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Winston - Oncology story
30 July 2017
Winston is a lovely 10 year old Pug who was referred to us a year ago after being diagnosed with a possible malignant tumour in his mouth called a malignant melanoma. He had a very large, aggressive and invasive cancer growing on his left lower jaw bone. Unfortunately, because of Winston’s breed, such a tumour was particularly large in Winston’s little mouth.
He saw one of our medical oncology Specialists, James Elliott, who asked for some further testing to be performed on the biopsy as some features did not appear classical for melanoma – and this would significantly change the treatment advised. Further testing called immunohistochemistry was performed on the biopsy tissue, which revealed the mass was an unusual cancer called a poorly differentiated, high grade sarcoma. The cancer cells appeared particularly aggressive under the microscope and they could already be seen invading and climbing into nearby blood vessels – the first stage of tumour spread. A CT scan of his chest and belly was fortunately clear of any obvious secondary tumours – though there was a great deal of concern that some stray tumour cells could have detached from the mouth lump and be lurking somewhere in his body, waiting to grow later.
Luckily one of our Specialist soft tissue surgeons, Chris Shales, was able to expertly cut out the tumour surgically and achieved good margins of healthy tissue around the tumour. There was a lot of concern about how Winston would cope after such a big surgery (given the large size of the tumour and small jawbone!) but the alternative didn’t bear thinking about and so his owners bravely bit the bullet and went ahead with surgery. Winston recovered very well and ate and drank normally after surgery and was as happy as ever. Given the aggressive nature of his tumour, he started chemotherapy afterwards and coped extremely well with normal quality of life.
As a complete surprise, despite there being no obvious signs, on routine pre-operative blood tests Winston was also found to have extremely low albumin levels. After further tests, it was clear that this was due to some inflammation in the intestines (inflammatory bowel disease) which was caught in the very early stages, before Winston actually showed any signs. This allowed James to start some anti-inflammatory drugs which normalised his protein levels and are being slowly withdrawn.
Winston just returned for a follow-up almost a year after he first presented to us - with no evidence of cancer and an excellent quality of life. He just receives a low dose tablet type of chemotherapy which is hopefully helping to suppress the re-growth of any other cancer cells still in his body. It is so nice for a dog with so many problems to overcome them all and have an excellent quality of life!
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