Talk Cancer

Question:

If it is indeed fibrosarcoma then amputation may well be necessary. I’m just very thankful that I didn’t allow an unneccessary amputation on my dog for what turned out to NOT be cancer. Wow, and how smart were you!!  That is something, does this mean basically core needle biopsy’s are worthless?  Do you know if they can also show something as negative when it’s really positive?  In other words, I had a needle aspiration done on mine to confirm a fatty tumor.  Is that reliable??  Thanks for sharing this, you really made the right call for Viva!

I think (and I’m not a vet nor do I play one on TV so take this as speculation) that fine needle aspirates are generally considered to be at least somewhat unreliable. Core needle biopsies, which take out a chunk of tissue about the width of a pencil lead are more accurate, but that’s what Viva had which turned out to be a wrong call. The biopsy was read by Antech, which is a reputable company–all they do is read pathologies. Sorry I can’t be more definite. I know that in the future I will not depend on either a fine needle aspirate or a core needle biopsy to definitively tell me what I want to know about a tumor.

Response:

Many vets like to immediately remove the area of the sarcoma along with everything else around it. As Bones used to say on Star Trek, medicine is barbaric. A new drug has shown great success in removing these tumors without regrowth. It is called Acemannan Immunostimulant. Next time your vet wants to chop off a leg, ask him to look into it.

The science on acemannan is still speculative. There are no studies which say it conclusively does anything. It seems to work well for some animals, and not at all for others. The prevalent thought in excising tumors is to cut once and get it all–hence the wide margin. If the tumor is in a place where this removes muscle but not bone it’s not too much of an issue. If it’s in a leg or foot, and the suspicion is that it’s a type of cancer that grows slowly and doesn’t metastisize early (fibrosarcomas and peripheral nerve sheath sarcomas among those) then I would have to make a decision based on that particular dog. In my dog’s case, the inability to work would have had a huge effect on her quality of life. Another note. The surgeon was very angry at me for not going ahead and amputating toes on my dog. She was bullying, saying the tumor would grow back before the stitches were out, etc. I stood up to her. She didn’t say much when it turned out to be scar tissue except "gee, this is great news." I’m glad she didn’t have to say "I’m sorry we amputated, but gee, this is great news."

Response:

That is something, does this mean basically core needle biopsy’s are worthless?

……Not necessarily.  But it all depends on where the needle goes – could miss the relevant bits entirely.  It’s fine needle aspirates that are less reliable.  Core needle biopsies get more tissue. In other words, I had a needle aspiration done on mine to confirm a fatty tumor.  Is that reliable??

…….I think that if they found fatty tissue, then its probably a fatty tumor (lipoma).  I don’t think that you’d find that fatty tissue associated with a malignant lump.  But that would be a good question for your vet. buglady take out the dog before replying

Response:

I don’t think that you’d find that fatty tissue associated with a malignant lump.  But that would be a good question for your vet.

The vet was saying all along it was a fatty tumor, but I was still nervous as he’s had several of these showing up.  So one was slightly harder than the others so he aspirated it to satisfy me and said it is just a fatty tumor and not to worry.  But I got a little nervous when I read her post about the core needle biopsy. Debbie

Response:

That is something, does this mean basically core needle biopsy’s are worthless? ……Not necessarily.  But it all depends on where the needle goes – could miss the relevant bits entirely.  It’s fine needle aspirates that are less reliable.  Core needle biopsies get more tissue. In other words, I had a needle aspiration done on mine to confirm a fatty tumor.  Is that reliable?? …….I think that if they found fatty tissue, then its probably a fatty tumor (lipoma).  I don’t think that you’d find that fatty tissue associated with a malignant lump.

I agree.  In people, at any rate, FNA are not all that reliable.  If a FNA result is malignant, it’s probably accurate, but if it’s benign or inconclusive, it often means nothing. Sally Hennessey

Response:

Many vets like to immediately remove the area of the sarcoma along with everything else around it. As Bones used to say on Star Trek, medicine is barbaric. A new drug has shown great success in removing these tumors without regrowth. It is called Acemannan Immunostimulant. Next time your vet wants to chop off a leg, ask him to look into it.

Response:

If it is indeed fibrosarcoma then amputation may well be necessary. I’m just very thankful that I didn’t allow an unneccessary amputation on my dog for what turned out to NOT be cancer.

Wow, and how smart were you!!  That is something, does this mean basically core needle biopsy’s are worthless?  Do you know if they can also show something as negative when it’s really positive?  In other words, I had a needle aspiration done on mine to confirm a fatty tumor.  Is that reliable??  Thanks for sharing this, you really made the right call for Viva! Debbie

Response:

Amputation offers the best chance for a cure because the tumor is then removed with wide margins. A second option is to combine surgery with radiation therapy (meaning cut the tumor out and then do the radiation). However, with tumors located on the paw as is the case with your dog, there is not much room to expand the removal of cancer cells beyond the actual tumor. Therefore, cells are often left and that means you are cutting the chances of a complete cure.

I didn’t see the first post on this thread, so please forgive my ignorance of the case. But I have some "howevers" to add to the above, given that I just had a fibrosarcoma scare with Viva. Viva is a young dog, turns 4 this month. She had a very hard lump on her left foot, on the palmar side tendon leading from the inside toe. It was diagnosed as either fibrosarcoma or a peripheral nerve sheath sarcoma through a core needle biopsy. Viva is an active agility dog. They wanted to take two of her toes and her metatarsals up to the wrist joint. I refused. Why? Because I did research and found that fibrosarcoma, while locally invasive, is often slow growing and rarely metastisizes, especially in the location it was in (foot). I wanted to try to preserve Viva’s ability to work because her quality of life would be awful if she couldn’t go and do. So I opted for an excisional surgery, to be followed up by radiation if necessary. Guess what. It wasn’t fibrosarc at all–it was plain old fashioned scar tissue. So don’t necessarily take a fibrosarcoma diagnosis seriously unless the doctor has been able to get a really good tissue sample–more than either a fine needle aspirate or a core needle biopsy. If it is indeed fibrosarcoma then amputation may well be necessary. I’m just very thankful that I didn’t allow an unneccessary amputation on my dog for what turned out to NOT be cancer.

Response:

Amputation offers the best chance for a cure because the tumor is then removed with wide margins. A second option is to combine surgery with radiation therapy (meaning cut the tumor out and then do the radiation). However, with tumors located on the paw as is the case with your dog, there is not much room to expand the removal of cancer cells beyond the actual tumor. Therefore, cells are often left and that means you are cutting the chances of a complete cure. Actually, dogs do fine with just three legs. I haven’t actually had this experience personally but I would say it has come down to a choice of survival over just buying some time. Hard choice for sure. Even if you did get someone who has gone through something similar (with the chemo) chosing that over amputation is still a matter of chosing a procedure offers less of a success rate. If it were my dog, I would chose amputation without giving it a second thought. Maybe someone can tell you how well a dog does without his paw vs. three legs. I haven’t really heard anything about that. Good luck in whatever you choose. here is a site for cancer in dogs and it mentions Fibrosarcoma specifically: http://oncolink.org/specialty/vet_onc/faq/faq_dog_fibro.html

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