I have made it something of a policy to not entertain thoughts of metastasis, but I found myself really nervous at his 5th visit. It probably had everything to do with a woman I met in the waiting room. As all do, she inquired about Cas, smiling and telling us how sweet he is. She was there with her dog for her 6th treatment. Osteosarcoma.
She said, "but they found it in her lungs." Still waiting to meet with the oncologist, she didn't yet know what her options were. She looked at me as though she missed being where I was 4 weeks prior. Also, as if I were going to be in her situation in another 4.
That day, as Cas was being treated, I spent my time researching lung metastases and options for treatment. I discovered such useful things as inhalant chemotherapy and pulmonary metastasectomies.
Did you know that a dog can survive with about 55% of normal lung capacity? They have 4 lung lobes on the right side and 2 on the left. In some instances of lung cancer, you can have whole or partial lung lobes removed, aka pulmonary metastasectomy.
In fact, I found a very interesting, seemingly good, though not "for dummies" (i.e., a bit jargony and technical) book, Small animal clinical oncology, by Stephen J. Withrow and E. Gregory MacEwan. (You can read some of it through its Google books preview.)
Needless to say (though perhaps I already have), I got a bit carried away by my fears. I was reassured by the UC Davis staff that I could wait to take chest rads until our next visit, so I took Cas home and tried to Ctrl-Z my concerns and sleep it off with the kitten. (Bed hogs!)
The Last (planned) Chemo Visit
The funny thing is that I wasn't nervous at all that day. Rob confessed that he was, and it was very mildly contagious. For the most part though, my nerves were dormant.
We dropped Cas off. The plan was to get chest rads and, if all was clear, administer his final dose of Carboplatin. They would call when he was ready to go.
After about 2 hours, I assumed that his lungs were normal. Otherwise, they would have called already. (Right??) About another hour passed, and the call came.
"Castor's ready to go home," a brief, yet loaded statement.
Dr. O'Brien came out to chat with me after I had Cas back, sitting in my lap.
(I exchanged emails with Dr. O'Brien the week prior where I complained about one of their tech's attitudes at visit 5 and told her I wanted time to chat about how to proceed at his next visit. She was extremely friendly, kind and apologetic about my experience with the tech. She was very approachable and had the sweetest things to say about Cas.)
She told me the good news, that his lungs had no sign of metastasis. (Woo hoo!) He had his 6th dose of chemo, and now, we would just need to check his lungs every 3-ish months.
I asked her if there were any other treatments I should consider. For example, another dane osteosarcoma survivor, Nova the Great, was put on a daily dose of Piroxicam and another chemo that she didn't continue using, due to sensitivity. Dr. O'Brien didn't think there was any evidence in the literature to support that route. She said there was nothing more to do, in her opinion.
She said we had already done the best for Castor. Now, we just keep enjoying our time together and come visit our old friends at Davis every few months. (YAY!)
As for symptoms of metastasis, I read that they can exhibit flu/cold symptoms. O'Brien said they can but might not. A recent client brought in her dog, saying "he just seems off." Indeed, in that case, it had spread to his lungs. She said that usually people will just sense that something's wrong.
(I am considering putting him on Artemesenin, but our alternative medicine vet, Dr. Rice, suggested we wait until his body has a break from the chemotherapy. We will talk about it at our acupuncture visit in early March. I'll post about it then.)
I can't express how happy I am that Cas doesn't have to have chemo anymore, that his lungs are clear, that he is happily, hoppily by my side every day. Though I enjoyed our Davis day trips together, I'm sure he'd much rather romp at the park and have me work next to him on our apartment floor. Sounds good to me too (we have a lot of comfy pillows).
The best thing I heard that day and in many, many days surrounding it was something O'Brien slipped in a tad nonchalantly. After she told me the results of his chest rads, she said, "so we consider him to be in a full remission now."
The proverbial music to my ears.
Cas ♥ Treats!