Date: 2011-02-22 01:04:50 UTC
Subject: [ferrethealth] Re: Intestinal lymphoma - treatment/opinion
What your vet is suggesting is adjuvant chemotherapy. The thinking in medi=
cine is that once the major tumor is removed, chemotherapy will be more eff=
ective in destroying remaining microscopic metastases.=20
In terms of increased survival rates, so much depends on age, concomitant i=
llnesses (i.e., adrenal disease, insulinoma, etc.), whether the lymphoma is=
T-cell or B-cell origin, the site of the primary tumor, previous pred use,=
>From my personal experience with various forms of lymphoma, stages and grad=
es; and the numerous international studies I've read, this much can be stat=
ed with certainty:
=95 Steroids (pred/dex) do appear to improve quality of life but results ar=
e not enduring. Every single study or report I've read states this, I beli=
eve there is consensus on this fact.
=95 Chemo does appear to extend life i.e. modified COP protocols (Antinoff=
& Hahn, 2004); Tufts protocol (Mayer, 2006)
=95 Surgical excision plus adjuvant chemo does appear to extend life (Onuma=
et al., 2008)
=95 How much longer??? More studies need to be done before that can be ans=
wered with any accuracy.
=95 Any treatment/surgery carries risks or adverse side effects. Some ferre=
ts can be desperately sick with chemo, others barely notice.=20=20=20
=95 Nothing `cures' lymphoma
My personal compass is `quality of life.'
Aggressive medical/surgical intervention that leaves a ferret miserable, th=
e majority of the time, but gives him a few more weeks, in my view, is bein=
g done for the owner's sake and not in the best interests of the ferret.
However, if he'll be miserable for a short period of time, but gets to live=
the majority of the time left relatively comfortable, pain-free albeit low=
er energy, then the more aggressive intervention is worth pursuing.
Questions I ask myself=85. Am I doing this for the ferret or for me? Will =
the treatment/intervention alleviate his/her pain or add to it? Will it ma=
ke him/her `feel' better?
Similar questions to those you are pondering.
If he were mine, and this is my personal, non-professional opinion -I'd mak=
e sure the infection was thoroughly gone before starting any steroids or ch=
emo protocol because both knock out the immune system. I'd let him recover=
fully from the surgery and fatten him up as much as possible with nutritio=
us extra supplemental feedings of your favourite duk soup recipe.
The chemo isn't going to cure him, so it can wait a couple of weeks while h=
e gets stronger. Pred will likely make him feel better, but again it will =
knock out his immune system. I'd wait for the infection to be cleared.
> The vet wants to start him on chemo. My concern is several-fold: 1) Since=
he had a tumor that was fairly advanced, how successful is chemo likely to=
be? 2) If the spot on his lung turns out to be a mestasis of the lymphoma,=
is there any point to chemo? 3) I always thought lymphoma was treated with=
pred; has that protocol changed? (would it make sense to treat him with pr=
ed if the spot on the lung is a mestasis, knowing he won=E2=80=99t last lon=
g anyway) 4) How do ferrets react to chemo meds? Like people? Will he be mi=
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