Prostatic cancer can affect both humans and animals. In dogs, it tends to present as a particularly aggressive form of the disease with a high potential of metastasis. Prostatic neoplasia can be either a prostatic urothelial cell carcinoma or a prostatic adenocarcinoma. Traditionally dogs with prostatic cancer have been treated with intravenous chemotherapy but the response to this, unfortunately, can be limited.
At Fitzpatrick Referrals, we firmly believe in searching for better ways to treat cancer. One area we are particularly keen to develop treatment of is lower urinary tract tumours – including bladder and prostate cancer. Through pioneering new treatments, we hope to be able to offer an improved quality of life and improved survival times for patients.
What are the signs and symptoms of canine prostate cancer?
- Difficulty and frequent attempts at urinating
- Straining to pass faeces / ribbon like faeces
- Hind leg lameness / gait abnormalities
- Weight loss
How is prostatic cancer diagnosed?
Prostate cancer is diagnosed through a combination of clinical signs, advanced diagnostic imaging such as ultrasound/CT scan and obtaining cells from the prostate for cytology.
What treatments are available for prostatic cancer?
Traditionally prostatic cancer is treated with a combination of intravenous chemotherapy and non-steroidal anti-inflammatory drugs (NSAIDs). A recent study showed the benefit of intravenous chemotherapy and NSAID treatment in these patients with an increase in mean survival time of dogs who received this compared to those who did not (106 days vs 51 days).
Our Interventional Radiology Senior Clinician Gerard McLauchlan (European and RCVS Specialist in Small Animal Internal Medicine) has been working with colleagues at the Royal Surrey hospital, UC Davis veterinary school in California and our own medical and surgical oncology teams to deliver new techniques in the treatment of prostatic neoplasia and other cancers.
Prior to treatment, we normally recommend patients undergo staging with a CT scan in order to assess the extent of disease present and determine what treatment options are most suitable for the individual patient and their family.
Prostatectomy surgical treatment is unfortunately often not possible due to spread of the cancer at time of diagnosis and the complications that can occur following removal of the prostate.
Minimally invasive interventional medicine
Intra-arterial (IA) chemotherapy
Intra-arterial chemotherapy involves delivering chemotherapy directly to the arterial supply of the tumour under fluoroscopic guidance. No increase in side effects is seen compared to IV administration (some studies suggest the side effects may actually be less following IA administration).
Research studies have shown this can increase the concentration of chemotherapy delivered to the bladder, prostate and local lymph nodes by over eight times. A clinical publication documented dogs were more likely to have their tumour enter remission following IA chemotherapy than after standard IV chemotherapy.
Over the past 18 months, the Interventional Radiology service has treated 10 cases of prostatic cancer with IA chemotherapy. Results have been very promising with several clinically well over 12 months post diagnosis. The results of this treatment were presented by Gerard at an international veterinary conference in 2018 and are expected to be published soon. Read more about IA chemotherapy.
This involves administering an embolic agent (microsphere beads) to the prostatic artery under fluoroscopic guidance. The aim of the procedure is, therefore, to remove the blood supply to the tumour resulting in cell death. Recent pilot work at UC Davis has shown very promising results with prostatic tumours shrinking by a mean of 40% following treatment. The technique is very similar to the approach for intra-arterial chemotherapy and is available at Fitzpatrick Referrals Oncology and Soft Tissue hospital in Guildford, Surrey, where we are the first centre in Europe offering this new treatment for prostatic cancer.
What are the potential complications of prostatic embolisation?
In a case series of dogs treated with prostatic embolisation, no side effects were reported.
Advice for your patients
We know that on occasion, speaking to one of our specialists is valuable and enables you to deliver the best options to your client. We are available every day to provide advice to vets. Our goal is to speak to you when you call, but if this is not possible, one of our clinicians will call you back within a few hours of making a clinical enquiry.* Please call the Fitzpatrick Referrals Oncology and Soft Tissue hospital on 01483 688100.
*Advice within a few hours applies to normal working hours (8am – 8pm) Monday to Friday – out-of-hours we can give advice for emergency cases.
On the blog
By Michael Macfarlane