Basic Principles of Cancer Therapy
Therapeutic treatment of cancer often depends in large part on finances in veterinary oncology. While surgery is still the most commonly used treatment option, chemotherapy, radiotherapy, and imaging modalities such as PET scans used in human medicine are
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Basic Principles of Cancer Therapy Mathias Brunnberg, Robert Klopfleisch, and Melanie Wergin
3.1
Oncologic Surgery – 38
3.1.1 3.1.2 3.1.3 3.1.4 3.1.5
Patient Preparation – 39 General Aspects of Oncologic Surgery – 39 Oncologic Surgery of Bone Tumors – 40 Oncologic Surgery of Skin Tumors – 41 Oncologic Surgery of Central Nervous System Tumors – 41 Oncologic Surgery of Tumors of Viscera/Internal Organs/Body Cavities – 43 Postoperative Patient Care – 43
3.1.6 3.1.7
3.2
Cancer Chemotherapy – 43
3.2.1 3.2.2 3.2.3
General Forms of Chemotherapy Protocols – 44 Chemotherapeutic Agents – 45 Mechanisms of Chemotherapy Resistance – 46
3.3
Radiation Oncology in Veterinary Medicine – 48
3.3.1 3.3.2 3.3.3 3.3.4 3.3.5 3.3.6
Biology of Radiation Therapy – 48 Indications for Radiation Therapy – 49 Adverse Side Effects of Radiation – 52 Radiation Treatment Devices – 53 Therapy Planning – 54 Internal Beam Radiation – 56
Suggested Reading – 56
© Springer International Publishing Switzerland 2016 R. Klopfleisch (ed.), Veterinary Oncology, DOI 10.1007/978-3-319-41124-8_3
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M. Brunnberg et al.
Therapeutic treatment of cancer often depends in large part on finances in veterinary oncology. While surgery is still the most commonly used treatment option, chemotherapy, radiotherapy, and imaging modalities such as PET scans used in human medicine are prohibitively expensive in veterinary medicine. However, new state-of-the-art treatment centers are being built in most countries, which make cutting-edge diagnostics and therapy available to veterinary patients. Although still a sobering diagnosis, cancer is no longer the death sentence that it once was, and treatment options in veterinary oncology are evolving rapidly. The most common therapeutic modalities in veterinary oncology are surgery, chemotherapy, and radiotherapy, each applied with variable success. Selection of the treatment option and success of treatment, both very much depend on the tumor type, the stage of tumor development, and the location of the tumor. Defining some of the common terms and definitions used in veterinary oncology will help us in our discussion in the following chapters on general and specific aspects of cancer therapy. Curative therapy aims at and anticipates the complete removal or killing of all tumor cells and thus the complete cure of the patient. Palliative therapy, in contrast, aims at palliation of unpleasant symptoms associated with the neoplastic disease. Cure is neither achievable nor expected. The definition of the extent of remission during or after therapy is defined by the Response Evaluation Criteria In Solid Tumors (RECIST). Remission is difficult to differentiate in its stages and to define in veterinary medicine. In human medicine, PET scans are often used as the imaging modality of choice to detect the presence of neoplastic cells after therapy and determine remission status. This is not commonly available in veterinary medicine due to cost considerations. Complete remission (CR) is the complete disappearance of the tu
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