It is important to remember that the best treatment for a particular tumor does not necessarily constitute the best treatment for a particular patient or the best treatment from the owner’s perspective. The most important patient-related factor to be considered is the animal’s general health and activity or performance status.
For example, a cat or dog with markedly diminished activity and severe constitutional signs (i.e., poor performance status) may not be a good candidate for aggressive chemotherapy or for the repeated anesthetic episodes required for external beam radiotherapy.
Age by itself is not a factor that should be considered when discussing cancer therapy with the owner (i.e., “age is not a disease”). For example, a 14-year-old dog in excellent health is a better candidate for chemotherapy or radiotherapy that a 9-year-old dog with chronic renal failure or decompensated congestive heart failure. Patient-related factors should be addressed before one institutes specific cancer treatment (e.g., correct the azetomia, improve the nutritional status with enteral feeding).
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