Radiation Oncology: Nasal Cancer

The diagnosis is often confirmed using a series of tests, including a CT scan (also called a CAT scan), rhinoscopy and biopsy.

What is the prognosis?

• Nasal tumors are rarely curable. Without treatment, pets rarely survive more than a couple of months.
• The diagnosis is often confirmed using a series of tests, including a CT scan (also called a CAT scan), rhinoscopy and biopsy.
• The best reported prognosis is associated with radiation therapy.
• Prognosis is influenced by several factors, including:
• How extensive the tumor is within the nasal cavity, and whether it extends outside of the nasal cavity.
• If it has spread to distant parts of the body. Common sites of spread include nearby lymph nodes and the lungs.
• Type of nasal cancer, which is determined when a pathologist reviews the biopsy samples.
• Type of treatment.

What are the treatment options?

• Surgery can cause short term improvement of symptoms, but rarely improves survival over no treatment.
• Use of chemotherapy for treatment of nasal cancer in pets has not been well studied. Newer, more targeted therapies like Palladia™ can also be considered. These types of treatment can be effective in some cases of nasal cancer, but are not great options in other cases.
• The best reported prognosis is associated with radiation therapy.
• Radiation therapy is the most effective treatment that veterinarians have for managing nasal cancer in pets.

Types of radiation therapy

• IMRT: We deliver full-course radiation therapy using a relatively new technique called IMRT (intensity-modulated radiation therapy). 5 treatments per week are given for about 4 weeks, with fewer side effects than possible using more conventional techniques. Such full-course radiation therapy has been well-studied, and is currently considered the best possible treatment in most cases of nasal cancer.
• SRT: Stereotactic radiation therapy is the newest form of treatment available for nasal cancer. It is the most convenient form of radiation therapy. It’s not as well studied as IMRT, but the doctors at NC State have a lot of experience with both IMRT and SRT and feel that SRT can, in many cases, can be just as effective as IMRT. Not all pets with nasal cancer are eligible for SRT, so if you’re interested, be sure to ask your radiation oncologist.
• pRT: Palliative-intent radiation therapy can be a good option for pet owners who would like to pursue a treatment that will make their pet feel better, but cannot afford IMRT or SRT

Navigating the options

	IMRT	SRT	pRT
Schedule	18-22 treatments, given once daily, 5 days a week (M-F)	3 treatments, given on consecutive days.	4-6 treatments given either daily or once weekly.
Approximate cost*	$8,500	$7,500	$4,000
Side effects	Mild	Minimal	Moderate
Prognosis	Offers the best possible prognosis. Goal is to improve quality of life and prolong life as long as possible.	Similar to IMRT	Focuses on improving quality of life, but does not control the tumor’s growth for as long as either IMRT or SRT.

Cost estimates include a radiation oncology consultation, a CT scan to plan the treatment, radiation therapy planning, quality assurance testing, anesthesia and radiation treatments. If a CT scan needs to be performed, that generally adds about $1500.

Facts about radiation therapy

• Performed on an outpatient basis. Patients typically arrive at the hospital in the morning. Families are called and come pick their pet up after they have received that day’s treatment. This is often in the afternoon.
• Radiation therapy is similar to getting an X-ray. The type of radiation therapy most commonly used for treating nasal cancer is called external beam radiation therapy. It involves delivering large amounts of focused energy to the tumor. The energy is strong enough to destroy the tumor, and focused enough to avoid bad side effects.
• Painless. Pets are anesthetized for each radiation treatment. Anesthesia is not used to prevent pain. Instead, it is to make sure the patient remains perfectly still while being treated. This ensures that the highly focused radiation beams hit and destroy the tumor, rather than adjacent tissues.
• Side effects are usually mild, temporary and manageable. New radiation technologies and techniques have revolutionized treatment of nasal cancer, allowing for effective cancer treatment with few short term side effects.
  • Some of the side effects of radiation therapy can cause temporary discomfort, but this is relatively uncommon with nasal cancer, and the doctors and nursing staff will work with you to make sure your pet is as comfortable as possible during and after treatment.
  • More severe and long-lasting side effects are possible, but uncommon. Your radiation oncologist will talk more about these risks during consultation.
• Radiation therapy is safe for families. The types of radiation therapy used for treating nasal tumors do not make your pet radioactive. There is no danger for you or your family to interact with your pet after they have received radiation therapy for nasal cancer.