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Grade Three Mast Cell Tumour...help Advice Urgently Needed!


hugsnkisses
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Hi everyone,

My name is Sue and I am new to this forum. We have just found out in the last week that our beautiful 13.5 year old beagle girl, Sally, has a grade three mast cell tumour. Let me start from the beginning...

Last December Sally had a mass removed from the outside of her belly that had come up overnight. She had had a skin tag there for years and every so often our vet would do a biopsy and everything was fine. It blew up literally overnight and was quickly removed. We and our vet were extremely surprised for it to come back a high grade two mast cell tumour. As the margins, although clear, were very slim (our vet did not suspect it would be an MCT at the time of the op) Sally went back in and had a rather large slice of her underbelly removed. Pathology on it came back clear and we commenced chemo more or less as a precaution. Since December she has had 7 of the 9 rounds she was due to have - she was on Vinblastine, prednisolone and cyclophosphamide. A week and a half ago she was rolling and I noticed a lump under her front left arm (which had been small and had been biopsied three times and given the all clear) had ballooned. Off to the vet we go. A biopsy revealed a single identifiable mast cell and so she was operated on. The entire lump and as much as the vet could take without compromising her leg was removed. The pathology came back a high grade three MCT without clean margins. Our vet has contacted an oncologist Dr Tony Moore who has come up with a couple of options. Since the original chemo regime was ineffective (understatement) he is recommending a rescue protocol of Lomustine, Prednisolone and L-aspaginase for 21 weeks. The alternative he is recommending is Palladia.

We are very undecided what to do and have emailed him several questions regarding these treaments, their effectiveness and the effects they wil have on Sal. I have also been reading these forums (particulaly posts relating to Ollie and Lucinda) and have changed her to a grain free, high protein, low carb diet and added 1000mg omega 3 fish oil twice daily to her diet. I have also scheduled a phone appointment with Barbara from All Natural Vet Care.

My questions to all of you are:

1) is there anyone who has had experience good or bad with Palladia

2) is there anyone who has had experience with the protocol being suggested - i.e. lomustine, prednisolone and L-asparaginase

3) any other grade 3 MCT's out there with any experiences or advice/tips to share

4) is there any way you can tell if either is working (assuming we go with one of the alternatives)

5) has anyone dealt with this oncologist (Dr Tony Moore) before

In Sally's case the tumour just removed blew up when her prednisolone dose was halved (she was being weaned off it as her chemo was coming to an end) so it would seem that in her case despite the vinblastine being ineffective the prednisolone was doing something. They are not sure if the tumour just removed was a lymph node or not (pathology said probably not but the oncologist and the vet assume it was, so is being considered a metastases of the first tumour).

In herself she is excellent. Although she is 13.5 she is a REALLY GOOD 13.5. She has had absolutely no health problems up until this (has only every been to the vets for her annual checkup and twice for having the vomits - not bad for 13 1/2!!) She eats well, wees and poos normally, barks, runs, sniffs....you just would not know. It is only the stitches and missing fur that give the clue something is wrong. Because she is so well in herself we really want to do the bet thing by her but we also don't want to lose her. Our vet has said that what she has will kill her and I think at some point that will be the case, but I am desperately trying to make it much later rather than sooner. She breezed through the last course of chemo (all for nothing I might add) and is very strong, determined and, like Lucinda, an alpha female (pack leader in Beaglese!!!). We often laugh about how I am in the pack...and she and I know it. Should we choose to do nothing the oncologist says she has a couple of months at most, hence our dilemma. We love her to death, she is a huge part of our family and cannot imagine what the future holds for her and us. So unfair. She is also so very good in herself at the moment that it is very hard to imagine she has cancer let alone could be gone within a couple of months. I just can't bear the prospect to be honest and just wish this was all a bad dream...but I know its not.

I know there a people here going through the same as us so any advice would be very appreciated.

Thanks in advance,

Sue

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Hi Sue, I have responded to your PM - sorry it took so long.

I have heard and read good things with Palladia...

If you are unsure of your oncologists protocol for Sally, then I suggest you get a second opinion. We used Dr Rod Straw and his assistant at the time (sorry can't remember her name)...

Rod Straw

All the best and keep us updated

Jodie

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Hi Everyone,

Our visit to the oncologist went well. Sally started Palladia last night and is fine today. He added anti-histamines to her list and we will cross our fingers to see how she goes. He recommmended Palladia over further chemo with Lomustine etc as Sally's cancer was chemo-resistant the first time. Lomustine is in the same group as Cyclophosphmide so he thought it probably would not have much of effect so recommended Palladia. Also Palladia hsa a knack of working for chemo-resistant MCTs which is us. May do nothing but at least it is a chance. He is currently treating 15 dogs with Palladia with varying degress of success. One dog had a high grade 2 MCT with mets and has been taking Palladia for over 12 months with great success. He said the hardest thing to know is whether you take the dog off assuming a cure and see what happens orcontinue. He is continuing at the moment. Worst side effects are vomiting and/or diarrhoea. The diarrhoea can be managed with Immodium and if things are too bad then, unlike traditional chemo, a break from Palladia witll allow the dog to bounce back to "normal". We cannot test for c-kit here in Australia (always in the backwaters it seems lol) but even if your dog does not test positive there are benefits to be gained from Palladia. It can also help switch on the genes to help fight cancer - don't know how but sounds great to me!! I asked about dogs that died on Palladia and was told that was usually attributable to them having large tumours which had not been removed which released a large amount of histamines when Palladia was started. In Sally's case the large tumour was removed and the dregs are left - hopefully easier to attack than a large tumour. He spoke about the benefits of a good quality diet such as the no grain, low carb, high protein diet Sally is on, said fish oil was a really great supplement and complementary therapy (we consult a holistic vet) has its merits as well. All in all a very positive visit. Just need the Palladia to do its job.....

Crossing our fingers,

Sue and Sally

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Just an update, Sally has had her Palladia dosage twice (Friday night after the oncologist visit and last night (Monday night). So far so good. She is also having her anti-cancer Chinese herbs. She seems fine (wees and poos are normal - the things we do!!!) and so far shows no signs of nausea - is eating like a horse - early days I suppose. I have started giving her a spoonful of natural yoghurt a little before her Palladia and before she goes to bed, thinking the flora in it would be good for her belly. I do think (although it may be hopeful imaginitis) that a lump that was under her arm where the lymph node was removed has decreased but maybe that is wishful thinking. We return to the oncologist (Dr Neil Christensen) either Thursday or Friday so hopefully all will still be well.

Sue and Sal xx

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Just an update. Yesterday we returned to Sydney to see our oncologist. Sally's bloods were perfectly normal as was her calcium which had been down a little last week. He was extremely pleased with her as she is tolerating the Palladia very well. Apart from a little loose you know what one day she hasn't missed a beat. She had her stitches out in the week and all seems well under her arm so far. Our vet even said he thinks her lymph node is still there which I think might make things a little less gloomy. The pathology came back that they didn't think it was lymph node tissue but because of the location everyone assumes it was. Still a grade three with dirty margins whichever way you look at it. She has a lump behind her arm which the oncologist said he wasn't worried about and that he will needle it if it grows but said he wasn't concerned with it. She did have a lipoma somewhere there but after surgery who knows what is where and what is left behind. I figure he knows his stuff and if he isn't worried then I won't be - at least that is what I am telling myself. She will be weaned off the pred in a couple of weeks time so that will reduce what she is on. All in all a very positive visit and we could not hope for more as far as lack of side effects and her tolerance of the Palladia go. Hopefully it will continue. Because she is so well he is continuing with the maximum dose for her weight which is 70mg Mon Wed Fri which is great news. A bit early to tell if it is doing anything but I suppose no blowup is a good thing. No matter what the outcome I feel we have gone down every avenue and given her the best chance we can. Yes she is 13 1/2 but she is a really good 13 1/2 and to look at her you would think she'd have another 10 years at least, she is so full of life. We will continue with our holistic vet who I will have a consult with next week (she has been in the US the past week). Our oncologist believes in the benefits of being holistically treated as well so that is definitely a bonus as the two can compliment each other. Now that Sally is on Palladia Barbara says she will be able to prescibe herbs to help with her GI tract, immunity etc. She is already having a chinese anti-cancer herb one teaspoon twice a day - I think Barbara called it "Mansion of the Mind" - it is used to treat a whole range of cancers and mast cell is one that it specifically treats. If anyone is interested I will list the chinese name. So far so good. Hope it continues.

Sue and Sally the Wonderdog xx

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Hi all,

Another update. We saw Sally's oncologist again yesterday and all is still well (yippee!!!!!!). Her weight is stable, her bloods normal, no new lumps and the ones we are watching have not grown. He is extremely pleased with her and if all is still well next week she will be given 4 weeks worth of Palladia and we will not need to see him for four weeks. She is tolerating her Palladia extremely well - no vomiting, diarrhea or anything else to report, just seems normal. The first week she had one little loose you know what. Since then I have changed her evening meal with Palladia and the breakfast the following morning to cooked chicken mince, some cottage cheese, pumpkin and shitake mushrooms. I figure the easier on the gut th better and so far it seems to work very well. She is still having her omega 3 fish oil and her chinese herbs. Spoke to Barbara form All Natural Vet Care and, now that we have chosen to do Palladia we will add Anti-Ox (made by Medigenics - hope that's spelt right) to her regime. It is a supplement rich in selenium, milk thystle, ginko, vit A, D, C etc. It is a powerful anti-oxidant mix which is anti-inflammatory as well. It also supports the major organs such as the liver. Apparently anti-oxidants do not interfere with Palladia as it it not chemotherapy as such.

Just hope everything continues as it has been. You would not know she is even sick apart from the missing fur.

Thinking of everyone going through the same battle as we are. Keep your chins up - it is never over til it's over!!! Never lose hope!

Sue xx

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