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Geriatric Cancer Patients
Caring for Geriatric Cancer Patients
Companion Animal Diseases and Health Management
VETE – 4321 – 011
Michelle Hervey, LVT
10-18-2015
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There are many different factors that come into play when caring for a geriatric patient
with cancer. Geriatric patients pose a hindering factor of different types of cancer treatments due
to disease. These diseases are usually due to their old, older and geriatric age. Patients are not the
only ones that require attention during this difficult time. An owner requires certain things from
veterinarians and veterinary technicians. The ways veterinarians and veterinary technicians help
the owner is by education about cancer, treatment options available, assistance with support of
the owner’s feelings, and patient care. In this discussion many aspects of patient and owner care
after diagnosis of cancer will be addressed.
When caring for a geriatric cancer patient they can have extremely challenging
circumstances. There are problems deciding which treatment options are available to them
because they can have elderly disease. These diseases are heart disease, hypothyroidism, chronic
kidney disease, Cushing’s disease, and Addison’s disease, etc. just to name a few. Because the
patient can have underlying diseases including the cancer diagnosis patients cannot be offered
certain cancer treatments that are available. Some helpful cancer treatments require patients to be
anesthetized to remove a cancerous tumor, but if the patient has heart disease this could pose a
problem for anesthesia. If the patient has kidney disease the veterinarian will exclude certain
treatment medications due to its nephrotoxic side effects. Treatments for cancer often include a
combination of options such as surgery, chemotherapy and radiation therapy (Villalobos, Kaplan,
2007). Before deciding the treatment options for the patient the veterinarian will need to perform
routine lab work such as a complete blood cell count (CBC), chemistry panel with electrolytes to
evaluate what is happening with the patient’s blood cell count, and organs. Other diagnostics
include fine needle aspirates/biopsy of tumor, radiographs, ultrasound with or without aspirates
or biopsy, bone marrow aspirate/biopsy, CT scan with contrast, or MRI. These diagnostics can
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evaluate the type of cancer, how large the patient’s cancerous tumors is, what organs are affected
if any. The veterinarian will be able to come up with an ideal treatment plan for the patient once
all information is evaluated.
When the owner is made aware that their pet is being diagnosed with cancer the
veterinarian and veterinary technician have a very big responsibility ahead of them. Not only will
the patient need the care that is best for them, but the client is going to require help. The
veterinarian and veterinary technician need to evaluate the owner’s bond with their pet, and
understand how far they are willing to go with treatment. When going into the room the
veterinarian and technician need to provide the owner with information about the patient’s type
of cancer, this also include giving them readings, informational pamphlets, and direction to
reputable internet sites. The reason this is provided to the owner is to give them an active role in
their pet’s diagnosis, and care. Owners and the bond with their pets have grown over the years,
and they want to participate in having an active role in caring for their pets. The information will
give them a chance to be in the privacy of their home to read and research their pet’s condition.
The bond between the owner, veterinarian and veterinary technician needs to be strong.
Owners need to feel like they are working with the veterinarian and technician as a team when
decisions are made in the best interest of the patient. The treatment options available to the
patient are going to be dependent on the severity of the patient’s disease process and the severity
of cancer. If the cancer is diagnosed early the patient could have a good prognosis for remission
of the cancer, and if the cancer is diagnosed in later stages the prognosis might not be as
favorable. Either way the owner needs to have a support system that they can trust will help them
with the right options for their pet whether it is treatment types, or palliative care.
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The owner’s role will include treating the patient, watching for side effects of
medications, and cleaning up after the pet. This can take an incredible toll on the owner. Many of
them grieve in different ways such as feeling like they are saying goodbye every day. Caring for
geriatric cancer patients can bring up old memories of loved ones that were sick and passed away
for owners. This can cause them to wonder if they are doing the right thing for their pet or not. It
is important to have conversations with owners about how the patient could react to medications,
and treatment therapies. This way they are fully aware of what to expect when caring for their
pet. The owner and pet bond grows stronger as they age. Pets are considered family members,
and can replace a family member that has passed, serve as a child for someone, or be the last ties
to someone in the family that has passed. It is the veterinarian and veterinary technician who
serve as the council for owners who are grieving for lost family members, or their pet’s condition
when treating them for cancer.
Sometimes the pet’s condition is too hard to handle for the owner, and they opt for
palliative care or euthanasia. The veterinarian and veterinary technician should not judge the
owner’s decision for palliative care or euthanasia. They need to support whatever decision the
owner has come to. Geriatric patients can be suffering from their underlying diseases more than
their cancer. Pets could be suffering from incontinence, or pain not associated with the cancer.
Palliative care would be to care for pets during the end stages of life and keeping them
comfortable until the owner decides to humanly euthanize. If the pet is suffering from diseases
and the cancer is also causing an increased risk of death with treatment the owner might decide
to euthanize the patient because even trying to keep the pet comfortable would result in a
decrease in quality of life.
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Quality of life is another factor in coming up with a good plan of treatment or therapies.
Is the patient going to still have a great quality of life while receiving treatments, and therapies?
Ultimately the patient can still have a great quality of life, but their lifestyle will change
depending on the treatments and therapies. The pet might decrease its activity level, but still
play. As long as the owner knows the realistic goals set by the veterinarian it will be easier for
the owner to make decisions. If the owner’s decision is to treat the pet even though they know
the prognosis is not favorable the veterinarian cannot judge their decision. All the veterinarian
can do is keep the owner aware that the outcome is not going to result in saving their pet, but
might prolong the pet’s prognosis.
Veterinarians and veterinary technicians need to be aware that many geriatric cancer
patients will not be treated due to owner reluctance, financial constraints, concurrent illness, or a
logistical problem (Villalobos, Kaplan, 2007). There are different options available to pet that
will not receive treatments and therapies. Many times the palliative care the patient receives can
be therapeutic for the pet and the owner combine. Palliative care is caring for pets during the end
stages of life, and the owner should be well aware of this. There is a service that can be provided
by the veterinarian and technical staff called Pawspice which is a form of hospice for pets with
end of life care provided at their home. The patient is taken care of in the home until the pet
passes away or is humanly euthanized. It is time wholeheartedly admit to ourselves that despite
our great medical advances, compassionate supportive care for the patient and emotional support
for the family is often the best medicine that we can provide at the end of the road for the humananimal bond (Villalobos, Kaplan, 2007). The palliative care and Pawspice is a great option for
these pets because the owner can be close to the pet in the confines of their own home, and they
are able to privately say goodbye to the pet. This helps the human-animal bond. Most
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importantly the pet needs to be peaceful and pain free during this time of palliative care or
Pawspice.
In conclusion, no matter the outcome know that owners will need the veterinarian and
veterinary technicians to help them through the difficult time with their pet. The human-animal
bond will be very strong, and the owner and pet will need a support group to turn to in times of
need and grief. Even though the veterinary medical team will be working with all odds against
them; the owner needs to know they are still giving the best quality of care to the pet as possible.
Owners need to trust that the veterinary team will assist them in the decision for the best interest
of the pet.
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Geriatric Cancer Patients
References
Moore, A. H., Rudd, S..(2008). BSAVA Manual of Canine and Feline Advanced Veterinary
Nursing Second Edition. British Small Animal Veterinary Association: England.
Villalobos, A., Kaplan, L..(2007). Canine and Feline Geriatric Oncology Honoring the HumanAnimal Bond. First Edition. Blackwell Publishing.
Withrow, S. J., Vail, D. M., Page, R. L..(2013). Withrow and MacEwen’s Small Animal Clinical
Oncology Fifth Edition. Elsevier Saunders.