Free The Dog Cancer Survival Guide by Susan Ettinger Demian Dressler Page B

obvious and least controversial answer I have.
Cancer Can Be Invisible
    Some cancers simply are not visible to the naked eye, cannot be felt with the fingers, and don’t produce a noise that can be heard with a stethoscope. These cancers are often advanced by the time the dog decompensates and the guardian realizes something is wrong. This can be true for human cancers, too. In deep body cancers, we don’t usually realize something is wrong until after symptoms start to show up.
    Cancer can take a long time to develop; we’ll talk more about this later. For now, it’s important to realize that cancer does not appear overnight. It just seems to.
Cancer Can Start Before Birth
    Some dogs are born with genetic mutations passed on from their parents’ DNA, which can develop into cancer later.
    This is a very complex subject, so I’m going to vastly over-simplify it. Cancer goes through many steps – for the sake of explanation, let’s pretend it is ten steps – before it is fully developed and diagnosed. If a dog is born with a genetic mutation that pre-disposes her to develop cancer, she may already be on, say, step three of ten, at birth. If the cancer does develop, it may take years for recognizable signs to appear.
    To the guardian, that cancer may seem to pop up overnight when, in fact, it developed over the genetic history of the dog. If it were possible to trace the molecular history of that genetic mutation all the way back to where it began in her ancestors, you could even say that in some cases cancer develops over millennia.
Cancer Screening Can Be Difficult
    It would be ideal if vets had screening tests that could catch cancer early, but, we don’t. While some human cancers can be found by measuring certain markers in the blood, we can’t do this for most dog cancers.
    Routine physical exams can uncover suspicious lumps and bumps. Unfortunately, many dog lovers seem to think of the vet like they do a car mechanic: they take the dog in only when something is obviously wrong. Regular physicals are critical for finding cancer as early as possible, but, even they can’t always catch cancers that start on a microscopic level, or are located deep in the body.
The Wait and See Approach
    When some vets find a lump during an exam, they recommend taking a “wait and see” approach. They advise the guardian to look for changes or growth before testing the lump for cancer. However, waiting can be problematic. If a lump is cancerous and left untreated, it can spread, becoming much harder to treat later.
    No one, not even my oncologist co-author Dr. Ettinger, can tell what a lump is without testing it for cancer cells. When I see or feel a lump on a dog, I can often make an accurate,
educated guess
about whether it is a malignancy. However, I can also make an
inaccurate
, educated guess.
    If I believe a lump is benign, I tell my clients something like this:
    “Nine out of ten times when I feel a lump like this, it turns out to be benign ... but if your dog is the one dog about which I’m wrong it won’t matter to you that I was right about the other nine dogs. If you choose not to get this tested, keep in mind that your odds are good, but that you are still gambling.”
    Many vets are hesitant to recommend extensive or expensive testing procedures, because we are sensitive to guardians, who might be thinking that we’re just “running up the bill.”This is especially true if tests come back negative.
If you weren’t going to find anything, why did you order that test in the first place?
    While it’s true that there may be a few vets who run unnecessary tests, it’s impossible to know for certain that cancer is present without at least a fine needle aspirate and/or a biopsy. Metastasis, or cancer spread, can only be confirmed with X-rays or some other imaging test, blood tests, urine tests, and other screening tools, depending upon the cancer’s type. There is simply no way around it – in order to get a