Article Outline

• Section A
• • Management of Chronic Cancer Pain
  • • How Painful Is Cancer in Animals?
    • General Approach to Cancer Pain Management
    • The Importance of Alleviating Pain in the Cancer Patient
    • Assessment of Cancer Pain
    • Principles of Alleviation of Cancer Pain
    • • Pharmacologic Therapy
      • Classification of Cancer Pain
    • Drugs and Strategies Used for Management of Pain in Cancer Patients
    • • Nonsteroidal Antiinflammatory Drugs
      • Acetaminophen
      • Opioids
      • N-Methyl D-Aspartate Antagonists
      • Combination Analgesics
      • Anticonvulsant Drugs
      • Tricyclic Antidepressants
      • Sodium Channel Blockade
      • Steroids
      • Bisphosphonates
    • Neuronal Ablation or Exhaustion Therapy
    • Radiation Therapy
    • Acupuncture
    • The Future: Toward a Mechanistic Understanding of Cancer Pain
  • References
• Section B
• • Nutritional Management of the Cancer Patient
  • • Metabolism of Cancer: Substrate Utilization
    • Cancer Anorexia and Cachexia
    • Epidemiology, Prevention, and Risk Factors
    • Implementing a Nutritional Plan for the Oncology Patient: Nutritional Assessment
    • Feeding the Hospitalized Oncology Patient
    • Coax Feeding and Pharmacologic Appetite Stimulation
    • Assisted Enteral Support
    • Parenteral Support
    • Nutritional Support in the Cancer-Bearing Patient
    • • Substrate
      • Amino Acids
      • Polyunsaturated Fats
      • Vitamins and Minerals
      • Antioxidants/Supplements
  • References
• Section C
• • Relationship-Centered Approach to Cancer Communication
  • • A Paradigm Shift: Paternalism to Partnership
    • Relationship-Centered Care
    • Core Communication Skills for Cancer Communication
    • • Gathering Information
      • • Identify the Client's Full Agenda
        • Elicit the Client's Perspective
      • Explaining and Planning
      • • Assess the Client's Knowledge Level
        • Give Information in Manageable Chunks and Checks
      • Building Relationships
      • • Offer Partnership
        • Ask Permission
        • Express Empathy
        • Demonstrate Appropriate Nonverbal Behavior
      • Providing Structure
      • • Summarize
    • “I Don't Have Time for This…”
    • Approaches to Cancer Conversations
    • • Delivering Bad News
      • Discussing Prognosis
      • Assessing Quality of Life
      • Transitioning to Palliative Care
      • Preparing Families for Euthanasia
      • Providing Support for Grief and Loss
      • Caring for Yourself
    • Conclusion
  • References

More details.

• • General Principles of Cancer Chemotherapy
  • Mechanism of Cancer Therapy
  • Terminology and Concepts
  • Indications and Goals of Therapy
  • Tumor Susceptibility and Resistance
  • Tumor Cell Sensitivity
  • Tumor Cell Resistance
  • Combination Therapies
  • Toxicities Associated with Drug Therapy of Cancer
  • Safety Concerns of Cancer Drug Therapy
  • Pharmacologic Principles in Cancer Therapy
  • Pharmacokinetics
  • Pharmacodynamics
  • Pharmaceutics
  • Specific Chemotherapeutic Agents
  • Alkylating Agents
  • Nitrogen Mustards
  • Nitrosoureas
  • Other Alkylating Agents
  • Antitumor Antibiotics
  • Doxorubicin
  • Mitoxantrone
  • Actinomycin D (Dactinomycin)
  • Antimetabolites
  • Cytosine Arabinoside (Cytarabine)
  • Methotrexate
  • Gemcitabine
  • 5-Fluorouracil
  • Antimicrotubule Agents
  • Taxanes (Paclitaxel and Docetaxel)
  • Vinca Alkaloids (Vinblastine and Vincristine)
  • Topoisomerase Inhibitors
  • Epipodophyllotoxins (Etoposide and Teniposide)
  • Steroids
  • Prednisone
  • Others
  • Platinum (Carboplatin and Cisplatin)
  • Hydroxyurea
  • L-Asparaginase
  • Future Directions in Drug Therapies for Cancer
  • Individualized Dosing
  • Population Pharmacokinetics
  • Molecular Profiling
  • Tumor Sensitivity
  • Prognostic Evaluation
  • Novel Combinations
  • References

• CANCER CACHEXIA
• • Phases of Cachexia
  • Alterations in Carbohydrate Metabolism
  • Alterations in Protein Metabolism
  • Alterations in Lipid Metabolism
  • Changes in Energy Requirements
• DIETARY MANAGEMENT OF CANCER PATIENTS
• • Diet Characteristics
  • Calculating Energy Needs
• METHODS OF FEEDING
• CONCLUSION
• References

The veterinary oncology profession is uniquely able to contribute to the many advances that are imminent in immunotherapy. However, what works in a mouse will often not reflect the outcome in human patients with cancer. Therefore, comparative immunotherapy studies using veterinary patients may be better able to bridge murine and human studies. Many cancers in dogs and cats seem to be stronger models for their counterpart human tumors than presently available murine model systems. This author looks forward to the time when immunotherapy plays a significant role in the treatment and/or prevention of cancer in human and veterinary patients