We discussed the options and are not sure what direction to go. Our vet said without any treatment he wouldn’t have very long.
Lymphoma is a cancer of a white blood cell circulating in the body called a lymphocyte, which normally plays an integral role in the function of the immune system. The swelling you noticed were enlarged lymph nodes under the jaw. This is one of the most common symptoms that people notice. Loss of appetite, weight loss, and other subtle changes may also be present early in the course of the disease. Lymphoma is one of the most common cancers in dogs, and golden retrievers, boxers, and Scottish terriers are some of the more commonly affected breeds.
Many times a diagnosis can be made by collecting cells from one of the enlarged lymph nodes. Occasionally a surgical biopsy may be needed to get a definitive diagnosis. Sometimes other tests are needed to determine the extent of the disease such as X-rays of the chest and an ultrasound of the abdomen. Most forms of lymphoma are called multicentric, which affect the lymph nodes, spleen, liver, and bone marrow. However, other more rare forms can occur that can be in the intestinal tract, mediastinum, central nervous system, or skin.
Hearing that your dog has cancer can be shocking, but there are options for treating lymphoma. Chemotherapy with a combination drug protocol has the best response rates in dogs. Unfortunately, a cure is generally not achieved, but the median remission or disease-free time is about one year, with 25 percent surviving two years. The word chemotherapy generates a profound reaction in most people, but it simply means using drugs rather than surgery or radiation to treat the cancer. Chemotherapy in dogs is generally much better tolerated than in people and serious side effects from treatment are less than 5 percent of cases. Most often people have no outward indication that their dog is being treated for cancer.
The important thing to remember is that there is no wrong decision as it relates to treatment. While the response rates are excellent and side effects are generally mild, you are dealing with a disease that is rarely cured. Treatment means regular trips to the veterinarian and regular testing to watch for adverse effects. There are also less-involved treatment protocols that can still have good results, but the duration of remission is less than the multidrug regimen. Your veterinarian can help you sort through what can be a potentially overwhelming situation and my heart goes out to you during this difficult time.
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