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There was a time when the diagnosis of cancer, especially when it has metastasised (that is having spread from its primary location to the lymph nodes or beyond) meant that we had reached the end of the road, there was nothing more that we could do and the cancer had beaten us. The same was true of relapsed, or recurrent, cancer. We had used our surgery and our medicines and they had failed, and that further treatment in either case was wrong. The end was inevitable and in both cases we would step back and say the perhaps we should “let nature take its course”. How could we extend the life of our patients with the quality they deserve when that cancer had defeated us?
But now, as our understanding of the way different cancers behave…their natural history…has increased, and the range of new treatments – treatments that have parallels in human cancer care, and that are improving and evolving all the time – have become available, and as the nature of our relationship with our pets has changed over the years, so our goals have changed too. We can now begin to treat advanced disease, to control it, and to provide our companions with an extended life that is above all of high quality. We no longer think of curing cancer but rather of controlling it. Cancer has become a chronic disease that requires chronic treatment, tailored to the individual patient in just the same way as we manage other chronic conditions like kidney disease, heart disease or diabetes.