From:
sukie crandall
Date: 2005-07-17 06:41:42 UTC
Subject: from FHL: If you worry "CANCER" here is a Golden Oldie which
To: ferrethealth@smartgroups.com
Message-id: <719A32F0-D531-4CD0-AD2A-B35B53D890A2@optonline.net>
It seemed like this was a good time to run a golden oldie that has
some important definitions for folks, so here you are.
I actually have not had to run this info for over a year in the FML
which means that many people have probably learned this, but some are
appearing again who don't know these important things, including that
most adrenal growths are not malignancies but still need to be
tackled and that insulinomas only very rarely metastasize. See:
http://fhl.sonic-weasel.org/browse.php?msg=SG5054 from Dr. Bruce
Williams
which reads in part:
>Actually tonight I am working on a promised article to Ferrets Mag
>about adrenal disease. But I think that Melissa and Sukie have
>covered the dire possibilities very well (and they are very real.)
>However, even under the best conditions, when there is no malignancy,
>there is no bone marrow toxicosis, there is no prostatic cystic
disease -
>even the most mild prediction is a sad one. Ferrets with adrenal
disease
>have a diminished quality of life - they have progressive muscle loss,
>low grade anemia, they tend to redistribute weight to the abdomen,
further
>making it difficult to walk, they have an increased incidence of
gastric
>ulcers as a result of the stress of chronic illness, decreased bone
density
> - none life-threatening, but all life-compromising. Even medical
treatment,
>which is not my preferred way of treating adrenal disease, gives
slight
>relief to symptoms. Doing nothing is not kind and not in a ferret's
best interest.
(Since then careful and controlled testing has shown Lupron Depot,
Suprelorin, and to a lesser extent also melatonin to be more useful
than previously thought for actual proven adrenal growths though
surgery is still the most effective approach for most ferrets. The
meds offer an option when surgery can not be done. Two excellent
places to learn more about them: http://www.miamiferret.org/fhc/ and
http://fhl.sonic-weasel.org/ (esp. posts from AFERRETVET).)
BTW, there are two every interesting new articles on melatonin use in
ferrets in the latest JEMM&S so if your vet gets that see if you can
arrange to pay for photocopies. It may be that for some small
ferrets (under 600 grams) the current implant dosage would be too
high, and there are further possible refinements for this approach.
eases many people's minds
Please, note up-front that even though most adrenal tumors are benign
that removal is still normally advised for both quality and quantity of
life except for those ferrets who are not surgical candidates due to
many
factors including dangerous complications. (If surgery isn't possible
Lupron and other meds are advised: See info from Dr. Jerry Murray on
that.) You will also want to see past info written by Dr. Bruce Williams
on how prompt surgery for insulinoma (when cases give early warning) can
be curative is about 60% of cases. See:
http://fhl.sonic-weasel.org ,
http://listserv.cuny.edu/archives/ferret-search.html ,
and the Critical Refs at
http://www.ferretcongress.org .
Most adrenal growths are benign neoplasia and some others tend to not
spread readily to distant sites in the body though some types can do
so; insulinomae also tend to not spread, though at times they do.
There is yet more on that aspect and on why blood tests do not
diagnose lymphoma/lymphosarcoma at
http://www.afip.org/ferrets/Clin_Path/ClinPath.html and elsewhere.
Many actual health professionals avoid the words "cancer" or "tumor"
because they are so often misused and misunderstood.
There are multiple pieces of info on the misuse of the term
"cancer"; here's one which combines the marvelous post of a
veterinary pathologist who is a highly respected ferret expert (Dr.
Bruce Williams) and some dictionary definitions from veterinary/
medical dictionaries. For example, message 6510 (There ARE others
with more info):
At 8:59 AM +0000 8/20/01, Dr. Bruce Williams wrote:
BEGIN QUOTE
The thread on this is pretty good, and both Sukie and Stephanie have
very valid points. The terminology of neoplasms can be confusing,
and I'm sure even vets can be confused from time to time.
The proper term for what you are talking about is neoplasm (or
literally "new growth). For one reason or another, a clone of cells
begins to grow uninhibited by normal substances or mechanisms. The
word "tumor" may be technically correct, but it is actually non-
specific - tumor is Latin for a swelling, but it could also be an
abscess, or anything else that causes swelling - so I try to stay
away from it.
Now this neoplasm may be benign - without the ability for cells to
detach into the bloodstream or lymph, move to another tissue, and set
up shop - or malignant (where they can do this.) The process of a
microscopic piece of a tumor moving to another organ is called
metastasis.
Metastasis is the hallmark of malignancy. The worst tumors have the
propensity to go anywhere and start growing (like lymphoma).
However, we can recognize malignant tumors even before they
metastasize, often by characteristic features seen under the microscope.
Adrenal carcinomas (malignant adrenal tumors) are interesting
neoplasms. Although they possess the ability to metastasize, only a
small number do, and usually only late in the course of disease. It
is likely that they do metastasize a lot, but have trouble gaining a
foothold in distant tissues, so it takes a long time and many
attempts if they ever truly metastasize.
Insulinomas are generally not malignant tumors as they only very
rarely metastasize. The presence of multiple tumors in the same
organ over time is not metastasis. We do not understand the
mechanism behind the generation of these tumors, and when we do
surgery to remove them, we really are only treating the end point of
this process, without addressing the cause. Thus it is really no
surprise that the rate of recurrence is about 40% within 10 months.
With kindest regards,
Bruce Williams, DVM
END QUOTE
Treat this as a supporting document to Bruce William's excellent post
above taken from FHL digest 348. I especially liked his providing
the direct translation of "tumor" as "swelling", and his explanation
that not all growths which can metastasize do so readily. These
definitions are combined ones from medical, veterinary, and biology
dictionaries, but emphases are mine and i am willing to be corrected
if I blew it... (New note in 2005 -- in the 4 years that this has
run no one has disagreed with the medical dictionary definitions and
it has been read by vets, physicians, and other experts in that time.)
Important Note: some more recent dictionaries don't even include the
term cancer as a valid health term any longer, and I have heard vets
who won't use it due to the widespread confusion out there, and even
some vets who won't use "tumor' due to too many assuming that any
tumor is malignant.
TUMOR: ANY abnormal mass resulting from the excessive multiplication
of cells; a swelling, especially that resulting from the growth of
new tissue; a neoplasm
CANCER: Any MALIGNANT tumor; carcinoma; a carcinoma or sarcoma
MALIGNANT: pertaining to or denoting progressive growth of CERTAIN
tumors which if not checked by treatment spread to DISTANT SITES,
terminating in death; a tendency to progress in virulence, cancer is
the best known example
BENIGN: not malignant, as in CERTAIN tumors; not recurrent, favorable
for recovery
NEOPLASM: a tumor; ANY new growth, specifically one in which cell
multiplication is uncontrolled and progressive, neoplasms may be
benign or malignant
(Subsets from Saunders:
NEOPLASM, BENIGN: a neoplasm having none of the characteristics of a
malignant neoplasm (see below), i.e.it grows SLOWLY, expands WITHOUT
METASTASIS, and USUALLY does not reoccur [See the notes of Dr. Bruce
Williams above in relation to why LOCAL reoccurance is NOT metastasis.]
NEOPLASM, MALIGNANT: a neoplasm with the characteristics of
ANAPLASIA, INVASIVENESS, and METASTASIS
There are several other subsets of neoplasia in this dictionary.
METASTASIS: the transfer or disease from one organ or part to another
NOT DIRECTLY CONNECTED WITH IT
ANAPLASIA: LOSS OF DIFFERENTIATION of cells
Those who have the _Saunder's Comprehensive Veterinary Dictionary_
will find that this resource often provides details beyond these bare-
bones descriptions, (though certainly there also will be nuances in
practise that those of us who are not medical professionals simply
won't understand). It is a marvelous resource; I love it. If I had
a rating for refs around here it would be among the best buys. It's
better than any of my other medical dictionaries, even for sorting
through things too technical for me in the _PDR_ books on herbs and
on supplements that i have at home. Marvelous book: clearly written
and very inclusive; more than worth what it cost.
-- Sukie (not a vet)
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