Could you please introduce yourself and tell us a little about your career to date?
I completed my undergraduate veterinary degree in Dublin and knew I wanted to specialise in a medical subject. After an internship in Glasgow the following year, I became fascinated by cancer in pet animals and the impact veterinary care could have for pets with cancer. Specific Oncology specialist training was not established then, so I worked in private practice for a couple of years, then became an Internal Medicine resident at the Royal Veterinary College and became an Internal Medicine specialist. During this training, I also did a Masters degree in Clinical Oncology at the University of Birmingham and developed a research idea into a cancer-focused PhD studentship, also at the Royal Veterinary College. Since then I have always worked as an Oncologist, first in private referral practice and then in the charity sector. While I was doing my PhD, the European Diploma in Veterinary Oncology was established and I attained this qualification, becoming an Oncologist, a cancer specialist. Most recently, I have worked at the University of Edinburgh before moving back near London in 2016. I founded the Oncology service at London Vet Specialists in Spring 2017.
What does a veterinary oncologist do?
A veterinary Oncologist sees pets with cancers of all sorts and pets with masses or other conditions which are thought highly likely to be tumours but have not yet been confirmed as such. For most cases, some type of minimally invasive investigation is needed, and these results enable me to offer a set of bespoke treatment protocols to the owner, who selects the best option for their pet. I then implement their chosen protocol, maintaining the pet’s quality of life throughout, as this is the top priority for both the owner and for me. Many clients are surprised to hear that in 80-85% of pets receiving chemotherapy there are no side effects, as our approach is quite different from human Oncology practice. Because of this, it is quite common for us to see a patient who is initially unwell with their tumour and actually make them feel better on chemotherapy, which is very rewarding.
What motivated you to specialise in veterinary oncology?
My motivation to become an Oncologist was in part my internship at the University of Glasgow, where Oncology was a separate department, which had not been the case during my initial training. But the main factor was the impact that Oncology care has on pets and their owners. Designing a bespoke protocol for an individual and carrying it out effectively can have a genuinely transformative effect, with the only people happier than me with the results being the owners.
What type of treatment can a veterinary oncologist offer that is not available at your typical vet?
There are some aspects of care that only a veterinary Oncologist can offer, such as medications which are often initially or always restricted to specialist Oncology practice by the manufacturers, such as the OnceptTM Canine Melanoma Vaccine. Many newly developed treatments are only released to all veterinary surgeons after a period of being restricted to Oncologists, however, so it is very common for the care of an individual pet to be shared between London Vet Specialists and their local vet surgery. Additionally, at London Vet Specialists, we have a CT scanner on site which is a very sensitive way to characterise masses and whether they have spread or not. Repeated CT scanning is a non-invasive way of very accurately assessing the response of deeply-seated tumours to our treatments. We also offer every type of standard chemotherapy and as we see so many pets for treatment, we also have in stock rarely used antidotes, in the rare event of complications. Overall the combination of facilities in London Vet Specialists and the wealth of experience of our on site diploma holders in Oncology, Internal Medicine, Surgery including keyhole surgery, Anaesthesiology, Emergency and Critical Care, Imaging, and Dermatology, offers uniquely comprehensive care in London.
Traditionally a diagnosis of cancer has been considered a death sentence by both vets and pet owners. Recent developments in the veterinary world have changed this. Can you tell us about these developments have produced different outcomes for your patients?
Veterinary Oncology has frequently benefitted from studies of comparable human tumours. Some of the techniques and medications which have become standard of care in the treatment of pets with certain tumours were established from studies primarily designed to help understand human cancers. In the recent past, while this association between human and pet tumours has deepened, we also benefit from an ever growing body of independent, wholly pet-focussed studies. This means that compared to several other areas of veterinary medicine, treatments and investigations for pets with tumours are changing and improving rapidly. A specialist who is a diplomate in Oncology is best placed to be able to offer the most up to date advice and newly emerging treatments which are sometimes restricted to specialist Oncologists only. Admittedly, just as in humans there are some types of tumours which are remarkably aggressive, and for both people and pets, such rare tumours are associated with only brief survival. However, the number of such aggressive tumours is becoming vanishingly small over time as we increase our understanding of tumours. Therefore, it is always worthwhile discussing a tumour with an Oncologist, even if historically such an individual mass might have been associated with brief survival, as new developments might offer improved outcomes currently and in the future.
How can diagnostic imaging assist with the process of diagnosis and treatment?
Diagnostic imaging can help a pet with a tumour in several ways. Often we want to find out if a mass has remained within the tissue from which it arose, or if it has started to metastasize/spread. Knowledge of whether a mass has spread or not allows us to be more accurate in predicting the outcome, and more accurate in deciding on which is the best treatment or combination of treatments for that individual pet. For deeply-seated masses, compared to x-rays a CT scan offers a much higher resolution and more precision in defining the size and local extent of tumours. The change in size of a mass after treatment allows us to more robustly assess the effectiveness of the previous treatment and whether it is best to continue to use that treatment, or whether it is best to change to a different treatment.
What advice do you have for a pet parent who receives a cancer diagnosis for their beloved pet?
Given that Oncology is a rapidly advancing field and the number of patients for whom we have more and better treatments to offer is getting larger all the time. Therefore, I would suggest that after an initial diagnosis of a tumour please discuss your pet with your local vet. They might have a lot of experience in treating your pet’s particular type of a tumour already without having to consult with an Oncologist. That said, a diplomate Oncologist will always be the best source of information and treatments for any pet with a tumour, and owners can request a referral to an Oncologist at any point in their pet’s care.