Human Guide to Oral Melanoma in Canines

Quick Facts

Urgency level: Extremely urgent

Mortality rate: 79% to 100% – Oral Melanoma is one of the most deadly cancers your dog can get

Survival rate: 21% – 27% of canines who have surgical removal will survive at least 1-year post operation as long as the surgeon is able to get clean margins and removal the entire tumor from the jaw

Survival time: Without surgical intervention = 30-90 days. With surgical intervention = 1 year

Rarity: Rare

Age of onset: 10 years or older

Breed susceptibility: Any breed with dark oral pigmentation in the gums is at an increased risk of having oral melanoma occur, especially the older they get. Breeds where this is more common are: Miniature Poodles, Miniature Schnauzers, Doberman Pinschers, Boxers, Cocker Spaniels, Scottish Terriers, German Shepherds, Golden Retrievers, and Chow Chows.

Is there a cure: No

Is there effective treatment: Yes – somewhat

Is there an effective vaccine: Yes – somewhat

Name of vaccine: OnCept

Cost of Vaccine: $1,000 to $1,500 / dose. Canines must get 1 dose every 2 weeks initially then one every 6-months.

Prognosis of the Vaccine: Uncertain – OnCept alone will not stop the oral melanoma from forming or from spreading. OnCept must be used in conjunction with other treatments, typically surgical removal.

Known effective treatments: Surgical removal with clean margins (i.e. the surgeon has to remove all of cancer in the jaw and a margin around this cancer where cells might already be infected) is the only known, effective treatment.

Cost of Surgical Treatment: $7,000 to $15,000

Total Cost of Initial Treatment in the USA (surgery + vaccine): $11,000 to $21,000

Long term risks: Extremely high – if not taken care of as quickly as possible your canine companion will die due to this disease in a very short period of time that may feel sudden or unexpected.

Long term prognosis: Low – Even with surgical removal + the vaccine only a small percentage of canines survive more than 1-year post-operation.

Time to spread to the body: between 3 or 4 weeks to a few months

Most effective treatment plan: Proactive continual cleaning of your dog’s mouth, attempt to avoid harsh dental surgery at all costs, constant monitoring of your dog’s gums and mouth after age 10 for early detection, once detected and confirmed by your veterinarian get surgery scheduled asap, post-operation use OnCept vaccine to help your dog’s immune system fight recurrence of the cancer.

What is it:

This is a cancer that arises from damage to melanocyte cells in the mouth, the cells that give the tissue pigmentation.

What causes it:

There is no 1 known exact cause, however, there are many suspected causes including genetics, dental surgery, heart issues, trauma to the mouth or gums, burns to the mouth or gums, deep bacterial infections in the mouth, air pollution, tobacco or other chemical smokes/vapes, household chemicals, and radiation exposure.

It is safe to say that if you have a dog with a dark coat or dark pigment in their gums you should be extremely wary about many things as they age for example drinking water on the street, hitting their face on things, keeping them far away from household chemicals, and oral health to help mitigate or avoid this nasty cancer.

Why dental oral surgery in older dogs might cause this:

If you have an older dog with pigmented gums that needs one or more teeth extracted the veterinary surgeon might have to cauterize the wound closed if it is too big to sew shut. The trauma of the tooth extraction and the trauma from the burning might be enough to trigger the DNA damage to the melanocyte cells that then leads to this cancer forming a malignant tumor.

There might be alternatives to cauterization for the wound, make sure you ask about this prior to the surgery.

Stages of Canine Oral Melanoma

This cancer is defined by 4 distinct stages.

Stage 1: The tumor is less than 2 centimeters in diameter and is unlikely to have spread. In size this is somewhere around the size of one or two peas put together or smaller.

Stage 2: The tumor is somewhere between 2 centimeters and 4 centimeters in diameter and is unlikely to have spread. This is roughly larger than a US quarter up to the size of 2 AAA batteries combined.

Stage 3: The tumor is larger than 4 centimeters in diameter and is likely to have spread to at least the lymph nodes. Anything larger than 2 AAA batteries combined in diameter is likely to be a Stage 3 tumor.

Stage 4: The tumor is known to have spread to other parts of the body and can be any size in diameter at this point.

Stages 1 and 2 have a great prognosis if surgery is done quickly. Stage 3 has a lower prognosis considering the cancer might have spread. Stage 4 has a terrible prognosis.

Heart Conditions and Stage 3 or Stage 4 Oral Melanoma

A dog with a heart condition and oral melanoma might be at increased risk of health complications even in earlier stages. This is because cancer cells from the tumor might start breaking away and entering the bloodstream where they cause at least temporary clotting. If your dog has a heart condition and the cancer progresses before you can obtain surgery you may want to talk to your veterinarian about possible warning signs of blood clotting by circulating tumor cells (CTC’s) and request medication to give as an intervention to help your dog be a little more comfortable while awaiting treatment or approach the end of their life.

One symptom of these blood clots might be your dog going limp at seemingly random times and being unable to move muscles in one or more legs for short periods of time.

What you might experience from your veterinarians:

The ordeal might start fairly normal, especially if your dog has had a mass in their mouth before. Dog owners tell us it often appears after an oral surgery, injury to the mouth, or after heavier than normal exercise in dogs with a heart condition.

Your veterinarian will schedule an appointment to surgically remove the mass and send off a biopsy of it for testing. The test may come back negative for cancer or it might come back as inconclusive. In either case there is still a chance the mass is cancerous and it will reappear in a few weeks or months time, usually in the exact same spot.

If your veterinarian does a second removal and/or biopsy it may come back as cancerous.

Once your veterinarian gets a positive result they are most likely going to stop offering any treatment or surgery and will refer you to a local veterinary oncologist. When this happens you should ask your veterinarian if they will give your dog ongoing care throughout the cancer treatment.

It is imperative at this moment that you begin pushing for your dogs treatment in terms of scheduling appointments and getting things done. The faster you are able to move through the following steps, the more likely your canine is to avoid progressing to Stage IV Oral Melanoma where it has metastasized and spread to the body. Once it spreads, there is no way of stopping this type of canine cancer just yet, your buddy will pass away from the cancer or complications caused by it in a few weeks or months.

This is an incredibly urgent situation, however, most major cities only have a few veterinary oncologists or veterinary oncology clinics so you will likely be getting scheduled a few weeks away.

Most oncology clinics will have your canine companion go through a couple of stages, the first being a consultation. Once you have the consultation and the oncologist and you agree on a treatment your next appointment will be a diagnostic exam. Some clinics only use X-Rays, others only CT scans, and others a combination in order to determine for sure that the cancer has not spread through the body and to show the surgeon exactly where to cut.

Here we must note that is imperative you do not seek a second opinion or wait to make a decision. You have at best 24-hours to make your decision or risk being pushed back even further, placing your dog at risk of passing due to the cancer.

Generally you’ll have a consultation, get an estimate, agree to the price, schedule a diagnostic appointment, then schedule the surgery for 1 to 2 days after the diagnostics. The entire process from the moment your veterinarian diagnosis the oral melanoma will take approximate 2 weeks to 1 month depending on how quickly the oncology clinic is able to move. This time frame might be disrupted by local holidays or other issues that would lead to closure of the clinic for a day or two such as a severe weather event or natural disaster. Anything that can impede this timeframe leads to increased likelihood that your canine buddy does not get the surgery in time to avoid spreading.

Dog owners have reported to us that some veterinary oncologists, probably in an attempt at being gentle, have told them to get a second opinion or take their time to make their decision on the surgery. This is a fatal mistake, if you can afford the surgery it is the only viable option.

Distant Metastasis happens in nearly 100% of cases, once your pup has oral melanoma it is only a matter of time before it reappears and spreads even with surgical removal, the vaccine, and radiation therapy.

Problems With Current Care

Currently the care systems for Canine Oral Melanoma have several problems.

• Extreme costs – The cost for the surgery alone is astronomical as is the cost for the only partially effective vaccine. Part of the reason for this is the a lack of competition in the anesthesiology industry which allows exorbitant prices for surgery often taking up 70% to 80% of the total surgical costs.
• Slowness in treatment plans – The slowness built into the system that requires multiple vet visits across several weeks before action is taken gives this cancer plenty of time to proliferate. Especially in large urban areas where potential patients are plentiful it doesn’t make much sense to have such a long space of time between appointments for something so deadly if left untreated for too long.
• Oral care contributions – It appears clear, though yet to be thoroughly proven, that dental surgery places at risk dogs at higher risk especially when wounds are cauterized closed in the mouth.

Treatment Effectiveness:

No treatment: Ineffective, 0% survival rate

Surgical removal: Effective, 21% to 27% survival rate, median time of survival 6 months to 1 year

Radiation therapy: Effective, 83% to 100% survival rate, media time of survival 211 to 363 days

Chemotherapy: Ineffective, 30% survival rate, median time of survival unknown

Immunotherapy: There is a vaccine for this disease with moderate success rates (OnCept) many clinics will not mention or offer it due to costs and the low efficacy

Nutritional Information:

Like many cancers Oral Melanoma can utilize sugar to power its cells instead of relying on standard processes. This means your dog should have as little sugar as possible that may remove many of their favorite treats and foods including fruits like watermelon and blueberries, pup cups, and many treats found at pet stores.

Preparing fresh food for your dog may help them eat more and keep up their strength.

Supplement Effectiveness:

While your canine is fighting this cancer there might be some supplementation that helps them.

There is no supplement or over the counter medication that will shrink the tumor or cure this cancer. Only use supplements to try and moderate the growth of the tumor prior to surgical removal and for ongoing care post operation.

Electrolyte water for dogs – As the tumor grows it will siphon various resources from your dog’s body, water designed to help replenish dogs could help your dog fight the cancer while awaiting surgery or going through other treatments.

Blushwood Berry Seed Extract – While low in bioavailability comparatively, this is the same berry the miracle treatment for canine mast cell tumors that have not yet spread comes from – Stelfonta. These berries and their seeds contain an anti-cancer compound called EBC-46 which is known to help reduce the size of tumors although there is little evidence for this specific cancer and for the safety in canines. It can be purchased in various places including Amazon and Etsy though is rarely found in vitamin stores or pet stores.

Ashwagandha Leaf Extract / Powder / Leaves – The leaves of the Ashwagandha plant contain an anti-cancer compound called Withaferin-A which might help reduce the size of tumors or kill cancer cells. There is little research into the efficacy of this and into the safety of it for canines. While Ashwagandha plant supplements are commonplace the most often are made solely our mostly out of the roots which have a lower concentration. You can find the leaves and live plants which to derive them from on Etsy, however, there are currently no known tablets or capsules made for canines from this.

Mushroom supplements – These mushroom supplements are safe for dogs to eat in small quantities and have some supporting evidence of their anti-cancer potential or ability to stimulate the immune system, Reishi, Shiitake, and Maitake.

Things You Should Not Try to Help Treat This Cancer

Red Light Therapy – While red light / cold laser / infrared therapy can help dogs in other ways, it likely does nothing or worse helps the oral melanoma tumor grow. It’s important to note that many things that help healthy cells in your dog’s body will also help the cancer cells / tumors.

Photo Reactive Therapy – In a clinical or at-home setting Photo Reactive Therapy (PRT) is unlikely going to help shrink the tumor or cure the cancer.

Other Things that Might Shrink the Tumor:

These are potential home remedies that might work to get our canine companion through the process of scheduling consultations and diagnostics. These are not intended to be long-term solutions, but temporary measures to try and slow the tumor as much as possible. Always talk to your veterinarian or oncologist about these options.

Ice Pack on the Snoot – Place an ice pack over a towel and apply it to the side of your dog’s mouth where the tumor is for 10 to 15 minutes 2 to 3 times day. Your dog is going to hate this, so make sure to give them a treat each time (a sugar free treat).

Fenbendazole – Giving this canine dewormer as soon as you hear that the mass is a cancerous tumor might help slow its growth down giving you and your canine friend the time you need to get through the various roadblocks in the weeks ahead before getting in for surgery.

Blushwood Berry or Ashwagandha leaf gel – Purchase an oral gel or toothpaste at any pet store and mix in some of the anti-tumor supplements mentioned above. If your dog allows you to place your hand in their mouth rub this on the tumor and do your best to keep your dog from licking it. While most will get licked off, some might stick and help keep the tumor’s growth in check while you wait for your appointment.

RESEARCHERS & VETERINARIANS AREA

What we are missing that would help canines with this cancer

Here are things that would help canines suffering from this cancer:

1. A one shot kill medication – Stelfonta, which is FDA approved for Mast Cell tumors in canines already, is a good candidate for this and is in clinical testing, but should the current trials fail, canines need something else that any veterinarian could give when such a tumor appears to kill it. Obviously this means the tumor wouldn’t spread, providing a much longer survival time and likely higher survival rate.

2. Improved Oral Checkup Schedule – Zero veterinarians we have spoken with ask the owners of dogs that have pigmented gums to come in more frequently for oral checkups. While vets may not do much without the dog being under anesthesia, they could examine the tooth line and gums of friendlier dogs on a more frequent basis looking for any early warning signs or bumps that might be tumors growing.

3. Improved communication to dog owners about oral hygiene and potential ramifications – Most veterinarians do not talk with dog owners for dogs that are at risk for oral melanoma about training their dog to brush their teeth or other oral hygiene techniques. This should be part of the initial consultation and brought up annual and mid-annual checkups for at risk dogs. Dog owners of at risk dogs deserve to know that oral trauma or poor oral hygiene could cause Oral Melanoma and given time to train their puppy and have a plan for if and when it arises.

4. Preventative Measures for Oral Surgery – A medicated gel or paste that could be applied to the gums of at risk dogs might help reduce the risk of oral melanoma appearing post-operation and avoid the painful, costly, and heart-wrenching journey the human and canine will have to embark on.

5. Safety research on anti-cancer supplementation – We need documentation on anti-cancer supplementation to show how safe it is in dogs and what levels dogs of certain breeds and weights should ingest. This includes blushwood berry, ashwagandha leaf, and mushrooms.

6. Efficacy research on anti-cancer supplementation – We need studies that track the efficacy of at risk dogs in taking supplements to avoid this cancer and of early to mid-stage dogs in reducing or eliminating this cancer.

7. A better Veterinarian to Oncologist to Surgery pipeline – Everyone in the veterinary medical fields knows the first thing to do is to perform surgical removal asap, especially if the tumor is deep in the gums and normal surgery at a general practice won’t be able to remove it completely. However, the process as noted above can take weeks and months to play out all the while the tumor is more and more likely to metastasize and spread. A clinic that is able to reach out to referrals quickly would cut down on time, as would one that could manage to do initial consultations and diagnostics in the same day. General practice / primary care veterinarians should give quite stern warnings to their humans that delaying could be fatal instead of working to get second and third opinions. Estimates should be sent asap so humans can apply for CareCredit or otherwise organize the finances. If the Primary care vet is able to do CT scans quickly and move the canine right to Oncology to surgery within a few days that would be incredible.

8. Reduction of Costs of Anesthesia Services – The number of cost for most canine surgeries is anesthesia. This cost often inflates the overall cost of a procedure out of the budget of many canine owners. In some cases we are told this is due to exclusivity agreements that are structured in ways that do not violate national or state laws and in other cases due to lack of providers in an area which drives up prices.

9. A way to nebulize the lungs with anti-tumor compounds – Nebulizing lungs for various issues is an existing technology, a way to modify this to help canines whose oral melanoma progresses too quickly and is considered by oncologists to be inoperable and untreatable is likely to save lives.

10. Better information at the point of cancer discovery – Veterinarians and/or oncologists need to do a better job of giving patients information on what to do with the diagnosis. That should include instructions such as not feeding the dog any sugars, increasing the dog’s protein intake, and moving as quickly as possible to schedule the necessary appointments and surgeries.

Experimental Treatments:

1. Stelfonta – Clinical trial underway at University of Edinburgh in Scotland to see if this shot works on oral melanoma tumors as well as it does on mast cell tumors.

2. Blushwood Berry Supplements – Oral supplements made from the blushwood berry plant that provides the main ingredient in Stelfonta might provide some help in managing malignant tumor growth.

3. Ashwagandha leaf Supplements – Oral supplements made from the leaves of the ashwagandha plant might provide some help in managing malignant tumor growth.

4. Fenbendazole – This deworming ingredient is FDA approved for use in various animal treatments and is sold under brand names such as Panacur C and Safe-Gaurd for canines with parasite or worm infections. It is also a proven cancer therapeutic in humans and canines that works be disrupting glucose uptake and by keeping microtubules from being assembled. While this is an over-the-counter drug, it is not advised to use it more than the short course you normally would to rid your dog of a worm infection. Veterinarians should bring this up with their patients quickly since it may help keep the tumor in check will canines are awaiting surgery, Oncologists should also mention it since it could help.

5. Post-Operative Gel – A medical gel or paste that includes anti-tumor molecules given after aggressive oral treatment to at risk dogs might reduce the occurrence of tumor growths or slow down the growth of the initial malignant tumor giving more time to respond.