Osteocarcinoma of the Jaw

[btrtevino]

Hi,
I hat to start my membership on this board on such a dismal note, but I am wondering if anybody has any advice or info regarding this topic. My 9 year old rottie Sheva was just recently diagnosed wth an osteocarcinoma of the jaw. It pretty much came up over night. I thought she got bit by an insect and took her to my vet. unfortunately, after radiographs and a biopsy she was diagnosed with this horrible disease. I am meeting with a specialist tomorrow, but from what i have been told my only option will be a hemimandiblectomy where they rewmove half of her lower jaw. According to 3 different vets, she will be able to resume her normal life after recovery, but I am not sure if I believe this. From what I understand her prognosis is 71% chance the cancer will not return at a year. Plus my vet told me that after that, it probably won't return. However, there is a 28% chance it will return and most likely within 12 weeks or so. The decision is killing me. I love her to death, but do not want to keep her alive for my sake only. The surgery will cost between 2k-3k which I will gladly spend if there is really a good chance she will ive a happy life after this. But I definitely don't want to put subject her to such invasive surgery only to find her facing the same problems or lacking a good quality of life. Has anyone ever done this surgery before? I am sorry this is so long, but I am frantic for info, and need to make the decision soon because my vet says that although the pain is controllable now, it won't be in a week. Apparently the cells in this type of tumr double every two days. Any info or insight would be greatly appreciated!

[spidey]

One vet at the clinic I work at has done a hemimandiblectomy a few times and she says the dogs do very well, so that's now four vets' opinions. I think this is one of those things that is worse for the humans ("ew, I'd hate to have that happen to me") than for the dog.

That said, I'm sorry about your dog, and only you can decide if this is the right thing to do for an older dog.

[brunie's mom]

I would not do it on an older dog. We have a forum member here who's dog has the same type of cancer (Anne)...and she did not opt for surgery and is just treating the dog with pain meds and some other form of treatment.

You can cut out the jaw...but it does not mean that the cancer has not spread already all over the body. The jaw is so close to the lymph glands...that it spreads like crazy. Osteo is not a cancer that can be cured....it may buy the dog a bit of time having her jaw removed...but if that time is spent in pain and recuperating...it's not much of a life.

I am sorry that you are going through this and must decide what to do.

Gina

[moondog]

Originally Posted by btrtevino

Hi, I am meeting with a specialist tomorrow, but from what i have been told my only option will be a hemimandiblectomy where they rewmove half of her lower jaw.

According to 3 different vets, she will be able to resume her normal life after recovery, but I am not sure if I believe this.

I'm very sorry this is what has brought you here, but you are not alone. Many of us found this website when our dogs became very ill, me included (different disease).

I think you are VERY wise to be skeptical. From everything I've read about bone cancer (and yes my dog did succumb to it in the end ), the primary tumor sends tumor "seeds" throughout the body, along with a chemical to inhibit their growth. Once the primary tumor is removed, so is the chemical that inhibits growth, and they begin to grow in other parts of the body. Osteosarcoma is not survivable and not curable. I would not do this surgery on my dog.

We have another member who did have it done and the poor dog has gone through one thing after another, including needing to have one of her eyes removed. Here's a search on her (username "kimi") and you can decide for yourself if this is something you'd want to put your dog through (begin reading from bottom to top as the threads are in reverse order by date):

Rottweiler Discussion Forums - Search Results

Another good source of insight is this thread:

Ethical Issue: Cancer Treatment Decisions

Ultimately it's up to you, just keep in mind that a vet's job is to treat the sick, and so they will. Whether that is wise or not depends on what the dog has to go through to accomplish it, and is a question each owner faced with decisions regarding cancer treatment needs to take to heart prior to making those decisions. These dogs can't speak for themselves....it is our job to do that for them in the best way we know how.

I'm very sorry you and your dog are going through this.

[AngelBunny]

I am so sorry your introduction to RDN is on such a sad, unhappy note. I feel for you and your dog.

I've had Rotties as my only breed of dog since 1984. All my Rotties, with the exception of one, including one foster (we're active in Rottie rescue) died from various types of cancer, mainly osteo. We kept our dogs comfortable, then put them down when their quality of life clearly was compromised.

The average life span of a Rottie is 8-10 years, making your Sheva an old dog.

Based on my experience, I will not pursue aggressive methods with future dogs, should they be inflicted with the scourge of cancer. Neither I or my DH regret following the path we did with our past dogs. In our minds, since there's no cure for osteo, surgery and other aggressive treatment only buys time and for whom would this be done?

I am a big believer in quality of time.

If Sheva was my dog, I'd treasure every moment we have together, treat each day as a gift, love and spoil her, and then let her go.

I am so very very sorry for you.

[Anne]

As Brunie's Mom said, my dog who turned 7yo one month ago has osteosarcoma of the mandible. The percentage of 71% you were given is far greater than the research I've done reveals. The percentages I've noted have a much lower success rate, particularly in our breed. The percentages they speak of is whether or not the dog is still alive at 1 year post surgery irrespective of the condition or comfort of the dog. They are not to do with a complete remission of the disease.

In Sopie's case the osteosarcoma is poorly differentiated and therefore very aggressive. I also believe that by the time a diagnosis is made the cancer has already metastasised. I spent, and still spend many days and nights researching and I made my decision in accordance with what I was able to learn about this awful disease.

Osteosarcoma is not curable irrespective of surgery. It may prolong life for a few months but to me, a few extra months of life with radical surgery and chemo, with the associated pain of the surgery was asking too much of my dog. Each owner needs to make their own decision about which treatment they give their dog. Don't be pressured into anything by the specialist.

I decided not to proceded with surgery or chemotherapy. We see an oncologist every 2 to 3 weeks and Sophie is on a metronomic protocol of a number of combined drugs. Amongst these drugs there is one chemo drug.

This therapy has slowed the progression of the cancer. My girl has a tumour on her gum which is a manifestation of the osteo in her mandible. This is the part that is visible and it's a very fast growing tumour. I have had it debulked twice to relieve pain.

On the mentronomic protocol the tumour stopped growing for 3 weeks but is now growing again. Sophie has her bloods and urine done every time we see the oncologist. The results of the tests enable the oncologist to alter the drug therapy and dosage as required.

I am able to keep Sophie pain free at this stage with Piroxicam and Tramadol.
Her quality of life is my priority. She is still playful, happy and has no pain. If she does show any sign of discomfort I increase the pain meds.

btrtevino: Don't let the specialist convince you that a hemimandiblectomy is your only choice. It is not. There are other choices but surgeons push for surgery and chemo. They did in our case too and certainly put pressure on me to do so. It was very stressful and they will give you statistics for all breeds of dog. These statistics I found are of little value. I had up to date statistics on the Rottweiler breed and they're far lower than the general statistics. I didn't consider an extra 2 or 3 months of life worth the trauma and pain of the surgery.

Surgeons will say the surgery is successful but what do they consider to be successful? To me it's a case of the surgery was successful but the patient died and that is the case with osteosarcoma. All surgery will give your dog is a few extra months, if you're lucky. I have had more time with Sophie than was expected with her poor prognosis. She's not ready to go yet.

I'm so very sorry you are going down the same road with your dog as I am. I understand the anxiety and stress you are going through. Research thoroughly and make your own decision. Don't be pressured into surgery because it definitely won't cure your dog of the disease. Seek out all the options available to you.

Please keep posting and let us know how things are going with your dog and what you decide to do.
Anne

[Anne]

Originally Posted by spidey

One vet at the clinic I work at has done a hemimandiblectomy a few times and she says the dogs do very well, so that's now four vets' opinions. I think this is one of those things that is worse for the humans ("ew, I'd hate to have that happen to me") than for the dog.

That said, I'm sorry about your dog, and only you can decide if this is the right thing to do for an older dog.

That may be the opinion of 4 vets. The surgery may do very well but osteosarcoma can not be cured. Better to seek out the statistics of dogs who surive for years. I doubt you will find any dogs with osteosarcoma of the mandible live for years after surgery and that's the only way to assess the success of surgery.

As I said in an earlier post. It's often a case of "The surgery went well but the patient died shortly after". Most vets do not have the expertise or the knowledge of cancer that an oncologist does.

What does 'dogs do very well' when surgery is done mean? It won't cure the disease so that to me doesn't mean the dogs do well at all. The end result is they die of the cancer. By the time osteosarcoma is able to be diagnosed it has already metastasised.

It is definitely not a case of anthropomorphising. I don't think "ew, I'd hate to have that happen to me". Walk a while in my shoes. That's superficial and diminshes the love we have for our dogs. I would do anything to keep Sophie alive. If surgery could give her pain free years then I'd go ahead but it can't.

[btrtevino]

Thanks for all the imput. I am wondering, is there a difference between osteocarcinoma and osteosarcoma? All the info I am finding is either ambiguous or not specific to either one. Are they all just considered jaw cancer and have about the same prognosis?Thanks again.

[moondog]

Originally Posted by btrtevino

I am wondering, is there a difference between osteocarcinoma and osteosarcoma?

They are both malignant, the difference is in the type of cells they originate from.

carcinoma n. , An invasive malignant tumor derived from epithelial* tissue that tends to metastasize to other areas of the body.

• *Epithelial cells are those that cover organs of the body. These cells form a layer over the internal and external surfaces of the body.

sarcoma n. A malignant tumor growing from connective tissues, such as cartilage, fat, muscle, or bone.

[Anne]

Originally Posted by btrtevino

Thanks for all the imput. I am wondering, is there a difference between osteocarcinoma and osteosarcoma? All the info I am finding is either ambiguous or not specific to either one. Are they all just considered jaw cancer and have about the same prognosis?Thanks again.

I just googled this and Medicines Businesses and Services. Information and Reviews from Medicineworld.com describes the word osteocarcinoma as follows:-
<tumour> Undesirable and obsolete non specific term for a metastasis of carcinoma or a carcinoma that contains foci of ossious tissue <as a result of neoplasia>

It seems the veterinary and medical profession now use the term osteosarcoma to describe this disease.
Hope that helps.

[btrtevino]

Well today did not go well. Howevewr, I did get the answers I was looking for. I went to a consultaion with a surgeon to discuss my options for Sheva. Surgery is not an option. It was doubtful that even with a hemimandiblectomy it would be possible to make good enough margins to give her a good prognosis. Although part of me wanted suergery to be an easy fix, I am glad that I did not have to make a decision or wonder either way if I made the right decision. Although logically I am coming to terms that my Sheva will not be with me long, I still can't grasp the idea. Does any body have any suggestions that may help prevent bleeding at tht tumor sight? My vet gave me some silver nitrate sticks to stop the bleeding, but I would like to prevent it from starting because even though they work great, it is hard to rub the sticks on her tumor because I know it hurts. Also, for those who have experience with this is it normal for her tumor to grow so fast. In a matter of 2 weeks, it has gone from unnoticeable to painful and huge. Also, I hate to ask this because the though is so unbearable, but does anyone know how long she has before it becomes unbearable. She is now on antibiotics, dermaxx and tramadyl. I am sorry I am asking so many questions, but I really value personal experience when dealing with this tragedy.

[Liz]

Have you looked at cancer starving diets and immune system supplements? We have unfortunately lost several dogs over the years to cancer and found that these helped a lot.

Janni, my second rottweiler and heart dog (Chrome's mother and Elfi's grandmother), had osteosarcoma of the jaw towards the end - she was 12 when it was dx'd and 13 when she passed away. She had already had several mastectomies for metastatic breast tumors and had been on a cancer starving diet since she was about seven. We also used Lew Olsen's supplement, Berte's Blend.

Her tumor didn't bleed a lot, it was the smell that got to us, but it didn't bother her, so we just learned to live with it

Liz

[Anne]

Originally Posted by btrtevino

Well today did not go well. Howevewr, I did get the answers I was looking for. I went to a consultaion with a surgeon to discuss my options for Sheva. Surgery is not an option. It was doubtful that even with a hemimandiblectomy it would be possible to make good enough margins to give her a good prognosis. Although part of me wanted suergery to be an easy fix, I am glad that I did not have to make a decision or wonder either way if I made the right decision. Although logically I am coming to terms that my Sheva will not be with me long, I still can't grasp the idea. Does any body have any suggestions that may help prevent bleeding at tht tumor sight? My vet gave me some silver nitrate sticks to stop the bleeding, but I would like to prevent it from starting because even though they work great, it is hard to rub the sticks on her tumor because I know it hurts. Also, for those who have experience with this is it normal for her tumor to grow so fast. In a matter of 2 weeks, it has gone from unnoticeable to painful and huge. Also, I hate to ask this because the though is so unbearable, but does anyone know how long she has before it becomes unbearable. She is now on antibiotics, dermaxx and tramadyl. I am sorry I am asking so many questions, but I really value personal experience when dealing with this tragedy.

I share your feelings of despair, grief and desperation. Sophie's tumour in her mouth doesn't bleed though. It's growing so very quickly and has turned blue in color. The tumour is painful to the touch but the mandible (bone) doesn't seem to be painful. Is this the same situation with Sheva?

It may be worth seeing an oncologist and looking into the metronomic protocol. I've had Sophie on this since the beginning of January and it did stop the tumour in it's tracks for 3 weeks but it's now growing again. She does however have a quality of life because the Piroxicam and Tramadol are effective in relieving pain. If I see any sign of pain I increase the dose. I've only needed to do this once and was then able to cut back to the normal dose and she's holding well on this.

The oncologist does a blood count and a sterile urine test every time we go there and adjusts the drugs Sophie is taking accordingly. One of the drugs Sophie is on is to limit the blood supply to the tumour to try to starve it and another is to try and kill off tumour cells...it does kill off healthy cells in the process. She takes another drug to strengthen and build bone. She is also on a high dose of docycyline. These drugs are all tablets that I administer at home.

We had the pathology results showing an agressive highly malignant anaplastic tumour in December. Her prognosis was guarded and she was not expect to be with me for very long at all.

Sophie is still enjoying life and having fun. She still wants to play fetch, she is happy and is always ready for a walk. I put this down to the drug therapy she is on. It was not expected that she would have long but she is not ready to go yet. I don't know how much longer she has. I make every minute I have with her count.

Sheva will let you know when she's in pain. Be guided by her because she will tell you what she needs.
I'm so very sorry we are both in this situation with our beloved dogs.

edited to add that I have Sophie on a very alkaline diet because cancer needs acid to survive.

[btrtevino]

I have an appointment with an oncologist Monday. The wait is killing me but that is the soonest I could get it. Also, Anne, you say you feed an alkaline diet, do you have any specific suggestions. I have to use soft food because kibble irritates the tumor and causes her to bleed. I have heard good things about flaxseed oil so I bought a bottle to try. Does anyone have any suggestions to getting her pills down. I can't just put them down her throat because I think it hurts her mouth. She quickly wised up to putting it in a bite of canned food,crushing it in her food, and coating it with peanut butter on top of that semi-soft food that comes in a package like sausage. Also, today is the first time I tried the oil, and she would barely touch her food when she smelled it. Any suggestions would be greatly appreciated. Also, I wanted to let everyone know how much I truly appreciate your input.

[observer]

Try wrapping the pills in velveeta-type cheese. Also, make a few balls of cheese that DON'T have pills in them. You could use the rolled dog food you've already tried the same way. Make a happy game of it! Give her a couple of those without the pills, then the one with the pills, then another empty one in as quick a succession as she can handle. She should be happy enough for the cheese balls she won't notice the pills.

I don't know about the benefit of flaxseed oil, but assuming it is helpful, does it come in capsules? Then you could do as above, if it works for her.