4. Characteristic Benign Malignant Shape Round, wart like or pedunculated Irregular Metastasis Not present Present Mitotic figures Less More Blood supply Less Marked
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10. Localised tumour Invasion of extra cellular Matrix Detached tumour penetrate basement membrane Integrins helps to bind to ECM Invasion is assisted by secretion of Proteases Further Migration also occurs in same manner Haematogenous lymphatics Trans coelomic
72. This bronchoscopic image from a dog demonstrates a large mass that extends from the wall of the trachea and nearly occludes the entire tracheal lumen. Lateral cervical radiograph of a dog with a spaceoccupying soft tissue mass within the laryngeal lumen (arrow). Biopsy of this mass revealed a rhabdomyosarcoma.
The genetic damage or mutations must be – Genetic damage must be non-lethal Three classes of regulatory genes
Until recently, nutritional management of cancer patients has not been considered important. This despite the fact that patients not eating is one of the biggest problems facing cancer patients. Therefore, It is now recognized that proper nutritional management is important in treating cancer cachexia (which is a clinical condition due to severe malnutrition) In addition, proper nutrition can control the malignancies of cancer and certain nutrients can help limit the side effects associated with chemotherapy and radiation therapy.
Cancer severely alters the metabolism of proteins, carbohydrates, and lipids in the patient. This results in inefficient uses of nutrients. This occurs early in all cancers and decreases quality and quantity of life. The metabolic and clinical alterations in cancer have been described in four phases…
So to prevent and reverse clinical conditions like cachexia, we need to give the best nutrients available to our patients. Specific nutritional requirements of animals with cancer is unknown but we do know in general what nutrients are needed for healthy animals. What is different in cancer patients is the change in metabolism that occurs as mentioned earlier.
So, Cancer affects carb metabolism. Bottom line on carb metabolism; Tumors preferentially metabolize glucose for energy by anaerobic glycolysis forming lactate. This forces the body to waste energy converting lactate to glucose.
Tumors preferentially use protein for energy at the expense of the host. When protein degradation and loss exceed synthesis you see decreased immune function, decreased GI function, and surgery healing.
However, research has shown that increases in the consumption of certain AA can be beneficial to cancer patients. I’ve just listed a few above, but as more research is done, the benefits of different AA will be discovered So the bottom line is that a diet with moderate amounts of highly bioavailable protein may be of value to the cancer patient.
So, tumor cells readily utilize protein and carbs but tend to have problems utilizing lipids as a energy source. Therefore, they are usually the last to be depleted in the patient. Some research indicates that the type of the fats consumed is more important than the amount of fat, specifically n-3 fatty acids.
Okay, vitamins and minerals. There has been some research on that certain vitamins and minerals (as listed above) can have some positive effects for cancer patients. Although, it seems like as one research study say Vit X does this, another study comes out saying that it does nothing so in my personal opinion that in moderation, supplementation of vitamins and minerals wouldn’t hurt, and may improve the QOL of the patient.
Can’t forget adequate amount of fiber to maintain normal bowel health. Garlic is also commonly mentioned in helping prevent and treat cancer in humans and animals (by inhibiting carcinogens),but no concrete studies on the efficacy. Similarly, there is absolutely no proof that shark cartilage works so we shouldn’t recommend giving that to patients since its expensive and maybe we can save a few sharks in the process.
Okay food aversion . A common phenomenon in human patients, it is the act of the patient associating eating, sight or smell of food (or all three) with unpleasant side effects such as nausea and pain). There has been a lot of anecdotal evidence it occurs in animals and it should be assumed that they do experience food aversion. Food aversion can be avoided by created a feeding plan.
So we have all this wonder nutrition information so now we need to develop a feeding plan. The three main things we want to ask ourselves is what the best food to feed, how to feed the food, and is the patient getting better on this feeding plan we chose? Also, don’t forget none of this matters unless the clients are educated about the importance of nutrition in the management of the cancer.
The ideal diet would have minimal simple carbs, highly bioavailable proteins with the aforementioned AA, and higher fate levels with n-3 fatty acids. It also helps that the food taste great and has a pleasant aroma. There are several commercial veterinary therapeutic foods that provide the key nutrients in appropriate levels. In addition, these requirements can be achieved by homemade diets (sources available in books, online).
Euthanasia should be discussed constantly with the client; before and during cancer treatment is occurring. The client should be educated on all their options available besides euthanasia. Although, sometimes doing everything medically possible is not the best choice for the patient and owner. Therefore, once the client makes the decision for euthanasia, we as doctors should support their decisions in their final kind act toward their pet.