30 Sept 2025
Vicki Adams BSc, DVM, MSc, PhD, MRCVS shares an update and review on how to approach this complex situation, including the vet-client relationship.
Vicki Adams
Job Title
Image: Drobot Dean / Adobe Stock
Veterinary oncology has undergone significant advancements over the past decade, emerging as an essential speciality within veterinary medicine due to the increasing incidence of neoplastic diseases in companion animals.
Understanding the complexity of cancer management in pets and fostering collaborative relationships with pet owners is essential for ensuring optimal care and maintaining the human-animal bond.
This review aims to provide an update on the current state of veterinary oncology, highlighting the importance of owner partnerships in maintaining quality of life for pets diagnosed with cancer.
Recent advancements in veterinary oncology have changed the landscape of diagnosis and treatment. The diagnostic approach to cancer in veterinary medicine has evolved significantly. New technology simplifies the screening and diagnosis of skin masses in dogs, while the use of advanced imaging techniques such as ultrasonography, CT and MRI can enhance the accuracy of tumour detection and staging (Alshammari et al, 2025). Furthermore, ultrasound-guided fine-needle aspiration or biopsy for cytological and histopathological evaluations can provide an accurate and timely definitive diagnosis in first opinion practice.
The use of immunocytochemistry and molecular techniques on cell blocks of cytological samples improved standardisation of lymph node cytology for staging, and the integration of cytology and histology with molecular information have all contributed to a more comprehensive understanding of tumour types and selection of appropriate therapeutic strategies.
Molecular analysis uses various techniques such as immunocytochemistry and immunohistochemistry to identify specific proteins expressed by tumour cells, PCR to detect specific gene mutations or amplifications, and next-generation sequencing to provide a comprehensive analysis of a tumour’s genome (Kehl et al, 2024). Liquid biopsy in veterinary cancer screening is emerging as a minimally invasive tool in the UK, offering a less stressful alternative to traditional biopsies for monitoring cancer progression in dogs (Alshammari et al, 2025).
Liquid biopsy refers to the analysis of cell-free DNA found in a blood sample to detect cancer biomarkers. Several companies and research institutions in the UK are developing and using liquid biopsy technology for canine cancer screening. While not a standalone diagnostic, it can be a valuable addition to a dog’s wellness check, potentially aiding in the early detection of cancer, informing treatment decisions and monitoring cancer progression and response to treatment.
Advances have also been made in therapy, with the introduction of several innovative treatment modalities. The introduction of new chemotherapeutic agents and protocols has improved treatment outcomes for various malignancies.
Metronomic or low-dose chemotherapy is becoming more common, using low doses of anticancer drugs given on a continuous or frequent, regular schedule (such as daily or weekly), usually over a long time. Metronomic chemotherapy causes fewer severe side effects than standard chemotherapy; giving low doses of chemotherapy may stop the growth of new blood vessels that tumours need to grow.
The development of targeted therapies has altered cancer treatment by focusing on specific molecular pathways involved in tumour growth; for example, the use of toceranib, a tyrosine kinase inhibitor, has shown efficacy in treating mast cell tumours in dogs (London et al, 2009) and other malignancies (Frezoulis and Harper, 2022).
The use of immunotherapy has grown, with promising results observed in various malignancies.
Canine melanoma vaccines have been developed to stimulate an immune response against melanoma cells, improving survival times in affected dogs (Pellin, 2022).
Precision medicine has also been developed, integrating genomic and molecular profiling into veterinary oncology, which has allowed for personalised treatment approaches. Assessing tumour-specific mutations and gene expression patterns can guide therapeutic decisions, optimising treatment efficacy and minimising side effects.
Interventional oncology is a new field that offers minimally invasive, image-guided procedures to diagnose and treat cancers, potentially leading to quicker recovery times with fewer complications and improved outcomes compared to traditional surgery.
Real-time imaging modalities such as fluoroscopy, bronchoscopy and cystoscopy are used to undertake minimally invasive procedures that may include the placement of stents to alleviate obstructions caused by tumours and help restore normal function, vascular procedures to block blood flow to tumours or deliver chemotherapy directly, and tumour ablation procedures using microwave technology guided by ultrasound, laparoscopy or during open surgery to destroy tumour tissue (Culp, 2024; O’Keeffe, 2024).
Veterinary surgeons and nurses play a pivotal role in the management of cancer in pets, extending beyond diagnosis and treatment to encompass owner education and emotional support.
Understanding the emotional responses of pet owners during a cancer diagnosis is critical for effective communication and support.
Common emotional responses include shock, guilt and anxiety, necessitating a compassionate approach from veterinary professionals (Bishop et al, 2016). Effective communication is essential in fostering a strong partnership among veterinary practice staff and pet owners. Clear, compassionate explanations of the diagnosis, treatment options and potential outcomes are crucial.
The use of visual aids and educational materials can enhance understanding and retention of complex information (Galmarini et al, 2024). Encouraging pet owners to ask questions and express concerns fosters an environment of trust and collaboration.
Regular follow-up consultations provide an opportunity to address emerging questions and ensure that owners feel supported throughout the treatment process.
Quality of life assessments are a vital component of veterinary oncology, guiding treatment decisions and ensuring that pets maintain a good quality of life throughout their cancer journey.
Various quality of life scales can be used to evaluate multiple factors, including pain, appetite, mobility and overall well-being (Brown et al, 2009; Giuffrida and Kerrigan, 2014; Giuffrida et al, 2017; Giuffrida et al, 2018; Hamilton et al, 2012; Harris et al, 2025; Lynch et al, 2011; Mellanby et al, 2003; Vøls et al, 2017; Yazbek and Fantoni, 2005).
Veterinary surgeons should work collaboratively with pet owners to develop a tailored quality of life assessment plan, emphasising the importance of regular communication regarding any changes in the pet’s condition. Pet owners should be encouraged to monitor their pets closely and report any signs of discomfort, pain or distress.
Palliative care is an integral aspect of veterinary oncology, focusing on enhancing comfort and alleviating clinical signs and symptoms, rather than pursuing potentially curative treatments.
In cases where prognosis is poor, palliative care becomes paramount in maintaining the pet’s quality of life (Paz et al, 2024). Veterinary surgeons should collaborate with pet owners to develop comprehensive palliative care plans that address the individual needs of the pet. This may include pain management, nutritional support, emotional support and recognising the importance of the human-animal bond.
Effective pain management strategies are essential for enhancing the quality of life in pets with cancer. NSAIDs, opioids, and adjunctive therapies such as gabapentin and amantadine can be employed to manage pain effectively (Williams and MacDonald-Dickinson, 2023).
Nutritional management plays a crucial role in supporting pets undergoing cancer treatment. Veterinary surgeons should guide pet owners in selecting appropriate diets that meet the nutritional needs of their pets, considering factors such as palatability, caloric density and protein content (Amaral et al, 2025).
Providing emotional support to pet owners is essential – especially during difficult times. Veterinary surgeons should be prepared to offer guidance, resources and referrals to support groups or counselling services for owners grappling with the emotional toll of their pet’s cancer diagnosis.
End of life care and decision making represent a crucial final stage in a pet’s life, holding equal significance and meaning as the clinical care provided throughout all previous life stages.
End of life care should aim to minimise patient suffering and maximise comfort at the same time as fostering a cooperative partnership with the caregiver (Bishop et al, 2016).
Timely, non-judgemental and empathetic communication is essential for effective caregiver support. Patients at the end of their life should not be allowed to pass away from natural causes without any consideration of the option of euthanasia; it is essential to ensure that measures to alleviate discomfort and distress are implemented.
Animal hospice care addresses the unique emotional and social needs of the patient, alongside the physical needs typically managed in clinical practice. A collaborative end of life treatment plan should incorporate an evaluation of the caregiver’s needs and goals for their pet, and a personalised written treatment plan that involves both the clinical staff and the caregiver.
Primary care practices should establish a dedicated team to implement palliative and hospice care for end of life patients. The manner in which the health care team responds to a caregiver’s grief following the loss of a pet can significantly influence a client’s ongoing loyalty to the practice. Referring clients to professional grief support counselling can be a valuable option in this context.
The human-animal bond is a significant aspect of the pet-owner relationship – especially during cancer treatment. This bond can influence treatment decisions, as pet owners may prioritise their pets’ well-being and comfort.
Veterinary surgeons should recognise the importance of this bond and encourage pet owners to engage in activities that promote their pets’ well-being, even during challenging times (Mason and Roper, 2018). Encouraging pet owners to spend quality time with their pets, engage in enjoyable activities and provide emotional support can significantly enhance the quality of life for both the pet and caregivers. Simple activities such as gentle play, grooming or spending time together can provide comfort and pleasure.
Providing comprehensive support to pet owners is paramount in veterinary oncology. Veterinary surgeons should facilitate access to educational resources that empower owners to make informed decisions about their pet’s care. This may include providing brochures, links to reputable websites and information on trustworthy support groups. Support groups and online communities can offer valuable emotional support for pet owners facing similar challenges; however, these groups must be known by your practice and evaluated before recommending them.
Encouraging owners to connect with these resources can help alleviate feelings of isolation and provide a sense of community.
Ethical dilemmas often arise in veterinary oncology – particularly regarding treatment options, financial considerations and end of life decisions. Veterinary surgeons must navigate these discussions with sensitivity and empathy, recognising that each pet owner will have different values and expectations (Bishop et al, 2016).
End of life decisions are among the most challenging choices pet owners face. Open and honest discussions about prognosis, treatment options and the potential for a good quality of life are essential. Veterinary surgeons should guide owners through the process of making informed decisions, prioritising the welfare and dignity of their pets. While euthanasia may be considered a failure by some, it is a valid and acceptable option.
As veterinary oncology continues to evolve, several trends are shaping the future of cancer care for pets. The integration of telemedicine allows veterinary surgeons to consult with specialists remotely, enhancing access to care and facilitating ongoing communication with pet owners (Alshammari et al, 2025). This approach can be particularly beneficial for owners in rural areas or those with mobility challenges.
Ongoing research into cancer therapies and treatments is also promising, with developments in precision medicine and immunotherapy paving the way for more effective and less invasive treatment options. Collaboration between veterinary schools, research institutions and pharmaceutical companies is essential for advancing knowledge and improving outcomes in veterinary oncology.
Veterinary oncology represents a rapidly advancing field that requires veterinary surgeons to be well versed in the complexities of cancer treatment and management.
Fostering collaborative relationships with pet owners is essential for maintaining quality of life and ensuring that the emotional needs of both pets and their owners are met. Through effective communication, education, and a focus on quality of life, veterinary surgeons can empower pet owners to make informed decisions that reinforce the bond with their beloved companions. As we look to the future, continued advancements in veterinary oncology, coupled with a compassionate and holistic approach to care, will undoubtedly improve the lives of countless pets and their families.
In summary, veterinary oncology is not merely about treating cancer; it is about honouring the bond between pets and their owners, and ensuring that every moment spent together is meaningful and cherished.
By embracing this partnership, we can navigate the challenges of cancer care with empathy and understanding, ultimately enhancing the quality of life for pets and their families.