From Episode 155 on the Medical Feed with Dr. Penny Thomas.
I always feel a sense of urgency when I diagnose osteosarcoma. If the client wants to try treating, then I’m in a rush to cut the leg off, because it feels like that horrible thing is just seeding more and more cancer to the rest of the body. I’m also kinda in a hurry to euthanise to be honest, because it feels like such a dismal prognosis. But this conversation with oncologist Dr Penny Thomas gave me some new perspectives:
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Amputation has nothing to do with metastases and everything to do with pain. We don’t amputate to stop the spread of cancer cells - that ship has sailed. We amputate because it hurts, and we’re removing the source of the hurt. (In fact, there’s some thought that the primary tumour actually suppresses the mets, which is why we need to start chemo as soon as that primary gets taken away.)
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Data that demonstrate this:
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Amputation has no significant effect on survival times. Cases that are managed without amputation, eg cases where the pain can be managed sufficiently, including by repairing pathological fractures, live as long as amputation patients.
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Average survival time with surgery or good pain control and chemo is around a year. That’s not that bad. Yes, the eventual outcome is not good, but a year of good life is a long enough time for many owners to justify treatment.
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Sometimes, just sometimes, osteosarcomas can undergo spontaneous resolution. The immune system switches on and just wipes it out. (It’s not the turmeric or the Reiki…) These are outliers to be sure, and definitely not something to make promises about, but it’s good for me to know about it.
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