While surgery, radiation therapy, and chemotherapy remain the most commonly used conventional therapies for pets with cancer, holistic veterinarians are finding increased success when combining these therapies with a number of natural path that remedies including supplements such as antioxidants. In some cases, an owner may choose not to do conventional cancer therapy or the therapy may not even be available (for example, there are no conventional therapies to help many pets who have liver cancer.) Even if an owner is willing to spend several thousand dollars on conventional cancer therapies, for many pets with cancer the expected prognosis for survival is only 6 to 12 months. In contrast, most pets treated with an integrative therapeutic approach that utilizes natural therapies to support the pet’s immune system, kill cancer cells and prevent further spread of cancer, minimize side effects from conventional therapies, and allow for detoxification of the cancer patient at a greater chance of living longer or do the expected 6 to 12 months. In my own practice, cancer patients treated with an aggressive integrative protocol typically live 12 to 24 months or longer!
Antioxidants are important in helping treat the patient with cancer. This article will review the controversy that surrounds the use of antioxidants during cancer treatment and provide you with information you may not get from your conventional veterinarian.
What are Antioxidants?
Simply put they are compounds (vitamins, minerals, or supplements such as coenzyme Q-10, quercetin, curcumin, resveratrol, etc.) that remove free radicals from the cell. Free radicals form as part of the normal cell life cycle, especially during cell damage or death. Increased free radicals, if not removed by antioxidants (supplied by the body itself or via supplements) will ultimately cause the death of the patient.
Why the Controversy?
The controversy arises because most conventional doctors feel (without any proof to back-up their feelings) that antioxidants should be avoided during conventional cancer therapies as these supplements might hurt pets with cancer by interfering with their conventional treatments.
Here’s the reason for the controversy: supplements, particularly antioxidants, inhibit cellular oxidation. Too much oxidation causes inflammation and cell injury; left unchecked, the inflammation and cell injury can damage a cell’s DNA and cause it to transform into a cancer cell. Therefore, the good news is that any supplements that can dampen this process should be helpful to any patient, especially one with cancer. The bad news is that some conventional therapies cause extra oxidation in the cancer cell; this overwhelming oxidation kills the cancer cell. If our supplements inhibit this process, a proposed theory is that the cancer cells won’t die. In essence, could our supplements prevent chemotherapy and radiation from working properly and could make the cancer even worse?
So what’s the truth behind this controversy? Are supplements safe or harmful if we use them in conjunction with chemotherapy and radiation?
First, keep in mind that while radiation therapy kills cancer cells by causing oxidation, most chemotherapy drugs do not. Therefore, with rare exception, there is no need to worry about supplements, particularly antioxidants, interfering with conventional chemotherapy.
Second, at least in people, we know that diets high in antioxidants (particularly natural sources such as fruits, vegetables, and natural antioxidant supplements,) are likely to minimize the formation of cancer (so-called cancer-preventing diets.) This is due to the fact that antioxidants prevent excessive oxidation of cells; excessive oxidation leads to cell (DNA) damage, inflammation, chronic disease, and/or cancer.
Third, cancer cells do not behave like normal cells (if they did, cells would never become cancerous.) So in theory, what we might think would happen to a normal cell doesn’t happen to a cancer cell.
There are no valid studies that show the use of supplements, when properly prescribed and used under medical supervision, made the cancer worse or interfered with conventional treatments.
Fourth, patients who are nutrient-deficient or who have poor immune systems do worse when treated with conventional therapies than patients who have stronger immune systems and better nutrient intake. In my own practice, my patients who are placed on supplements and a better diet generally do much better when treated with chemotherapy and radiation than other patients. It’s important to boost the pet’s strength, health, and immune system to help it better withstand conventional therapies and help it stay in remission once conventional therapies are no longer used. The greater the pet’s debilitation, the greater any therapy will fail.
Fifth and finally, the only reported studies that showed that supplements (antioxidants) increased cancer growth are those where individual, synthetic vitamins were taken at high doses (in effect, the supplements acted like drugs.) There are no valid studies in people or pets that show the use of supplements and diets, when properly prescribed and used under medical supervision, made the cancer worse or interfered with conventional treatments (there are numerous studies as well as my own clinical experience that show the exact opposite.)
In conclusion, all of the evidence we have, both in vitro (test tubes) and in vivo (living patients) show that properly prescribed antioxidants increase the death and reduce the spread of cancer cells. In other words, most patients benefit from antioxidant therapy and doctors should prescribe them for most if not all of their cancer patients to improve their prognoses.
This week there is a focus on cancer in people, so I thought I’d share my thoughts on cancer in cats.
While I don’t regularly see cancer in cats as much as I do in dogs, cats certainly can and do develop various forms of cancer. In my integrative medicine practice, the three most common types of cancer I see are squamous cell carcinoma (SCC,) lymphoma (LSA,) and vaccine associated sarcoma (VAS.)
Squamous cell carcinoma (SCC)
Squamous cell carcinoma is the most common feline skin cancer that I see in practice. It can occur anywhere on the body (as skin cells are squamous cells) but is usually found in the mouth, on the nose, and on the tips of the ears. Because it is a cancer that can be induced and exacerbated by ultraviolet light, light haired outdoor cats are more commonly affected with involvement of the tips of the ears and the nose.
Squamous cell carcinoma occurring in the mouth of cats is easy to diagnose but is often not found until later in the course of the disease when the cancer has become more aggressive and more difficult to treat or cure. I have found this cancer in the oral cavity of cats who were acting normally but presented for a routine dental cleaning (again showing the importance of regular dental cleanings done under anesthesia!;) the tumor was found on the gums, palate, or tongue when the teeth were being cleaned.
Clinical signs of SCC include any erosive or ulcerative skin disease, especially an erosion that does not heal within a few weeks despite proper therapy. Lesions of the well-known feline eosinophilic granuloma complex may be mistaken for SCC; any eosinophilic lesions which do not resolve with proper therapy should be biopsied to rule out the presence of SCC.
Clinical signs of SCC in the oral cavity can include reduced appetite, reluctance to eat on the affected side of the mouth, drooling, bloody discharge in the mouth, and a foul odor from the mouth. As previously mentioned, this form of SCC is often not diagnosed until the oral cavity is examined for another reason such as a dental cleaning.
If diagnosed early, squamous cell carcinoma can be cured. Small lesions on the tips of the ears can be removed surgically. Lesions on the nose might be cured with surgery if they are not too large. Larger lesions might be controlled or even cured with radiation therapy or cryotherapy (freezing the lesion.) Lesions of the oral cavity that are small and caught early might also be cured surgically or with radiation therapy. However, since most of these lesions are not diagnosed until they become aggressive, treatment is often palliative until the cat is euthanized due to a poor quality of life.
Integrative therapy using specific herbs and homeopathics may also help to control SCC. I have the best results when treating pets with cancer by combining both natural therapies and conventional therapies.
Lymphoma occurs when normal lymphocytes, white blood cells that are important in the immune system, become cancerous. There are several forms of lymphoma, and each form refers to the body system affected. In kittens and young cats, mediastinal lymphoma is more common. Cats with this form of lymphoma develop a solid tumor in the chest cavity. Cats with generalized lymphoma can develop tumors anywhere in their bodies; most commonly they develop in the kidneys, nervous system (especially spinal cord) and eyes. The alimentary form of lymphosarcoma, the most common form that I see in practice, develops in the gastrointestinal system. This form of LSA often develops after chronic and unsuccessfully treated inflammatory bowel disease (IBD,) reinforcing the need for prompt diagnosis and treatment of all cats with IBD.
Clinical signs of LSA depend upon the tissue involved. Cats with mediastinal LSA often develop difficulty breathing due to the presence of the tumor within the chest cavity or fluid developing in the chest cavity. Cats with generalized LSA can develop kidney failure, blindness, or varying degrees of paralysis depending upon which organ system is involved. Cats with alimentary LSA usually develop some combination of vomiting, diarrhea, and/or weight loss. It is extremely important that cats which vomit (especially if hairballs are not vomited,) show a change in fecal consistency, or have unexplained weight loss be evaluated for IBD and LSA. Diagnosis involves a variety of tests depending upon the form of LSA that is present, and can include a complete blood profile, urinalysis, radiographs, ultrasound, MRI, CT scan, and endoscopic examination and biopsy.
Therapy involves a combination of chemotherapy and herbs, homeopathics, and nutritional supplements. In general, cats do not respond as favorably to treatment of lymphoma as do dogs with the same disease. Complete response rates range from 50 to 70% with combination chemotherapy, and survival is reported to be around six months. However, those cats that do respond to chemotherapy may live one year or longer. The more guarded prognosis in cats compared to dogs may be due to several factors, including: many cats are diagnosed later in the course of the disease; many cats with lymphoma test positive for feline leukemia virus; anatomic location of the disease; and whether or not the chemotherapy drug doxorubicin is used as using this drug appears to increase response rates. Certainly an integrative approach combining natural therapies with chemotherapy tends to produce a better response than in pets treated with chemotherapy alone.
Since improperly treated IBD can progress to intestinal LSA, all cats with IBD must be treated aggressively with a combination of conventional medications (most commonly high doses of corticosteroids such as prednisone) and alternative treatments.
Vaccine associated sarcoma (VAS)
Vaccine associated sarcoma is probably the most common cancer that I see in my feline patients. As the name implies, VAS is a solid tumor of the subcutaneous tissues anywhere on the cat’s body caused by vaccination. While any injection has the potential to induce a VAS, this type of sarcoma is usually linked to a prior vaccination at the site of the tumor. VAS is a relatively new cancer, having first been discovered about 20 years ago as increasing numbers of cats received annual vaccinations for rabies and feline leukemia virus.
The exact cause is not known, and certainly most cats that receive vaccinations do not develop VAS. It is theorized that VAS develops in genetically predisposed cats that develop chronic inflammation which becomes neoplastic (cancerous) after immunization. These tumors began as small pea sized lumps usually between the shoulder blades or over the rump, common sites for vaccination. If not diagnosed and treated early, they can become quite large, making successful treatment difficult if not impossible.
Conventional treatment involves a combination of surgery (which is both diagnostic and therapeutic), radiation therapy, and chemotherapy. Aggressive surgery is necessary to remove as much of the tumor as possible. This type of cancer is known for spreading out some distance from the initial tumor. In effect, a VAS is like an octopus: the small lump you feel is the head and the arms containing cancer cells stretch out some distance from the tumor. Preoperative assessment of the spread of the tumor is usually done with an MRI or CT scan.
Many cats with VAS can live for several years following the initial diagnosis when an aggressive protocol of surgery, chemotherapy, radiation therapy, and natural therapies are used.
Integrative therapy for any of these cancers involves judicious use of immune enhancing herbs, homeopathics, and nutritional supplements. High doses of omega-3 fatty acids, antioxidants such as vitamins A, C, and E, coenzyme Q-10, Echinacea, Astragalus, medicinal mushrooms, DMG, and various homeopathics may all be helpful. Specific therapies targeting affected organs are also indicated in the integrative treatment of cats with cancer. No cat with cancer should ever receive further immunizations as this may bring the pet out of remission.