Glutamine and cancer.

OBJECTIVE: This overview on glutamine and cancer discusses the importance of glutamine for tumor growth, summarizes the alterations in interorgan glutamine metabolism that develop in the tumor-bearing host, and reviews the potential benefits of glutamine nutrition in the patient with cancer. 

SUMMARY BACKGROUND DATA: Glutamine is the most abundant amino acid in the blood and tissues. It is essential for tumor growth and marked changes in organ glutamine metabolism are characteristic of the host with cancer. Because host glutamine depletion has adverse effects, it is important to study the regulation of glutamine metabolism in cancer and to evaluate the impact of glutamine nutrition in the tumor-bearing state. 

METHODS: Data from a variety of investigations on glutamine metabolism and nutrition related to the host with cancer were compiled and summarized. 

RESULTS: Numerous studies on glutamine metabolism in cancer indicate that many tumors are avid glutamine consumers in vivo and in vitro. As a consequence of progressive tumor growth, host glutamine depletion develops and becomes a hallmark. This glutamine depletion occurs in part because the tumor behaves as a "glutamine trap" but also because of cytokine-mediated alterations in glutamine metabolism in host tissues. Animal and human studies that have investigated the use of glutamine-supplemented nutrition in the host with cancer suggest that pharmacologic doses of dietary glutamine may be beneficial. 

CONCLUSIONS: Understanding the control of glutamine metabolism in the tumor-bearing host not only improves the knowledge of metabolic regulation in the patient with cancer but also will lead to improved nutritional support regimens targeted to benefit the host.

Glutamine is a type of amino acid that has several essential functions in the body, including supporting the immune system, proper digestion and promoting brain activity. Glutamine is one of the most common types of amino acids found in the body. It is typically stored in the muscles and in the lung tissue. Because the body creates its own glutamine, deficiency of this amino acid is somewhat rare. For some people, particularly those with previous health conditions, glutamine deficiency can cause symptoms that may be difficult to manage.

Increased Infections

Part of the function of glutamine is to strengthen the body's immune system. Low levels of glutamine result in an increased susceptibility for infection, particularly among certain populations. During times of stress due to illness or excessive exercise, the body releases cortisol, which ultimately lowers glutamine levels that are stored. People who already have chronic illness, the elderly and those with lowered immune properties such as recent transplant recipients or those undergoing chemotherapy, may be more likely to develop an infection as a consequence of low levels of glutamine.

Weight Loss

Glutamine works to preserve the lining of the stomach and intestines. For people who have chronic gastrointestinal disorders, such as Crohn's disease or inflammatory bowel disease, low levels of glutamine may contribute to weight loss. Additionally, people with HIV/AIDS may lose weight and muscle mass due to their illnesses, a condition that may be exacerbated by low levels of glutamine. According to the University of Maryland Medical Center, glutamine supplements may help with intestinal absorption of important nutrients.

Bowel Changes

Low levels of glutamine can impact the gastrointestinal system. Under normal circumstances the body digests food from eating and converts some of it to glucose to be used by the cells for energy. If you need more energy than the body can provide through glucose, glutamine steps in to provide energy for the cells. It typically works among the cells of the gastrointestinal tract, and low glutamine levels result in diminished cell activity in this part of the body. In some situations, glutamine may be used as a supplement for people with inflammatory bowel disease or chronic disorders that cause excess diarrhea.

Energy Levels

Some people with low levels of glutamine may have decreased energy levels. Because it is stored in the muscles, low levels of glutamine may have an effect on those who train in sports such as weight lifting. This is observed among those who participate in excessive levels of exercise or who experience overtraining syndrome. Because the body undergoes stress during intense exercise, it may require higher levels of glutamine. If the body cannot keep up, the athlete may experience fatigue and poor performance.

References

• University of Maryland Medical Center: Glutamine
• University of California San Diego: Glutamine
• Baptist Health Systems: Glutamine

Cancer of Nasal Cavity Staging Chart

TNM Classification for Cancer of Nasal Cavity and Paranasal Sinuses

The TNM classification for cancers of the head and neck in the nasal cavity and paranasal sinuses is provided below, along with anatomic staging.

Table. TNM classification 

Primary tumor (T)
Maxillary sinus:
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	Carcinoma in situ
T1	Tumor limited to maxillary sinus mucosa with no erosion or destruction of bone
T2	Tumor causing bone erosion or destruction, including extension into the hard palate and/or middle nasal meatus, except extension to posterior wall of the maxillary sinus and pterygoid plates
T3	Tumor invades any of the following: bone of the posterior wall of the maxillary sinus, subcutaneous tissues, floor or medial wall of the orbit, pterygoid fossa, ethmoid sinuses
T4a	Moderately advanced local disease Tumor invades the anterior orbital contents, skin of the cheek, pterygoid plates, infratemporal fossa, cribriform plate, sphenoid or frontal sinuses
T4b	Very advanced local disease Tumor invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than maxillary division of trigeminal nerve (V2), nasopharynx, or clivus
Nasal cavity and ethmoid sinus:
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	Carcinoma in situ
T1	Tumor restricted to any 1 subsite, with or without bony invasion
T2	Tumor invading 2 subsites in a single region or extending to involve an adjacent region within the nasoethmoidal complex, with or without bony invasion
T3	Tumor extends to invade the medial wall or floor of the orbit, maxillary sinus, palate, or cribriform plate
T4a	Moderately advanced local disease Tumor invades any of the following: anterior orbital contents, skin of the nose or cheek, minimal extension to the anterior cranial fossa, pterygoid plates, sphenoid or frontal sinuses
T4b	Very advanced local disease Tumor invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than maxillary division of trigeminal nerve (V2), nasopharynx, or clivus
Regional lymph nodes (N)
NX	Regional nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node ≤3cm in greatest dimension
N2	Metastasis in a single ipsilateral lymph node >3cm but ≤6cm in greatest dimension; or in multiple ipsilateral lymph nodes, none >6cm in greatest dimension; or in bilateral or contralateral lymph nodes, none >6cm in greatest dimension
N2a	Metastasis in a single ipsilateral lymph node >3cm but ≤6cm in greatest dimension
N2b	Metastasis in multiple ipsilateral lymph nodes, none >6cm in greatest dimension
N2c	Metastasis in bilateral or contralateral lymph nodes, none >6cm in greatest dimension
N3	Metastasis in a lymph node >6cm in greatest dimension
Distant metastasis (M)
M0	No distant metastasis
M1	Distant metastasis

Euthanasia When is it Time? The decision regarding the euthanasia of a beloved pet may be the most difficult decision one makes in one’s entire life; obviously, the consequences are irrevocable. Whatever the decision is, it should be one that you can always look back upon and know that the best decision was made and that you would make the same decision over  again in the same situation. So how do you know if it is time? There are several criteria used in evaluating life quality and you should consider them carefully. Is your pet eating? Basically, quality life involves eating or at least interest in food. An animal that is hungry has vitality that must be considered, though this is not the only consideration. Is your pet comfortable? The pet should be free of debilitating pains, cramps, aches or even the psychological pain that comes from the development of incontinence in an animal who has been housebroken for an entire life.  Does the pet still enjoy favorite activities? The elderly pet does not necessarily need to continue chasing balls or jumping after discs but he should enjoy sleeping comfortably, favorite resting spots, the company of family, etc. You know your pet better than any one and only you can truly answer these questions.  Dr. Alice Villalobos, the veterinarian who started Pawspice, a quality of life program for terminal pets, has published a scoring system for life quality called The HHHHHMM scale.  The letters stand for: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More Good Days than Bad. Quality of Life Scale: The HHHHHMM Scale Pet caregivers can use this Quality of Life Scale to determine the success of pawspice care. Score patients using a scale of 1 to 10. Score Criterion 1-10 HURT - Adequate pain control, including breathing ability, is first and foremost on the scale. Is the pet's pain successfully managed? Is oxygen necessary? 1-10 HUNGER - Is the pet eating enough? Does hand feeding help? Does the patient require a feeding tube? 1-10 HYDRATION - Is the patient dehydrated? For patients not drinking enough, use subcutaneous fluids once or twice daily to supplement fluid intake. 1-10 HYGIENE - The patient should be brushed and cleaned, particularly after elimination. Avoid pressure sores and keep all wounds clean. 1-10 HAPPINESS - Does the pet express joy and interest? Is the pet responsive to  things around him or her (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet's bed be close to the family activities and not be isolated? 1-10 MOBILITY - Can the patient get up without assistance? Does the pet need human or mechanical help (e.g., a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling? (Some caregivers feel euthanasia is preferable to amputation, yet an animal who has limited mobility but is still alert and responsive can have a good quality of life as long as caregivers are committed to helping the pet.) 1-10 MORE GOOD DAYS THAN BAD - When bad days outnumber good days, quality of life might be compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully and painlessly, that is okay. *TOTAL *A total over 35 points represents acceptable life quality  Adapted by Villalobos, A.E., Quality of Life Scale Helps Make Final Call, VPN, 09/2004, for Canine and Feline Geriatric Oncology Honoring the Human-Animal Bond, by Blackwell Publishing, Table 10.1, released 2006. If you are considering euthanasia, discuss the pet’s condition with your veterinarian prior to making a decision or even coming in for an appointment. Every veterinarian has a story or two about the pet that was brought in for euthanasia but turned out to have a relatively simple problem and ultimately achieved a complete recovery.

Aspergillosis infection and nasal cancer - neoplasia -are the 2 most common diagnoses in dogs with

This information I culled from googling. I am not a vet.

Aspergillus fungal infection and nasal neoplasia are the 2 most common diagnoses in dogs referred with signs of chronic rhino-sinusitis. Dolichocephalic and mesocephalic large breeds dogs are most commonly affected. Sinonasal tumors are diagnosed in 33% of middle- to old-aged dogs, while aspergillosis is diagnosed in 12% to 34% of young to middle-aged dogs. Several systemic and topical antimycotic agents have been evaluated for treatment of canine sinonasal aspergillosis. Different techniques for the administration of clotrimazole solution or enilconazole emulsion have been successfully used for the treatment of sinonasal aspergillosis .

"Diagnosis of nasal aspergillosis and nasal tumor should be based on history and physical examination, imaging, endoscopy, and histopathological examination. 

Most frequent clinical signs in dogs affected by sinonasal aspergillosis and sinonasal tumor are nasal discharge, epistaxis, reverse sneezing, and sneezing. However, profuse purulent-hemorrhagic discharge, nasal planum alterations such as discoloration of the nostrils, crusts, erosion, ulcers and hyperkeratosis, and nasal pain are considered landmarks of nasal aspergillosis. Conversely, these clinical signs in the presence of decreased air passage through the nostril and snoring but absence of nasal planum alteration are more suggestive of nasal tumor.

Aspergillosis treatment for dogs

As long as the disease is limited to nasal and paranasal parts of the dog, topical treatment is preferred in most situations. Most veterinarians opt for Clotrimazole to begin with. This drug can either be administered as a single infusion through the nares or via the frontal sinuses of the dog. Local infusions normally cure 4 out of 5 dogs with nasal and paranasal Aspergillosis.
When the Clotrimazole is given through the nares, foley catheters are normally used to instill 0.5 g of Clotrimazole in each side of the dog's nasal cavity. The infusion is then left there for 60 minutes, during which the veterinarian will turn the dog around once in a while to increase penetration and make sure that the drug spreads out as much as possible.
Enilconazole is an alternative to Clotrimazole treatment and have a similar success rate. When Enilconazole is used, tubes are implanted surgically into the frontal sinuses of the dog. Enilconazole is then used in the form of instilled bid for 1-2 weeks. The normal dose is 10mg per kilogram body weight.

If local treatment is not enough, anti- Aspergillosis drugs can be given systemically. Examples of drugs that work in such treatments are Itraconazole, Fluconazole and Ketoconazole. Itraconazole and Fluconazole tend to be more effective than Ketoconazole. The standard dose for Itraconazole is 5-10 mg per kg bodyweight given once a day, while the dose for Fluconazole varies from 2.5 to 10 mg/kg and should be divided into several servings per day. If Ketoconazole is used, 5-10 mg/kg bodyweight should be given once a day for 6-8 week"

Aspergillosis Symptoms

YOU NEED TO USE DIFFERENTIAL DIAGNOSING

A fungal infection of your dog’s nasal and respiratory tract may involve the following symptoms:

• Sneezing
• Nasal pain
• Bleeding from the nose
• Visibly swollen nose
• Nasal discharge which may contain mucus, blood and/or pus
• Loss of pigment or tissue on the nose DOES DOG HAVE THIS ON HER NOSE?

If the aspergillosis infection spreads into other parts of your dog’s body, these additional symptoms may appear:

Nasal cancer from what I read stays pretty localized in general.

• Fever?
• Spinal pain
• Lameness
• Weight Loss
• Vomiting WHEN DID THIS START? 
• Paralysis
• Symptoms of nasal aspergillosis include sneezing, nasal pain, bleeding from the nose, reduced appetite, visibly swollen nose, and long-term nasal discharge from the nostril(s), which may contain mucus, pus and/or blood. In some cases, loss of pigment or tissue on the surface of the skin nose may also occur.
  Symptoms of disseminated aspergillosis in dogs may develop suddenly or slowly over a period of several months, and include spinal pain or lameness due to infection, and cause inflammation of the animal’s bone marrow and bones. Other signs which aren’t specific to the disease include fever, weight loss, vomiting, and anorexia.
  
  

Your veterinarian can determine nasal aspergillosis through a nasal swab or x-rays and/or a cat scan of the nose and sinuses. If the fungus has spread, spinal or other orthopedic x-rays or further blood testing may be required.

BUT......
Aspergillosis can be quite difficult to diagnose because the symptoms are common to many respiratory disorders. But examining a tissue sample (biopsy) is the most reliable diagnostic tool. Researchers are currently attempting to develop a practical, specific, and rapid blood test that would confirm Aspergillus infection.
Diagnostic procedures vary depending on whether the case is nasal or disseminated. For suspected nasal aspergillosis, analysis of nasal swabs, fungal cultures of nasal discharge, and a rhinoscopy -- inserting a small fiber-optic scope into the nose in order to examine the inside of the nose and its mucus linings -- can be expected. The symptoms for disseminated aspergillosis are mostly nonspecific and therefore more difficult to diagnose. Tests may include a urine analysis and X-rays to examine the spine.

There are three symptoms that are characteristic of aspergillosis:

• A profuse, clear to opaque discharge from the nostrils that may alternate with episodes of nose bleeding.
• Ulcerations on the external part of the nose.
• Pain or discomfort in the nose or facial area.
One, two, or three of these symptoms are usually present in infections with Aspergillus.

How is aspergillosis diagnosed?
There are several ways to obtain a positive diagnosis of aspergillosis. Swabs of the nasal area that are examined under the microscope are sometimes diagnostic, as are fungal cultures of the area. However, many times these fail to identify the organisms and could also be positive in a dog whose symptoms are not due to the Aspergillus; i.e., many normal animals may have Aspergillus in their nasal passages. Therefore, their use in detecting aspergillosis usually is not recommended. Radiographs (x-rays) of the sinuses and nasal areas often reveal a destruction of the bones in the sinuses. Nasal cancer also does this to bone, however.
The use of a small flexible bronchoscope to examine and obtain a biopsy of an infected area inside the nasal cavity or sinus is another effective diagnostic technique. There are also several blood tests including the AGID and ELISA tests that have given fairly accurate results and are a useful diagnostic tool.
Diagnosis is generally made through use of several of these diagnostic techniques. When a dog presents with nasal bleeding and discharge, it is important to differentiate between a tumor and aspergillosis. With a tumor, we rarely see ulcerations on the nose or nasal pain which are trademarks of aspergillosis."{

http://130.88.242.202/medicine/Aspergillus/Dropbox/Aspergillus_Website/aspergillus-web/articlesoverflow/16711614.pdf  vet written pdf of very detailed info


http://www.veterinarypartner.com/Content.plx?P=A&A=2545&S=0&EVetID=228974 Here is a vet link for it. Shows 
picture.


Here is a person who says cured the dog of Aspergillus fungal infection with some supplements
http://canineaspergillosis.blogspot.com/


http://www.holisticanimalmedicines.com/store/sinus_relief_fungal_aspergillus_cryptococcos_bacteria.html place I found with some natural stuff


http://www.naturalpaws.com.au/fungalyeast-skin-infections-usefulinfo-110-false.html info


http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=14&ved=0CEQQFjADOAo&url=http%3A%2F%2Fahvma.org%2F~ahvma%2Findex.php%3Foption%3Dcom_docman%26task%3Ddoc_download%26gid%3D113%26Itemid%3D134&ei=sfF9UPu2D4TeigKA-IEQ&usg=AFQjCNEGC8T0NxMrRg19_jtEZ-mSUgYitw&sig2=ftMKWI7Tu8lMAwQ0n2vYKQ this is a PDF from the Holistic vet journal about treating Aspergillus fungal infection with homeopathy.

http://www.ncbi.nlm.nih.gov/pubmed/22058356

here is some more

http://www.michvet.com/Client%20Education%20Handouts/Internal%20Medicine%20handouts/Chronic%20Rhinitis%20in%20Dogs.pdf

http://www.vcahospitals.com/main/pet-health-information/article/animal-health/aspergillosis-in-dogs/942

"How is aspergillosis diagnosed?

To diagnose nasal aspergillosis, at least two of the following four criteria must be met:

• Radiographs or a CT scan (Computed Tomography is the method of choice) are consistent with a fungal infection.
• Fungal plaques or aspergillomas are visible with rhinoscopy (a technique where a narrow needlelike camera is inserted into the nose).
• Aspergillus organisms are seen in or cultured from either a tissue biopsy or nasal discharge.
• A blood test is positive for antibodies against an Aspergillus species.

General anesthesia is necessary for diagnostic imaging (radiographs or CT scans) as well as for rhinoscopy. In many cases, the advanced equipment to perform these tests is only available at specialty referral practices or veterinary teaching hospitals. In some cases, the yellow Aspergillus plaques can be seen within the nasal passages without specialized diagnostic equipment.
Nasal aspergillosis Nasal aspergillosis is the most commonly diagnosed form of aspergillosis in dogs. Most cases of nasal aspergillosis are invasive meaning that the fungus destroys the delicate bones of the sinuses. The less common and less invasive forms of nasal aspergillosis create an accumulation of mucous and fungus commonly referred to as a "fungal ball" or "aspergilloma." What the pet owner observes is a chronic nasal discharge ("snotty nose") that often has a strong odor, lasts for weeks to months, does not respond to antibiotics or other common therapies and typically involves only one nostril. Nosebleeds may occur intermittently and the edges of the nostrils are often rough, inflamed and ulcerated (the tissue ulcerates because of the discharge, which is very irritating). Many times the affected dog is of a breed with a long nose (collie, greyhound, dachshund, etc.) although one recent study revealed retrievers and Rottweilers to have the highest incidence of infection; it is possible that the affected dogs lived in an area with high levels of pathogenic Aspergillus. However, it is important to note that any dog can develop nasal aspergillosis."


Probiotics have
been shown to have a stimulatory effect on the
immune system, with some strains showing the
capability to alleviate or prevent bacterial, fungal,
and viral infections in organs other than the
gastrointestinal tract. In the upper respiratory tract,
probiotics have been shown to reduce the incidence
of disease, as well as the occurrence of potentially
pathogenic bacteria. In addition, probiotics have a
protective effect in preventing antibiotic-associated
disorders.

Nasal Tumors in Dogs - Key Points

Nasal Cavity Tumors

*notes in italics are my comments on this article I found

Key Points

Nasal tumors are locally invasive and have a lower tendency to spread early in the course of the disease

Radiation followed by surgery seems to provide the longest survial times (except for my dog Lucy, who never got radiation, chemo, or surgery - just the supplements and chinese herbs I researched that would seem to help. Yes, she had a biopsy of postive nasal adenocarcinoma.)

Chemotherapy may be an option if radiation therapy is not an option

---

Introduction

• Cancer of the nasal cavity accounts for 1% of all cancers in the dog.
• About 80% of all nasal tumors in dogs are malignant.
• Nasal cavity cancer tends to be a locally invasive disease. Late in the course of the disease, the cancer can spread to other parts of the body, with the lungs being the most common site. In one study, 0 to 12% of cases were found to have metastatic disease at the time of diagnosis; however, at the time of death, 46% of the dogs had evidence of spread of the cancer to lymph nodes and lungs.
• The most common type of cancer that affects the nasal cavity in dogs is the carcinoma. This type of cancer includes nasal adenocarcinoma, squamous cell carcinoma and undifferentiated carcinoma and consists of 2/3's of all types of nasal tumors.

Clinical signs

• The average age of dogs with nasal cavity cancer is 10 years and males are slightly more affected by this tumor than females. Medium to large breeds more commonly develop nasal cavity cancer than small breeds.
• Clinical signs of nasal cancer include bleeding from the nose, white, yellow or green nasal discharge, deformity of the face and tearing from one or both eyes.

Diagnosis

• Although the aforementioned clinical signs can be due to intranasal cancer, other causes may include high blood pressure, fungal infection and allergies. If your pet has depigmentation of the nose and nasal discharge, fungal infection is likely to the be cause versus cancer.
• The first tests that are run include blood work such as a complete blood count, biochemistry profile, urinalysis and clotting profile.
• Chest radiographs (x-rays) are made to evaluate that patient for spread of the tumor to the lungs.
• Radiographs of the nasal cavity are generally of little diagnostic value to the clinician, therefore CT scan is recommended. This diagnostic modality will give the veterinarian a very good idea as to the type of disease process present (cancer vs. fungal infection) and the extent of the disease. (CT scans are about $1000! see next bullet point)
• Definitive diagnosis of a nasal tumor is based on the evaluation of a biopsy of the tumor and is typically performed at the time of a nasal CT scan. Anesthesia is required for both procedures.  (why not just do the biopsy first!)

Treatment options

• No treatment at all is an option, however survival times following diagnosis of a malignant intranasal cancer is quite short. One study showed a median survival time of 95 days. Dogs that had bloody nasal discharge had a median survival time of 88 days versus those dogs that did not have blood in the nasal discharge had a median survival time of 224 days. (my Lucy beat this by a mile...)
• Surgery alone results in median survival times that are less than six months, therefore is not recommended as the sole treatment.
• Surgery followed by orthovoltage radiation therapy resulted in a median survival time of 23 months in one study, however other studies have not been able to reproduce these results. The type of radiation therapy seems to play a role in patient survival. One study which included 42 dogs, showed that surgery and orthovoltage radiation therapy was inferior to megavoltage radiation therapy reported in other studies. (many thousands of dollars and some suffering for a month and other complications)
• Radiation therapy followed by surgical removal of the contents of the nasal cavity has given the longest survival times. In Adam's study (2005) of 53 dogs, the median survival time was 19.7 months with radiation alone and 47.7 months with 10 doses of 4.2 Gy per dose and subsequent surgery. Currently, this seems to be the best treatment for dogs that have intranasal tumors. (actually  it's not...)
• Photodynamic therapy (injection of the patient with a special light sensitizer and illumination of the site with a special light) has been reported in 4 cases and resulted in clinical remission of the cancer in the patients that had epithelial tumors, but not the dog that had a sarcoma.
• Chemotherapy (carboplatin, adriamycin and piroxicam) has been reported in a series of 8 cases, in which 75% responded to treatment. Disease free intervals in the responding patients ranged from 150 to 510 days. This treatment may be a consideration if radiation therapy is not an option. (piroxicam and doxycycline combo is cheap and works pretty well too according to studies)

Complications

• Recurrence of the tumor in most cases is expected.
• Chronic nasal discharge and recurrent infection in the nasal cavity is a common problem following radiation and surgery of the nasal cavity, thus intermittent treatment with antibiotics may be needed.
• Side effects of radiation include:
  • loss of hair over the bridge of the nose
  • chronic nonhealing wounds over the bridge of the nose
  • mucositis (sores in the mouth)
  • brain damage
  • blindness due to cataracts or damage to the eyes
  • oronasal fistulae - a hole that develops in the mouth that communicates with the nasal cavity

Summary of prognostic factors in dogs

• Dogs afflicted with a nasal cavity tumor tend to have a shorter life span with
  • bloody nasal discharge
  • age greater than 10 years
  • sex: males
  • metastasis of the cancer at the time of diagnosis
  • failure of resolution of clinical signs following radiation therapy
  • please note that just because your dog may have one or more of these factors does not mean that treatment will not extend quality of life

Specifics about cats and nasal cavity tumors

• Ninety-two percent of all nasal cavity tumors are malignant.
• Lymphoma is the most common cancer that affects the nasal cavity in cats. In a study of 123 cats afflicted with nasal cavity cancer, the second most common cancer was carcinomas (adenocarcinoma and squamous cell carcinoma). Older cats are generally affected with a median age of 9 months in one study.
• The most common clinical signs include nasal discharge, sneezing and vomiting. Other signs include loss of appetite, breathing difficulty and decreased activity.
• On study showed that lymphoma may be localized to the nasal cavity (in about one third of the cases) and radiation therapy may be the treatment of choice. Cats that are infected with Feline Leukemia Virus or Feline Immunodeficiency Virus generally do not do as well and development of lymphpoma in other parts of the body are quite possible. Almost all cases are B-cell lymphoma. Nasal lymphoma tends to be more resistant to chemotherapy than other forms of lymphoma.
• In a report of 19 cats that had stage 1 intranasal lymphoma, treatment with radiation and chemotherapy resulted in a disease free interval of 31 months and a median survival time of 31.4 months. Based on the fact that 17.6% of the cases had recurrences in distant locations, radiation therapy is not recommended as a sole treatment and chemotherapy should be also used.
• In a series of 8 cats with nonlymphomatous intranasal tumors treated with course fraction megavoltage radiation (4 to 6 treatments) the median survival time was 382 days.

References

1. Malinowski C. Canine and feline nasal neoplasia. Clinicial techniques in small animal practice 2006; 21:89-94.
2. Demko JL, Cohn LA. Chronic nasal discharge in cats: 75 cases (1993- 2004). J Am Vet Med Assoc
   2007;230:1032–1037.
3. Rassnick KM, Gldkamp CE, Erb HN, et al. Evaluation of factors associated with survival in dogs with untreated nasal carcinomas: 139 cases (1993-2003). J Am Vet Med Assoc 2006;229:401–406.
4. Mukaratirwa S, van der Linde-Pipman JS, Gruys E. Feline nasal and paranasal sinus tumours clinicopathological study, histomorphologial description and diagnostic immunohistochemistry in 123 cases. J Fel Medicine and Surgery 2001; 3: 235–245.
5. Mellanby RJ, Herrtage ME, Dobson JM. Long-term outcome of eight cats with nonlymphoproliferative nasal tumours treated by megavoltage radiotherapy. Journal of Feline Medicine and Surgery 2002;4:77–81.
6. Litle L, Patel R, Gldschmidt M. Nasal and nasopharyngeal lymphoma in cats 50 cases 1989 to 2005. Vet Pathol 2007;44:885–892.
7. Adams WM, Bjorling DE,McAnulty JF, et al, Outcome of accelerated radiotherapy alone or accelerated radiotherapy followed by exenteration of the nasal cavity. J Am Vet Med Assoc 2005;227:936–941.
8. Geiger T, Rassnick K, Siegel S, et al. Palliation of clinical signs oin 48 dogs with nasal carcinomas threated with coarse-fraction radiation therapy. J Am Anim Hosp Assoc 2008;44:116-123.
9. Lucroy MD, Long KR, Blaik MA et al. Photodynamic therapy for the treatment of intranasal tumors in 3 dogs and 1 cat. J Vet Intern Med 2003;17:727–729.
10. Sfiligoi G, The'on AP, Kent MS. Response of 19 cats with nasal with nasal lymphoma to radiation therapy and chemotherapy. Vet Radiology & Ultrasound, Vol. 48, No. 4, 2007, pp 388–393.
11. Northrup NC, Etue SM, Ruslander DM et al. Retrospective study of orthovoltage radiation therapy for nasal tumors in 42 dogs. J Vet Intern Med 2001;15:183–189.
12. Henry CJ, Brewer WG, Tyler JW, et al. Survival in dogs with nasal adeoncarcinoma 64 cases 1981 to 1995. J Vet Intern Med 1998:12:436-439.
13. Langova V, Mutsaers AJ, Phillips B, Straw R. Treatment of 8 Dogs with Nasal Tumours with Alternating Doses of Doxorubicin and Carboplatin in Conjunction with Oral Piroxicam. Australian Veterinary Journal 2004;82(11):676-680.

Dog Food and Dog Cancer Diets

Cancer loves carbs.

Anyway, how do dogs get carbs in the wild? They get a little in their meat and a little in the, well, guts of the meal. This is what they are built for. Protein and fat. Not carbs. Not grains. Not high in potatoes either. But, we need our convenience if we want to try to make their diet more natural for them and easy on us. Simple. Find high quality kibble that is the highest protein and medium fat. I use Taste of the Wild Buffalo and some of their other grain free dry dog foods. It is also a pretty good dog food for a reasonable price and is available at most independent pet stores. To rotate diet I also use Earthborn Holistic Primitive Natural. It is almost same great price and high quality. Other ones are Wellness Core, Zignature, Fromm Grain Free. So far, everything else I find is much more expensive and not much better. The above are grain free, lower in carb than most, and high protein. Lower carbohydrate recipes are often recommended by holistic veterinarians as part of a program for cancer recovery.

Here is a dog food review site I find very helpful to understanding better foods

http://www.dogfoodadvisor.com/dog-food-reviews/taste-of-the-wild-dog-food-dry/ Protein = 38% | Fat = 20%   VERY GOOD

http://www.dogfoodadvisor.com/dog-food-reviews/earthborn-holistic-primitive-natural/ Protein = 42% | Fat = 22%   VERY GOOD  But very heavy on the chicken. So be aware of possible chicken, beef allergy or intolerances in addition to no grains.

Compare this to grocery store bought popular brand
http://www.dogfoodadvisor.com/dog-food-reviews/beneful-dog-food-dry/
Read the whole analysis at the link above. This is what many foods are like. Not Good.
Here is the major ingredients:
"Ingredients: Ground yellow corn, chicken by-product meal, corn gluten meal, whole wheat flour, animal fat preserved with mixed-tocopherols (form of Vitamin E), rice flour, beef, soy flour, sugar, propylene glycol, meat and bone meal, tricalcium phosphate, phosphoric acid, salt, water, animal digest, sorbic acid (a preservative), potassium chloride, dried carrots, dried peas, calcium propionate (a preservative), L-Lysine monohydrochloride, choline chloride, added color (Red 40, Yellow 5, Yellow 6, Blue 2)"This is what many grocery dog foods are like. Not Good. Look at the all grains, the corn (the first and highest percentage ingredient!! )  and flours, and dyes. This food is also 50% carbohydrate! Ug. Dogs are carnivores. (But adding some cooked veggies can help health.)

Here is Hills Science Diet example first ingredients:
Chicken Meal, Brown Rice, Cracked Pearled Barley, Whole Grain Wheat, Brewers Rice, Whole Grain Sorghum, Soybean Mill Run, Pork Fat, Soybean Meal, Flaxseed, Soybean Oil, Chicken Liver Flavor,
Dogs should not be eating all this grain esp wheat, soy, sorghum.



You need to add real cooked meat to kibble diet.
 Add a fried egg and a handful of cooked ground turkey. Eggs and those frozen 'chubs' of turkey or chicken are really cheap and will up the protein and fat in the bowl. Add a few squirts of fish, coconut, or hemp seed oil from the health food store. Omega 3 oils are healthy for dogs too! It would be in their meals in the wild. Free Range beef is very high in Omega 3. Cancer cannot use fats or protein very well to replicate. Although dogs do not digest raw vegetables very well (they can but not everything gets utilized, it does help give fiber though and carrots clean teeth), they love a few small baby carrots(but careful on the hard  stuff if your dogs palate has been breached by cancer) and it's great for their teeth. I then add a little canned green beans, or yellow wax beans, or raw spinach. I know, dogs don't eat that stuff in the wild. But it does have anti-oxidents, minerals, fiber, and other stuff that helps their immune system and digestion of nutrients.

Carbs make dogs fat. Not meat calories. CANCER LOVES CARBS. Cancer cannot utilize protein or fats very well, but it latches right on to glucose levels created by all the dry dog foods generally high carb content.
Dogs are getting fatter and are getting cancer at higher rates than ever because there is WAY too much carbs and, of course, garbage in their food (why are there dyes in their food?). But I think the carbs might be worse. Look on the back of the package of most dry dogs foods. Forget the ingredients for now, look at the protein and fat content percentages. Add those two together and subtract from 100%. That is the percentage of carbs. Don't you think 40-60% (or more from really cheap kibble) carbs is too high for a dog? Geez. No wonder the manufacturers don't put the carb content on the bags. Dogs get their energy from protein and fats, just like they were built for millenia.

This is what Lucy has been on since April 2011, 2 weeks after biopsy definite diagnosis of adenocarcinoma nasal cancer. She is still in remission with no symptoms of nasal cancer as of 1/2013. No bleeds. No discharge. No bumps. No palate problem.  No eye problem. No appetite problem. No reverse sneezing. No blocked airway of left nostril anymore(though it took 3 months of this and my other protocols and treatments though to get to this point). She used to have some symptoms. No more. Please read all posts to understand all the other stuff you need to do. Not hard. Not expensive. Not hard on the dog.
Update 3/31/2016
Still alive and while not in 100% remission anymore she has had some minimal symptoms for the last year.