So many notes I don't know where to start : /

Ok, so Rocky's got a malignant fat tumour, which is from the group of cancers referred to as soft tissue sarcomas - a group that includes some blood vessel tumours and muscle tumours.

The specialist we saw said she thought the tumour was around 15 x 12cm and located alongside the lumber muscle. She could actually feel it pressing up against his back muscles and said she couldn't tell (without an MRI scan) whether it's invading them, or 'just' pressing up against them. She said it's right up against the 13th rib on the left side, but she can't feel an edge between them.

Sometimes a tumour of this sort can be just expanding outwards and pressing up against those organs and structures, but sometimes it's invading into/around them, and due to its location it could be expanding to the spine or between the bones of the spine. It could be superficial or really deep.

As this type of tumour is known to spread to the lungs and liver, they'd first need to get advanced imaging such as an MRI to rule out metastatic disease and make sure there are no secondary cancers there. (Liposarcomas have a higher chance of spreading than most soft tissue sarcomas.) If there were signs of metastatic disease, there would be no point treating the primary tumour as that alone puts us in the category of less than 3 months survival.

If there are no signs of cancer in the lungs or liver - then and only then would it be worth considering treating the primary tumour.

Apparently this is a big tumour in a bad location. The treatment for surgery alone would require wide edges around it - at least 3cm of normal tissue. If the MRI shows the tumour wrapping around the 13th rib or spine there's no way the surgeon could remove it completely. If it's just pressing up against the rib and spine she could take just a layer of fibrous outer muscle and use that as the margin - which would give them the possibility of doing a complete removal with surgery alone. She stressed that although this wouldn't be impossible, it would be a very big operation. It would mean a 7 to 10 day stay at the centre, then a very strict 4 week rest. Dogs that overdo it during the rest stage or get to the stitches usually end up being PTS because of the size of the removal - they really do have to be that restricted.

The other option, is a cyto reduction - which would involve her taking away all of the tumour that's visible to the naked eye, knowing she's leaving cancer cells behind, and following this up with low level chemotherapy. The dose of this is usually as toxic as they can manage while still allowing relatively normal everyday functions - eating, drinking, no diarrhoea/vomiting, etc. She also told us she wasn't sure if chemo would actually work with liposarcomas and would have to check this. So she'd remove everything visible then allow 2 to 3 weeks to heal then her colleague would follow up with a type of chemo called Metronome Chemotherapy - which rather than giving medium levels of chemo for 3 to 6 months, they'd give low level chemo for the rest of his life. Basically what they'd do is try to dampen down the cancer cells enough to stop them multiplying and regrowing at the site and to stop them spreading elsewhere. They've never done this with a Liposarcoma tumour before so it would be experimental - although she said she'd get her colleague to see if other oncologists have had any success with it.

Neither of the above options offer any guarantees (if only), and of course there's the usual risk with anaesthesia and complications - she said there's always the possibility he could die, or they might have to phts if there were serious complications.

The third option is to do nothing. In this case, she thinks what will happen is that it'll keep doubling in size, and will give him 3 to 6 months after the first signs (going off his food, looking 'uncomfortable', not wanting to exercise, looking sore when he gets up/down etc.)

When we asked her which of the two treatment options she thinks would be most likely, she said the second option - saying if the MRI showed she could get clean margins (in other words, if option one was a possibility) she would be 'surprised but pleased'. But she's concerned about where it is and the way it feels, which all suggests she might not be able to get clean margins.

I'll put up costs in case anyone else finds it helpful in the future.

Consultation - £180
Advanced imaging - £800
then:
Option 1 - £3000 to £3500
Option 2 - £1600 to £2000 for surgery, plus £1500 to £2000 for 6 months of chemo (and he'd require this for the rest of his life)

She didn't suggest radiation because they won't radiate the site as it's near his spine and other organs.

I thought the specialist was remarkably concise and honest, and someone I'd trust completely if we went ahead. I didn't for a minute feel she was trying to push us into one option or the other, as she was very candid about the risks and implications of everything. However, due to the size, the location, the extent of the operation, the amount of separation time, the amount of strict rest required, the overall risks from the procedure, the possibilities of secondary cancers, and that he'd be on chemo for the rest of his life, we have decided that we're not going to go for any of the options put forward by them. We just don't want to put him through all that when there are no guarantees he'd get well. The outcome may be that he just deteriorates over a longer timescale. As she said, he's an otherwise happy dog, getting on a bit now, and the tumour isn't causing him any pain at the moment.

So given all the above, we have decided to go down the natural route, and while it has certainly grown fast I think it's at least worth a shot as we're determined not to give up on him without a fight. I've already ordered him a number of supplements and will post how we get on in case others find it helpful - I know the odds are against us, but who knows, we might be able to beat this thing naturally.

Thank you all once again for your support - we appreciate you being there for us.

Good Luck Azz. It's a very difficult decision to make but, having read your posts, I think it's the one I would have chosen as well. I really hope the remainder of Rocky's life is as comfortable as possible and at least you can console yourself that you have done all that you can to save him from suffering too much.

Sending lots of positive vibes to you and Rocky, Azz.

It's one of those dilemmas that quite a few have had to face, or are facing at the moment, and I have to say I think you have made the right decision. Rocky is happy at the moment, a major op and further treatment could maybe prolong his life, but for how long, and would it be a happy, painfree life, or would he just be existing?

Such a difficult time for you all, and my heart goes out to you.

Please give him a special hug from me x

Am sorry Azz, don't really know what to say but am sure you're making the right decisions for Rocky and will do everything possible for his wellbeing and to keep him happy. Thinking of you all very much, stay strong, big cuddle for Rocky and hugs to all ((xx))

A difficult one for you xxx

Im sure you will go with what feels right, best wish to you and Rocky xxxx

Oh Azz, I'm so dreadfully sorry that it is not great news. Are you having the MRI scan?

As I was reading through the options, I guessed you'd probably go down the road you have chosen and I can fully appreciate why. It is such a hard decision, given the options, but I know you love Rocky so much and will always do the best for him. I imagine you will be doing an awful lot of research over the coming days.

I'm terribly sad for you and Rocky and I can imagine how shell-shocked and gutted you must be feeling. I just wish I could wave a magic wand and have this go away but all I can do is offer support and hugs.
xxx

Azz - I'm not sure if this is any use to you - there is some stuff on cancers and animals:

http://www.shirleys-wellness-cafe.com/acancer.htm

Also this (I haven't read it):

http://www.amazon.co.uk/Heal-Your-Do.../dp/1840002972

It's by Richard Allport: http://www.naturalmedicinecentre.co.uk/

So sorry that it is not better news Azz. I understand why you're going for the option that you are, you know Rocky better than anyone and what is best for him.

I am really pleased though that you have a good vet that you have confidence in, that always makes such a difference.

Huge hugs to you and Rocky.xx

I am sorry the news is not better for Rocky Azz.

I totally understand where you are coming from on the choosing the option you have. We had to hospitilise Ollie for MRi scans in the beginning and being a stressed out dog in the first place it was hard for him and us he did manage but we said anymore investigations would not be carried out due to stress and the fact he is not going to recover anyway.

A bit like you really we are doing all we can at home and he is now on Steroids and he will soon be on something else alongside for a fungal disease but that is as far as we are prepared to go now nature will take its course to a point and we will have to step in when it gets to much. We feel comfortable with the choices we have we made.

I am sure you feel comfortable with your choices or you wouldn't be travelling the road you are about to travel.

I think you are very brave to choose the way you have and I wish with all my heart you find it helps and gives Rocky a long and comfortbale life.

I am going to say it but I don't really need to say that you know we are all here for you and Rocky and to help you through your journey. Xx