2001-Tue Sep 25 17:19:01 EDT 2018
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I’ve recently had cause to contemplate the word “inoperable.” It came up after a client’s middle-aged cat was diagnosed with a brain tumor. To be sure, the tumor was an ugly-looking thing on the MRI — and it was even uglier when the cat suffered seizures because of it. But it wasn’t as bad as all that when it came down to brass tacks. Why? Because the veterinary neurosurgeon deemed it eminently "operable."
“This happens to be one of those feline brain tumors that we can access and extract with a minimum of stress and a better-than-reasonable chance of success,” the neurosurgeon offered in her bright, Central European accent.
I was sold. And I told the owner so. “Let’s get that thing out,” I remember chirping. I assumed it would be met with an equally enthusiastic remark. Given the owner’s willingness to go forward with expensive diagnostics, I expected a gung-ho attitude.
But I’d failed to consider the obvious: “Brain tumor = end of the road” for most pet owners, even if they do own half of Miami.
Yet, that’s not always the case. In fact, brain tumors tend to be highly treatable in pets.
In the past, I’ve had plenty of cause to champion the treatability of brain tumors. My Sophie Sue had one and still lived a full year after her diagnosis with radiation therapy. (A year is a very long, very wonderful amount of time for any dog, especially a well-loved one.)
In retrospect, I only wish my Sophie’s cancer had been operable. As surgeons like to say, “a chance to cut is a chance to cure.” And nowhere is this truer than in the case of most readily accessible brain tumors. We’d offer nothing less to a similarly afflicted human, right?
Unfortunately, I know someone who was diagnosed with a brain tumor a couple of weeks ago. After suffering a nasty, two-week flu, he had an inexplicable seizure. After toxicology screens convinced his docs he really wasn’t on drugs (he’s very young), the CT told the story: tumor.
And guess what? Within 48 hours, the thing was out of his head, and the biopsy was back — benign. That is, once it was out of his skull.
As I followed his progress, I couldn’t help but enjoy a moment of satisfaction as I considered my own strong recommendations in favor of surgery for my feline brain tumor patient.
Inoperable? Really? In this case, an otherwise operable brain tumor is realistically inoperable only if a) we don’t have the funds or b) we let ourselves be swayed by cultural biases that pets aren’t worthy of cutting-edge care.
Sure, there are times when “just because we can doesn’t mean we should” is a reasonable consideration, such as when lengthy ICU stays and painful procedures with highly uncertain outcomes are in play.
But when a veterinarian offers a reasonable chance of success, with a minimum of stress, to decline is to admit defeat as a result of financial constraints and/or cultural considerations.
My friend with the ex-tumor? It hasn’t even been two weeks post-op and he’s already taking the stairs in his house — three at a time. Not that he should, mind you, but it does get me thinking: How might my 8-year-old feline patient be doing right now if we’d elected to cut that thing out instead of euthanize her?
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