This excerpt is from “Chapter 20: Cancer” from The Ultimate Pet Health Guide: Breakthrough Nutrition and Integrative Care for Dogs and Cats by Dr. Gary Richter, M.S., D.V.M. (Hay House Inc., 2017, $22.99, 399 pp.) and is reprinted with permission. Footnote references have been removed.
You never know how strong you are until being strong is your only choice.
Chapter 20: Cancer
Within the realm of medicine, few terms elicit the visceral response that arises when cancer is discussed. By the time we reach adulthood, most of us have been personally affected by cancer. The dreaded disease strikes unexpectedly and threatens to claim life and limb from our friends, family, and beloved pets.
Treating pets with cancer is a challenging medical problem and an emotionally taxing experience. As we all know, in many cases, cancer is fatal. While dogs and cats can live years longer than expected with aggressive integrative care, many of these pets will ultimately lose the battle.
There is, however, a wonderful lesson to be learned from the veterinary cancer patient. Animals live in the moment every day. They have no self-pity; they don’t think, Why me? They live every day without fear of death or disease. As long as they are not in pain, every day is a blessing. This is the most valuable piece of wisdom I have ever received from my patients. A good example is Tyler the golden retriever.
Success Story: Tyler
At our first meeting, Tyler was 10 years old and diagnosed with a tumor called an osteosarcoma on his right hind leg. Osteosarcomas are painful tumors with a high rate of metastasis to other parts of the body. Given the nature of the tumor, conventional medical options were limited, and Tyler’s quality of life was of great concern. He was limping and in great pain, and his regular veterinarian and an oncologist both recommended amputation and chemotherapy.
Although the thought of amputation is upsetting to pet owners, it is sometimes the best way to eliminate a source of cancer pain and possibly prevent metastasis. Given Tyler’s age, however, the owner elected to delay the amputation as long as possible and see if we would be able to keep Tyler comfortable through alternative medicine.
We began by changing Tyler’s diet from a good-quality kibble to a fresh, raw-food diet. We also began a spectrum of nutritional and herbal supplements with the goal of supporting optimal body and immune system function while providing anticancer effects. Three months into his treatment, Tyler’s tumor had not changed much in size, but he was much more comfortable.
By month four, however, Tyler’s pain was increasing, so the owner elected to amputate the leg with the bone tumor. After a few days of recovery, the dog was up and around and happy. In fact, he was notably more energetic than he was before the surgery because the source of his pain was gone. Tyler continued to do great for another 14 months with a combination of complementary medicine and chemotherapy.
One day Tyler started coughing and an X-ray showed tumors in his lungs. Tyler’s quality of life deteriorated quickly, and he was euthanized not long after the discovery of the lung tumors.
Although Tyler eventually succumbed to the cancer, he lived far longer and with better quality of life than anyone would have expected. This was accomplished by successfully changing the conditions within his body to optimize health and create an inhospitable environment for cancer cells.
In the medical sense, animals like Tyler embody the powerful biological drive to survive. A biological system never gives up and will work to the very end to stay alive and get healthy. Holistic medicine relies on this innate programming. Even in cases where the prognosis is poor, we can optimize the immune system to help fight cancer, use anticancer herbs to slow or stop the progression of disease, and leverage nutrition in a way that feeds the body and not the tumor.
When Things Go Wrong: What Is Cancer?
Cancer takes many forms and affects pets and people in many ways. Cancer is described as a disease in which cells reproduce inappropriately, leading to tumor formation. Under normal conditions, the body replaces old or damaged cells through mitosis, or division of cells. Cellular division is kept in check by certain body processes, including a mechanism called contact inhibition that turns off mitosis and prevents overcrowding when cells are touching one another. Mutations that turn off contact inhibition cause unregulated cell growth, or cancer.
The origins of cancer are less clear. Cancer may arise from a host of sources including exposure to toxins, viruses, chronic inflammation, and genetic influence. Much of cancer research focuses on discovering specific abnormalities occurring within cancer cells. There are two main competing theories regarding the nature of these abnormalities.
Most current research is founded on the premise that errors in DNA and gene replica-tion lead to cellular malfunction and cancer. An alternative view of cancer is that it is a malfunction of a cell’s ability to generate energy. In 1931, Dr. Otto Warburg evaluated cancer cells and theorized that the primary malfunction is within the mitochondria rather than the DNA. Changes within the cell as a response to the damaged mitochondria lead to secondary changes in DNA and gene expression and ultimately to cancer. This process is known as the Warburg effect.
Regardless of the cause, in its earliest stages cancer occurs at the microscopic level. Although the exact figures are unknown, it is theorized that people (and presumably pets) develop cancer many times in their lives but the cancerous cell(s) are either destroyed or held in check by a process called immune surveillance. It is only when the cancerous cells evade immune surveillance that the cells replicate and cancer as a clinical disease occurs.
Many of the complementary and alternative therapies discussed in the sections below focus on supporting the immune system and immune surveillance. By the time cancer is diagnosed, however, more definitive measures are frequently needed to return pets to health.
Types of Cancer
Cancer is more than a single disease. There are many different cancers, each with its own pattern of behavior and susceptibility to treatment. While determining the specific type of cancer is paramount to Western medical therapy, it is not as important in the development of a holistic treatment protocol. Despite this, there are a couple of distinctions regarding cancer that are important to make.
Frequently, benign is thought of as “good” and malignant as “bad”; that is about 75 percent correct. Medically speaking, the term benign is used in several ways.
Benign can be used to describe a noncancerous growth like a skin tag, and it can also be used to describe certain cancerous masses. The distinction of a benign cancer is that it is not expected to metastasize (spread) to distant sites in the body.
Clearly, not metastasizing is a good thing. Unfortunately, this does not make a benign tumor harmless. If a tumor grows large enough or occurs in a very sensitive part of the body, its mere presence can lead to major complications. For example, a benign cancer growing in the brain may not metastasize, but its mere location can cause a massive problem. Additionally, benign tumors arising from glandular tissue may secrete hormones affecting the body.
In contrast to benign tumors, malignant masses tend to metastasize. They don’t always do so, but the risk is ever present; treatment decisions are frequently made based on a tumor’s metastatic potential. Even a small malignant mass that may not be causing any immediate danger should be removed (if possible) if there is a high metastatic potential. This would not be the case for a benign tumor in the same location. Once the tumor has spread, the horses are out of the barn (so to speak), and the hopes of achieving a cure drop dramatically.
The other major differentiator of cancer is whether it is a solid mass or is disseminated.
Solid tumors are growths that occur either on the surface or within the body. Solid tumors can be either benign or malignant.
Disseminated cancer describes cancer of various blood cells, such as lymphoma and leukemia. Because these cancers affect the blood, they do not occur in one place such as with a solid tumor. Disseminated cancers live in the blood, lymph nodes, bone marrow, and, sometimes, vital organs. These cancers are, by definition, malignant, as they are not localized in a single location or lump. Some are more aggressive than others, but all present a big challenge, medically speaking.
Diagnosis of Cancer
Like many diseases, in its early stages cancer often shows no symptoms. Pets often act and feel fine even if they have a visible tumor growing. The initial diagnosis of cancer generally starts either with a visible mass or some change in behavior that leads to a veterinary evaluation and further testing.
Most growths or masses occurring on dogs and cats are noncancerous or very low-grade benign tumors. Even for the trained eye, however, it is difficult to determine what is no big deal and what needs to be addressed immediately. Take your pet to the veterinarian for any new growth, ones that are changing, or if a growth bothers your pet.
Pets with cancer occurring within the body (rather than on the surface) are frequently diagnosed later in the course of the disease. Internal tumors can occur anywhere in the body, including the chest, abdomen, and head. Tumors within the abdomen can sometimes be palpated during a veterinary exam. Often, however, discovery requires some kind of imaging.
For cancers of the blood like lymphoma and leukemia, there is not a discrete mass to look for and evaluate. In the case of lymphoma, one or more lymph nodes are frequently enlarged. These enlarged lymph nodes may be peripheral, meaning they are just under the skin and can be palpated by hand. In other cases, the enlarged nodes are internal and require imaging to diagnose. By contrast, leukemia is most frequently diagnosed through the presence of abnor- mal cells noted on a blood panel.
• Physical exam: As with most diseases, the diagnostic pathway for cancer begins with a thorough history and physical examination. Your veterinarian will conduct a comprehensive exam, including lymph node palpation, abdominal palpation, and a rectal exam. Anything suspicious should be evaluated further as detailed below.
• Blood work: Many believe that cancer can be diagnosed via a blood panel; however, this is only the case with leukemia, which causes very high levels of white blood cells. The vast majority of pets with cancer have completely normal blood work. In these cases, the value in the blood work is determining your pet’s overall health as part of the diagnostic pathway and development of a cancer treatment plan.
• Imaging: Imaging is used for diagnosing and staging cancer as well as to screen for metastasis and help surgeons determine whether a tumor can be removed safely. The most common types of imaging in veterinary medicine are X-rays and abdominal ultrasound. Between these two modalities, the chest and abdomen can be very thoroughly evaluated. If there is a tumor to be found, chest X-rays and/or an abdominal ultrasound will very likely find it.
Some conditions, such as those involving the head and spine, are beyond the reach of ultrasound and X-rays. In these cases, imaging such as MRI or CT scanning may be necessary. Fortunately, advanced imaging is readily available at many veterinary specialty facilities.
• Fine needle aspiration and cytology: When a pet has a growth or swelling, the first test performed is often a fine needle aspirate (FNA). During an FNA, a needle is inserted into the mass, and cells are extracted and placed on a microscope slide. Evaluating material on a slide is known as cytology. FNAs and cytology can be performed on superficial lumps, palpable lymph nodes, and internal masses with the help of ultrasound guidance.
Cytology is a highly attractive diagnostic option because it is noninvasive. Only a very small needle is used, and no sedation or anesthesia is required. The limitation is the relatively small sample size. A lot can be determined from looking at cells on a slide, but sometimes a definitive diagnosis requires a larger sample such as one obtained through a biopsy.
• Biopsy and histopathology: When cytology does not provide enough information, biopsy is the next step. Rather than collecting small amounts of cells with a needle through an FNA, a biopsy removes a piece of tissue. The preparation and evaluation of tissue samples is called histopathology. Depending on the nature of the biopsy, tissue samples can be as small as a pencil point or as large as an entire organ.
Depending on your pet and the location of the mass, a biopsy can sometimes be done with sedation and a local anesthetic; other times general anesthesia is required. Options for sampling internal masses include ultrasound-guided biopsies, biopsies of the GI tract via an endoscope (flexible fiber-optic camera), or biopsies collected during surgery.
When a pet needs immediate surgery for cancer, such as with a bleeding splenic mass, diagnosis and treatment become one. When the organ or tissue in question is removed, it is submitted whole for histopathology.
• Special staining: In recent years, advanced techniques in cytology and histopathology have become available. One technique called special staining allows pathologists to diagnose more conditions with small samples such as through cytology or small biopsies. The special stains used allow pathologists to identify biomarkers specific to certain types of cancer. This process allows for easier diagnosis and more effective treatment.
Philosophy of Cancer Therapy in Pets
Prior to discussing the various methods of how to treat cancer in pets, let’s take a moment to look at the why: Why are we treating cancer in pets?
Answer: To preserve the quality of life for our pet for as long as possible. There is a very important distinction to make in comparison to the why of human oncology. The goal of cancer care for humans is often to preserve life for as long as possible (less emphasis on quality).
Because of the differences in objectives between human and veterinary oncology, treatment strategies differ. Veterinary oncologists do not always strive for a “cure.” In many cases, the goal of treatment is to slow the progression of disease so pets can live happily for longer, even though they may succumb to cancer in time. Veterinarians don’t push their patients as hard with treatment, and thus pets rarely have dramatic or prolonged negative responses to cancer therapy. When they do have strong negative reactions to therapy, veterinarians either change therapy or stop altogether. No one wants to torture a pet through medicine.
Conventional Medical Treatment
In veterinary medicine, the majority of Western cancer treatment can be classified into three groups: surgery, radiation, and chemotherapy. The course to take is determined by the specific diagnosis and stage of the cancer as well as the age and overall health of your pet. In deciding whether to choose one or more of these therapies, please consult with a board-certified veterinary oncologist. Even if you ultimately decide against Western cancer therapy, having all of your questions and concerns addressed by a highly trained specialist is time (and money) well spent.
The ideal treatment for cancer is to just make it go away, and there is no quicker way to do this than with surgery. For benign masses or malignancies that have yet to metastasize, surgery can fully remove and thus cure the cancer. At times, however, surgery to remove as much of the cancer as possible is only the first step of treatment.
Although the primary goal of surgery is removing cancer, it is also used to resolve a life-threatening condition, such as a bleeding tumor in the spleen, or to relieve pain, such as amputating a limb with a bone tumor. If there is knowledge (or suspicion) of cancer cells left behind after surgery, the next step is chemotherapy and/or radiation.
Chemotherapy is a term used to describe any pharmaceuticals used for the control of cancer. With solid tumors, chemotherapy is ideally used as a secondary therapy to “clean up” microscopic disease after a mass has been removed with surgery. For disseminated cancers like lymphoma and leukemia, chemotherapy is the primary treatment.
Possible side effects of chemotherapy are usually restricted to GI upset, although infections may occur due to suppression of the immune system. Both are frequently controlled with a combination of Western and complementary care.
In recent years, electrochemotherapy (ECT) has become available in veterinary medicine. In contrast to traditional chemo, which is given orally or by systemic injection, ECT delivers chemotherapy drugs directly into a tumor through an electrical current. The goal is to achieve higher doses of chemotherapy where it is needed while minimizing systemic side effects. Consultation with a veterinary oncologist is a must when considering ECT.
Described in detail in Chapter 10, the melanoma vaccine is a unique form of chemotherapy. The melanoma vaccine is designed to simulate the dog’s own immune system to recognize and destroy melanoma cells. The vaccine has been shown to have a significant effect on the progression of malignant melanomas in dogs and has extended the life span and quality of life in many pets.
Similar to chemotherapy, radiation therapy is used to clean up residual microscopic disease after a tumor has been removed surgically. Radiation is becoming more effective as better technology allows oncologists to use higher doses of radiation while minimizing collateral damage.
Because radiation patients have to be completely still during therapy, pets are briefly anesthetized for each session. Side effects are almost exclusively limited to tissue burns, which are similar to a bad sunburn. Hyperbaric oxygen therapy is very effective at treating these burns.
From a Western medical perspective, nutrition is not generally part of the conversation about cancer therapy in pets. The most important goal is to make sure pets are eating and maintaining their weight.
There is a prescription diet for pets with cancer. Its high-protein, high-fat, and low-carbohydrate content makes it very similar to diets suggested for cancer treatment based on the Warburg effect. However, the diet is not very palatable and sometimes causes GI upset.
Complementary and Alternative Medical Therapy
From a holistic perspective, cancer therapy is a three-pronged approach. First, we provide your pet with optimal nutrition, creating an environment that is inhospitable to cancer cells and supports ideal function of body systems. The next facet is to further optimize body and immune function through herbs and supplements. Last, herbs and supplements can also be used for their natural cancer-fighting abilities.
Nutrition for the Cancer Patient
Feeding a pet with cancer is a balancing act. The goal is to provide optimal nutrition to support the immune system while restricting nutrient access by cancer cells. Designing a nutritional plan to achieve this goal requires understanding the differences between cancer cells and normal cells. With this, we can exploit the cancer’s weaknesses.
According to the Warburg effect, cancer cells have an altered metabolism due to a defect in their mitochondria. The mitochondrial defect means cancer cells produce relatively little energy per molecule of glucose (fuel). The cancer cells’ increased requirement for fuel can be leveraged to your pet’s benefit.
If cancer cells need excessive amounts of glucose to survive and multiply, the obvious nutritional solution is restricting your pet’s glucose intake. It’s not quite that simple, but close. Since pets generally don’t consume sugar like we humans do, the glucose in their body largely comes from carbohydrates and, to a lesser extent, protein. “Cancer diets” frequently are high protein, moderate to high fat, and low carbohydrate.
Certain fats also have the potential to benefit the cancer patient through even more direct cancer-fighting effects. Omega-3 fatty acids such as those found in fish oil have been shown to decrease inflammation and improve survival times in certain cancer patients. Con versely, diets high in omega-6 fatty acids (often found in grains) may actually increase the rate of cancer progression due to their pro-inflammatory nature.
To be clear, a certain amount of blood glucose is necessary for pets to live. That said, animals are able to generate what they need from a small amount of dietary carbohydrates and protein. Anything beyond the necessary amount of glucose is potentially feeding the cancer. Remember that old saying, “Feed a cold, starve a fever”? Let’s rephrase that as “Feed the pet, starve the cancer.” Diets to support canine and feline cancer patients can be found in Appendix C.
When it comes to nutrition for cancer patients, there is a lot of discussion about the ketogenic diet. These diets have nearly zero carbohydrates and rely on fat and protein as energy sources to put the body in a state of nutritional ketosis. Very low carbohydrate intake results in low blood glucose and the production of ketones as fat is metabolized for fuel. Because cancer cells are unable to use ketones for fuel, and there is no glucose available for them either, the cancer cells starve.
While there is promise when it comes to ketogenic diets for human cancer patients, it is very difficult to put a dog or cat into a state of nutritional ketosis. A certain level of ketosis, however, may be achievable through the addition of the fat caprylic acid (see the section on nutritional supplementation). The only way to accomplish ketosis in pets is with a diet that is very high in fat (50 percent or more), which is not palatable and is likely to cause diarrhea and possibly pancreatitis. For these reasons, truly ketogenic diets are not recommended for pets.
Nutritional approaches to cancer are powerful tools. These diets can help fight cancer and slow its growth, and are most valuable when used in conjunction with other cancer therapies. Cancer diets not only limit the debilitating effects of cancer and restrict energy to tumor cells but also have the potential to improve how a pet responds to chemotherapy and mitigate the adverse effects of radiation therapy.
One final note regarding nutrition in cancer patients: The most important thing is that your dog or cat is getting enough nutrition. If they are running a calorie deficit and losing weight, their body’s natural cancer-fighting abilities cannot be optimized. It is more important that your pet eat and maintain their body weight than that you try to force them to eat the “best” food.
Nutritional and Herbal Supplementation for Pets with Cancer
A professor of mine once said that if a medical condition has a lot of different treatment options, it means nothing works consistently. If you do an Internet search for the term “treatments for cancer,” you get more than 200 million hits. That speaks volumes.
The following section outlines categories of supplements and specific compounds that I have used successfully in cancer patients or that are scientifically proven to have anticancer activity. There are many more supplements that may benefit pets with cancer; however, when considering a supplement not listed below, it is important to know whether the product is truly safe and effective. Always consult with a trained veterinarian before starting any supplement. Caveat emptor: Let the buyer beware.
• Whole-food supplementation: Immune system support is a cornerstone of holistic cancer care. Whole-food supplements help provide nutrition above and beyond what is possible through diet alone. The easiest products to use for pets with cancer are Canine Immune Support and Feline Immune Support by Standard Process. A health practitioner with experience using Standard Process may be able to further fine-tune a supplement protocol using whole-food nutrition.
• Probiotics: If a well-functioning immune system matters, then probiotics are a must. As previously discussed in Chapter 6, probiotics have significant positive effects on the immune system. Remember, 70 percent of the immune system resides in the GI tract.
• Caprylic acid: Caprylic acid is a medium-chain triglyceride (MCT), which are specific fats that have anticancer properties. When the body is in a state of ketosis, the combination of a low-carbohydrate diet with caprylic acid may create an environment where cellular food is preferentially provided to normal cells and restricted to cancer cells. Furthermore, research has shown caprylic acid to have specific anticancer properties. One of the most readily available sources of caprylic acid is refined coconut oil. The supplement Brain Octane made by Bulletproof is distilled from coconut oil to have a much higher concentration of caprylic acid.
• Essential fatty acids: In addition to overall body support and immune system support, omega-3s have been shown to prevent cancer and improve survival times in pets with cancer. Studies also suggest that the combination of fish oil and the amino acid arginine may have a synergistic effect in pets with cancer.
• Mushrooms: A mountain of scientific evidence has been published on the medical benefits of mushrooms. Mushrooms and other fungal organisms contain compounds called beta glucans, which have profound immune-supportive and anticancer effects. A wide variety of mushrooms are currently being utilized in the treatment of pets with cancer, including Cordyceps, Agaricus, coriolus, maitake, shiitake, and reishi. Coriolus versicolor (turkey tail mushrooms) in particular have been shown to increase survival time in dogs with a severe cancer called splenic hemangiosarcoma. The beneficial effects of mushrooms are a robust area of study, and undoubtedly more species and benefits will be discovered in the future.
Appropriate levels of dietary vitamins, minerals, and amino acids are necessary for optimal health. In certain instances, the use of specific vitamins, minerals, and amino acids in levels exceeding normal nutritional requirements has been shown to have immune-supportive and anticancer effects. Consult with a veterinarian for appropriate dosage and monitoring before starting supplementation with the following.
• Vitamins A and D: Supplementing with high doses of Vitamins A and D leads to apoptosis, or programmed cell death, of cancer cells. Caution is required as toxicity is possible with excessive A and D supplementation.
Caution: To avoid overdose, watch out for other supplements, such as fish oil, that also contain vitamin A.
• Vitamin E: In addition to being an antioxidant that helps support good health and immunity, vitamin E kills tumor cells.26
• Vitamin C: A well-known antioxidant, vitamin C is commonly supplemented for immune support and general well-being. In the field of cancer therapy, administering orthomolecular (megadoses given intravenously) vitamin C is reported by some to have significant anticancer effects. There is evidence of this in the scientific literature, although with inconsistent results. Unlike with vitamins A and D, the kidneys readily excrete vitamin C and therefore toxicity is not a major concern.
• Minerals: The minerals selenium and zinc can kill cancer cells and inhibit metastasis. Caution is required when supplementing with these minerals, as toxicity is possible.
• Amino acids: As the building blocks of protein, dietary amino acids are critical to supporting normal body processes. In pets with cancer, maintaining muscle mass is of particular concern. Beyond this, the amino acids arginine and glutamine are particularly important.
Arginine decreases both tumor growth and metastatic rates. When combined with omega fatty acids, it improves symptoms, quality of life, and survival times for pets with cancer.
Glutamine has known health benefits to the liver, GI tract, muscle support, and general support for pets undergoing chemotherapy. While cancer cells can use glutamine as an energy source in addition to glucose, current research indicates that supplementing glutamine does not promote tumor growth. Ultimately, the benefits of supplementation definitively outweigh the concerns.
Below is a list herbs and supplements with known anticancer properties. These are not the only ones; they are the ones I have had the most positive experiences with in treating pets with cancer.
The following herbs inhibit cancer progression by slowing growth, stopping metastasis, and/or inducing apoptosis (cell death) of cancer cells:
• Green tea extract (EGCG)
• Inositol hexaphosphate(IP-6)
• Superoxide dismutase
This particular herb deserves special mention. Until recently, the use of medical cannabis has been kept in the shadows. The current changes in public perception and medical marijuana laws have finally created an environment where cancer patients and owners of pets with cancer can finally speak with their health care providers about using this versatile herb.
There are more than 100 published scientific studies proving anticancer benefits provided by cannabis. Studies indicate that cannabis’s efficacy stems from multiple different metabolic pathways and that it enhances the effects of chemotherapy. There are no known specific interactions with conventional chemotherapy or radiation. The use of medical cannabis should be part of the treatment planning for every pet with cancer. (Chapter 9 reviews how and why medical cannabis works and provides an outline for dosing.)
Traditional Chinese Veterinary Medicine
With its aim of treating cancer while helping to maintain quality of life, Chinese medicine is an excellent therapy for pets with cancer. Acupuncture helps maintain a feeling of well-being, suppresses nausea, supports appetite, and helps control pain. Herbal therapy addresses these issues as well, while also possessing definitive anticancer effects.
Most herbal therapy for cancer is patient-specific and based on a Chinese medical diagnosis. However, in the case of pets with bleeding tumors, the herbal preparation Yunnan Baiyao is so consistently effective that many Western veterinarians have embraced it. Yunnan Baiyao is frequently given to pets with internal tumors of the spleen, liver, or heart that are at risk for spontaneous bleeding. It is also used to help stabilize pets whose tumors are already bleeding.
Hyperbaric Oxygen Therapy
While there are those who promote hyperbaric oxygen therapy (HBOT) as part of a treatment for cancer, the research is equivocal. Benefits have not been proven, although there is no evidence of any harm done either. I have treated pets with cancer using HBOT as part of a larger treatment plan, and they do seem to feel better overall. Whether it changed the course of their cancer progression is more difficult to assess.
One well-accepted use of HBOT in oncology is in the treatment of the side effects of radiation therapy. HBOT is an excellent way to speed the course of healing for these pets.
Integrative Treatment Plan
In a perfect world, the best therapy for pets with cancer is an aggressive integrative treatment plan that takes advantage of the best that both sides have to offer. In the real world, mitigating factors tend to get in the way. Availability of high-end Western and alternative oncology varies by geographic location. In addition, the age and overall health condition of your pet must be considered. Last, financial concerns frequently play a part in treatment decisions.
Main article photo by: alexei_tm/iStock