Withrow And Macewen's Small Animal Clinical Oncology - Elsevier Ebook On Vitalsource (retail Access Card)

With a unique focus on the most effective interventional techniques, Withrow & MacEwen's Small Animal Clinical Oncology, 5th Edition tells the full story of cancer in dogs and cats — what it is, how to diagnose it, and how to treat many of the most common cancers encountered in clinical practice. Nearly 500 color photographs, diagrams, x-rays, and gross views depict the clinical manifestations of various cancers. This edition covers the latest advances in clinical oncology, including chemotherapy, surgical oncology, and diagnostic techniques. With contributions from 65 veterinary oncology experts, this authoritative reference is a must-have for current, evidence-based therapeutic strategies on canine and feline oncology. "I really love this book. If you are interested in veterinary oncology, have a flick through this book online or at a conference when you get the chance. I hope that you agree with me that this is the definitive oncology reference source for the early 21 st century and that you feel compelled to buy it. Your patients will thank you for it." Reviewed by: Gerry Polton MA VetMB MSc(Clin Onc) DipECVIM-CA(Onc) MRCVS, UK Date: July 2014 Cutting-edge information on the complications of cancer, pain management, and the latest treatment modalities prepares you to diagnose and treat pets with cancer rather than refer cases to a specialist. A consistent format for chapters on body system tumors includes coverage of incidence and risk factors, pathology, natural behavior of tumors, history and clinical signs, diagnostic techniques and workup, treatment options, and prognosis for specific malignancies. A systems approach to the diagnosis and management of cancer facilitates access to information about the many malignancies affecting small animal patients. Nearly 500 color images provide accurate depictions of specific diseases and procedures. Helpful drug formularies provide quick access to information on indications, toxicities, and recommended dosages for chemotherapeutic and analgesic drugs used in cancer treatment. Expert contributors provide in-depth coverage of the most current information in his or her respective specialty in veterinary oncology. Chemotherapy protocols are included when case studies prove clinical efficacy. Discussion of compassion and supportive care for the management of pain, nutritional needs, and grief includes methods for handling the pet’s pain and nutritional complications as well as the pet owner’s grief when treatment is not successful. Thoroughly UPDATED chapters cover the most recent changes in the clinical management of melanoma, mast cell tumors, tumors of the skeletal system, tumors of the endocrine system, tumors of the mammary gland, urinary cancers, nervous system cancers, lymphoma, and histiocytic diseases. NEW Clinical Trials and Developmental Therapeutics chapter discusses the various phases of clinical trials as well as current challenges and opportunities in oncology drug development. NEW! A focus on the best recommended treatment options highlights therapeutic strategies that have been vetted by veterinary oncology experts. NEW co-author Dr. Rodney L. Page adds his valuable perspective, expertise, and research experience. Front cover Withrow and MacEwen's Small Animal Clinical Oncology Copyright page Contributors Preface Dedication Table of Contents Introduction Why Worry About Cancer in Companion Animals? References I The Biology and Pathogenesis of Cancer 1 The Etiology of Cancer n Section A The Genetic Basis of Cancer Genes and Cancer Risk Heritable Cancer Syndromes Genetic Influence in Sporadic Cancers The Hallmarks of Cancer Self-Sufficiency of Growth Signals Insensitivity to Antigrowth Signals Evasion of Cell Death Limitless Replicative Potential Sustained Angiogenesis Invasion and Metastasis Adaptive Evolution and the Tumor Microenvironment Emerging and Enabling Hallmarks Genomic Instability Tumor-Promoting Inflammation Reprogramming Energy Metabolism Evading Immune Destruction Epigenetic Events Cancer Stem Cells Summary References n Section B Chemical, Physical, and Hormonal Factors Chemical Factors Environmental Tobacco Smoke Pesticides, Herbicides, and Insecticides Cyclophosphamide Rural versus Urban Environment Physical Factors Sunlight Trauma/Chronic Inflammation Magnetic Fields Radiation Surgery and Implanted Devices Asbestos Hormonal Factors Estrogen and Progesterone Canine Mammary Cancer Feline Mammary Cancer Lymphoma Androgens/Testosterone Perianal Adenoma Prostate Cancer References n Section C Cancer-Causing Viruses Tumor-Causing Viruses of Dogs Papillomaviruses Pathogenesis Clinical Features Treatment Tumor-Causing Viruses of the Cat Papillomaviruses Pathogenesis Clinical Features Diagnosis Treatment Retroviruses Feline Leukemia Virus Transmission Feline Oncornavirus-Associated Cell Membrane Antigen Neoplastic Diseases Caused by Feline Leukemia Virus Treatment of Feline Leukemia Virus Infections Biologic-Response Modifiers Reverse Transcriptase Inhibitors Prevention and Control Prevention by Vaccination Feline Sarcoma Virus Clinical Features of Feline Sarcoma Virus and Induced Fibrosarcomas Feline Immunodeficiency Virus Transmission Feline Immunodeficiency Virus–Associated Neoplasms Treatment Comparative Aspects References 2 Tumor Biology and Metastasis Normal Cell Division The Cell Cycle Cellular Responses to DNA Damage p53 Functions as a Genomic Guardian Cell Death Summary From Normal Cell to Cancer Cell Multistep Carcinogenesis Oncogenes Growth Factors Growth Factor Receptors Protein Kinases Signal Transduction Nuclear Proteins and Transcription Factors Mechanisms by which Oncogenes Become Activated Tumor Suppressor Genes Retinoblastoma Forms the First Clues to the Existence of Tumor Suppressor Genes The p53 Tumor Suppressor Gene Cancer Arises through Multiple Molecular Mechanisms The Hallmarks of Cancer Self-Sufficiency in Growth Signals Insensitivity to Antigrowth Signals or Evading Growth Suppressors Evading Cell Death: The Roles of Apoptosis, Autophagy, and Necrosis Limitless Replicative Capacity Reprogramming Energy Metabolism Metastasis Metastasis-Associated Genes and Metastasis Suppressor Genes Intravasation Epithelial-Mesenchymal Transition Survival in the Circulation (Resisting Anoikis) Evasion of the Immune System Arrest in Target Tissues Early Survival at Distant Sites The Premetastatic Niche and Modulation of the Microenvironment Angiogenesis Metastasis from Metastases Ongoing Controversies and Areas of Research in the Field of Metastasis Does the Metastatic Propensity for Tumors Emerge Early or Late in the Biology of Cancer? Where Is the Inefficiency in Metastatic Inefficiency? What Is Dormancy and Where Do Dormant Cells Reside? The Enabling Characteristics Genome Instability Tumor-Promoting Inflammation The Pathway to Cancer The Tumor Microenvironment Cancer Cells and Cancer Stem Cells Endothelial Cells Pericytes Immune Inflammatory Cells Cancer-Associated Fibroblasts Summary and Future Directions References 3 The Pathology of Neoplasia Sample Handling Terminology Histologic Features of Neoplasia Grading and Staging of Neoplasia Assessment of Tumor Margins Assessment of Treatment Response Special Procedures Special Histochemical Stains Immunohistochemistry Electron Microscopy Flow Cytometry and Polymerase Chain Reaction Clinical-Pathologic Correlation and Second Opinions References 4 Epidemiology and the Evidence-Based Medicine Approach Measures of Disease Occurrence Incidence Prevalence Sources of Information on Cancer Occurrence Factors Associated with Cancer Risk Highlighted Findings from Observational Studies Environmental Exposures Hormones and Neuter Status Risk Factors in Cats Diagnosis and Screening Therapeutic Interventions Knowledge Gaps and Future Directions References 5 Paraneoplastic Syndromes Gastrointestinal Manifestations of Cancer Cancer Cachexia and Anorexia Protein-Losing Enteropathy Gastroduodenal Ulceration Endocrinologic Manifestations of Cancer Hypercalcemia Hypoglycemia Syndrome of Inappropriate Secretion of Antidiuretic Hormone Ectopic Adrenocorticotropic Hormone Syndrome Hypocalcemia/Hyperglycemia Hematologic Manifestations of Cancer Hypergammaglobulinemia Anemia Erythrocytosis Neutrophilic Leukocytosis Thrombocytopenia Coagulopathies and Disseminated Intravascular Coagulation Miscellaneous Cutaneous Manifestations of Cancer Alopecia Cutaneous Flushing Nodular Dermatofibrosis Necrolytic Migratory Erythema/Superficial Necrolytic Dermatitis Miscellaneous Syndromes Renal Manifestations of Cancer Neurologic Manifestations of Cancer Myasthenia Gravis Peripheral Neuropathy Diencephalic Syndrome and Miscellaneous Neuromuscular Syndromes Miscellaneous Manifestations of Cancer Hypertrophic Osteopathy Fever References II Diagnostic Procedure for the Cancer Patient 6 Imaging in Oncology Imaging Modalities Radiography Computed Tomography Ultrasonography Magnetic Resonance Imaging Nuclear Medicine Single-Photon Emission Computed Tomography and Positron Emission Tomography Advances References 7 Diagnostic Cytopathology in Clinical Oncology Sample Collection Collection Techniques Cytologic Stains Examination and Description of Cytologic Specimens Specimens of Diagnostic Quality Nonneoplastic Cells and Noncellular Material Found in Cytologic Specimens Description of Neoplastic Populations Sending Cytologic Samples to a Diagnostic Laboratory Interpretation of Cytologic Specimens Epithelial, Mesenchymal, and Discrete Round Cell Tumors Tumors of Epithelial Tissues Tumors of Hair Follicles and Sebaceous Glands Tumors of the Epidermis Tumors of Glands Salivary Gland Tumors Mammary Gland Tumors Perianal Gland Tumors Tumors of the Apocrine Gland of the Anal Sac Tumors of the Prostate Gland Tumors of the Urogenital System Transitional Cell Carcinoma Tumors of Organs Hepatocellular Tumors Biliary Tumors Tumors of the Exocrine Pancreas Renal Carcinomas Pulmonary Carcinomas or Adenocarcinomas Thymoma and Thymic Carcinoma Nasal Carcinomas and Adenocarcinomas Gastrointestinal Tumors Endocrine and Neuroendocrine Tumors Thyroid Carcinomas Parathyroid Tumors Chemodectomas Adrenal Cortical and Medullary Tumors Insulinomas Carcinoids of Lung, Liver, Intestine, and Colon Tumors of Mesenchymal Tissues Mesenchymal Tumors Composed of Spindle-Shaped and Stellate Cells Tumors of Fibroblasts Tumors of the Perivascular Wall or Nerve Sheath Tumors of Vascular Endothelium Tumors of Adipose Tissue Mesenchymal Tumors Composed of Thin Elongate Cells Tumors of Smooth Muscle and Stroma Tumors of Striated Muscle Mesenchymal Tumors Composed of Round or Oval Cells Tumors of Bone Origin Tumors of Chondrocytes Tumors of Synovial Cells Tumors of Melanocytes Mesenchymal Tumors Composed of Cells Arranged in Dense Aggregates Mesenchymal Tumors with Frequent Multinucleated Cells Discrete Round Cell Tumors Mast Cell Tumors Plasma Cell Tumors Lymphoma Tumors of Histiocytic Origin Cutaneous Histiocytoma Histiocytic Sarcomas of Dendritic and Macrophage Lineage Transmissible Venereal Tumor Mesenchymal and Epithelial Tumors That May Appear as Discrete Round Cell Tumors Tumor Metastases and Tumors Exfoliating into Cavity Effusions References 8 Molecular Diagnostics Goals of Molecular Diagnostic Testing in Oncology Methods for Analyzing Genes Detection of Chromosomal Abnormalities Polymerase Chain Reaction–Based Techniques: Detection of Mutations, Novel Genes, and Assessment of Clonality Detection of Genetic Insertions and Deletions Detection of Single-Base Mutations Detection of Fusion Gene Products by PCR Assessment of Clonality in Lymphoma and Leukemia Single Nucleotide Polymorphism Analysis Quantifying Genes and Gene Expression Real-Time Polymerase Chain Reaction Gene Expression Profiling On the Horizon—Counting Genes Methods for Protein Analysis Western Blots Immunohistochemistry and Flow Cytometry Proteomics Summary References 9 Biopsy Principles Biopsy Methods Needle Core Biopsy Punch Biopsy Incisional Biopsy Specialized Biopsy Techniques Endoscopic Biopsies Laparoscopy and Thoracoscopy Image-Guided Biopsy Excisional Biopsy General Guidelines for Tissue Procurement and Fixation Interpretation of Results References III Therapeutic Modalities for the Cancer Patient 10 Surgical Oncology Surgery for Diagnosis Surgery for Cure Lymph Node Removal Surgery for Distant Disease Palliative Surgery Cytoreductive Surgery Nonsurgical Locally Ablative Procedures Radiofrequency Ablation Cryoablation Hyperthermia Photodynamic Therapy Surgery and Chemotherapy Surgery and Radiation Prevention of Cancer Miscellaneous Oncologic Surgery Discussion References 11 Cancer Chemotherapy General Principles of Cancer Chemotherapy Mechanism of Cancer Therapy Terminology and Concepts Indications and Goals of Therapy Tumor Susceptibility and Resistance Tumor Cell Sensitivity Tumor Cell Resistance Combination Therapies Toxicities Associated with Drug Therapy of Cancer Safety Concerns of Cancer Drug Therapy Pharmacologic Principles in Cancer Therapy Pharmacokinetics Pharmacodynamics Pharmaceutics Specific Chemotherapeutic Agents Alkylating Agents Nitrogen Mustards Mechlorethamine Basic Pharmacology Clinical Pharmacology Clinical Use Melphalan Basic Pharmacology Clinical Pharmacology Clinical Use Cyclophosphamide Basic Pharmacology Clinical Pharmacology Clinical Use Ifosfamide Basic Pharmacology Clinical Pharmacology Clinical Use Chlorambucil Basic Pharmacology Clinical Pharmacology Clinical Use Nitrosoureas Lomustine (Cyclohexylchloroethylnitrosourea) Basic Pharmacology Clinical Pharmacology Clinical Use Streptozotocin Basic Pharmacology Clinical Pharmacology Clinical Use Other Alkylating Agents Dacarbazine Basic Pharmacology Clinical Pharmacology Clinical Use Procarbazine Basic Pharmacology Clinical Pharmacology Clinical Use Antitumor Antibiotics Doxorubicin Basic Pharmacology Clinical Pharmacology Clinical Use Mitoxantrone Basic Pharmacology Clinical Pharmacology Clinical Use Actinomycin D (Dactinomycin) Basic Pharmacology Clinical Pharmacology Clinical Use Antimetabolites Cytosine Arabinoside (Cytarabine) Basic Pharmacology Clinical Pharmacology Clinical Use Methotrexate Basic Pharmacology Clinical Pharmacology Clinical Use Gemcitabine Basic Pharmacology Clinical Pharmacology Clinical Use 5-Fluorouracil Basic Pharmacology Clinical Pharmacology Clinical Use Antimicrotubule Agents Taxanes (Paclitaxel and Docetaxel) Basic Pharmacology Clinical Pharmacology Clinical Use Vinca Alkaloids (Vinblastine and Vincristine) Basic Pharmacology Clinical Pharmacology Clinical Use Topoisomerase Inhibitors Epipodophyllotoxins (Etoposide and Teniposide) Basic Pharmacology Clinical Pharmacology Clinical Use Steroids Prednisone Basic Pharmacology Clinical Pharmacology Clinical Use Others Platinum (Carboplatin and Cisplatin) Basic Pharmacology Clinical Pharmacology Clinical Use Hydroxyurea Basic Pharmacology Clinical Pharmacology Clinical Use l-Asparaginase Basic Pharmacology Clinical Pharmacology Clinical Use Future Directions in Drug Therapies for Cancer Individualized Dosing Population Pharmacokinetics Molecular Profiling Tumor Sensitivity Prognostic Evaluation Novel Combinations References 12 Radiation Therapy Biologic Principles of Radiation Oncology Repair of Radiation Damage Cell Cycle Effects Oxygen Effects Relative Biologic Effectiveness Time, Dose, and Fractionation Acute and Late Effects Radiation-Induced Neoplasia Cell Survival After Irradiation Alternative Mechanisms of Radiation Injury Chemical Modifiers of Radiation Palliative Radiation Therapy Radiation Therapy Equipment Tumors Commonly Treated with Radiation Therapy Oral Tumors Efficacy of Treatment Radiation Considerations Treatment-Related Toxicities Nasal Tumors Efficacy of Treatment Radiation Considerations Treatment-Related Toxicities Brain Tumors and Pituitary Tumors Efficacy of Treatment Radiation Considerations Treatment-Related Toxicities Superficial Tumors of the Trunk and Extremities Radiation Considerations Treatment-Related Toxicities Bone Tumors Radiation Considerations Treatment-Related Toxicities Other Tumors Lymphoma References 13 Cancer Immunotherapy Immune System Control of Tumor Development and Growth Immune Surveillance of Cancer Mechanisms of Immune Evasion by Tumors Active Immune Suppression by Myeloid-Derived Suppressor Cells Induction of Regulatory T-Cells by Tumors Impaired Dendritic Cell Activation and Function Production of Immunosuppressive Cytokines Failure of Tumor Cells to Activate Immune System Strategies to Control Tumor Growth through Immune Activation Depletion of Immunosuppressive Myeloid-Derived Suppressor Cells to Allow for Effective Immunotherapy Nonspecific Immune Activation to Generate Antitumor Activity Using Biologic-Response Modifiers Bacillus Calmette-Guérin and Corynebacterium parvum Salmonella Superantigens Liposome-Encapsulated Muramyl Tripeptide Liposome-DNA Complexes Oncolytic Viruses Nonspecific Tumor Immunotherapy Using Recombinant Cytokine Therapy Interleukin-2 Interleukin-12 Interleukin-15 Interferons Interferon-α, Interferon-β, and Interferon-ω Interferon-γ Specific Immunotherapy for Cancer: Tumor Vaccines Tumor Antigen Targets for Immunization Tumor Vaccine Approaches Whole Tumor Cell and Tumor Cell Lysate Vaccines Immunization Against Defined Tumor Antigens Using Plasmid DNA Tumor Vaccination Using Viral Vector Vaccines Vaccination Against Tumor Antigens Using Dendritic Cells Antibody Therapy for Cancer Monoclonal Antibodies Conjugated Monoclonal Antibodies Cancer Immunotherapy Using Adoptive Transfer of T-Cells Transfer of Lymphokine- Activated Killer Cells Transfer of Tumor-Infiltrating Lymphocytes New Approaches to Adoptive T-Cell Transfers The Future of Cancer Immunotherapy References 14 Molecular/Targeted Therapy of Cancer n Section A Gene Therapy for Cancer Efficient Gene Delivery: The Major Hurdle to Clinical Benefits Viral Vectors Nonviral Gene Delivery Targeted Gene Delivery Gene Therapy Strategies for Cancer Rescue of the Cancer Cell Through Gene Replacement Technologies Destruction of Cancer Cells Through Delivery of “Suicide Genes” Utilizing Stem Cells to Deliver “Suicide Genes” Gene-Directed Immunotherapy Delivery of Chemoprotective Genes The Use of Replication- Competent Viral Vectors Miscellaneous Approaches to Cancer Gene Therapy Safety Considerations in Gene Therapy New Horizons References  Section B Signal Transduction and Cancer Protein Kinases and Normal Cells Protein Kinases and Cancer Cells Inhibition of Kinases Kinase Inhibitors in Veterinary Medicine Conclusion References  Section C Antiangiogenic and Metronomic Therapy Tumor Angiogenesis Antiangiogenic Therapy Inhibition of Proangiogenic Factors—Receptor Tyrosine Kinase Inhibitors Angiogenic Inhibitor Supplementation Direct Targeting of Tumor Endothelial Cell Surface Markers Other Antiangiogenic Agents Metronomic Chemotherapy Mechanisms of Treatment Clinical Trial Evaluation Veterinary Trials with Cyclophosphamide Other Alkylating Agents Platinum Compounds Biomarkers for Antiangiogenic and Metronomic Therapy Side Effects (Adverse Events) References  Section D Novel and Emerging Therapeutic Targets DNA Methylation Histone Deacetylase The Proteasome Heat Shock Protein 90 Poly Adenosine Diphosphate Ribose Polymerase and Poly Adenosine Diphosphate Ribose Glycohydrolase Carbonic Anhydrase References 15 Supportive Care for the Cancer Patient  Section A Management of Chronic Cancer Pain How Painful Is Cancer in Animals? General Approach to Cancer Pain Management The Importance of Alleviating Pain in the Cancer Patient Assessment of Cancer Pain Principles of Alleviation of Cancer Pain Pharmacologic Therapy Classification of Cancer Pain Drugs and Strategies Used for Management of Pain in Cancer Patients Nonsteroidal Antiinflammatory Drugs Acetaminophen Opioids N-Methyl d-Aspartate Antagonists Combination Analgesics Anticonvulsant Drugs Tricyclic Antidepressants Sodium Channel Blockade Steroids Bisphosphonates Neuronal Ablation or Exhaustion Therapy Radiation Therapy Acupuncture The Future: Toward a Mechanistic Understanding of Cancer Pain References  Section B Nutritional Management of the Cancer Patient Metabolism of Cancer: Substrate Utilization Cancer Anorexia and Cachexia Epidemiology, Prevention, and Risk Factors Implementing a Nutritional Plan for the Oncology Patient: Nutritional Assessment Feeding the Hospitalized Oncology Patient Coax Feeding and Pharmacologic Appetite Stimulation Assisted Enteral Support Parenteral Support Nutritional Support in the Cancer-Bearing Patient Substrate Amino Acids Polyunsaturated Fats Vitamins and Minerals Antioxidants/Supplements References  Section C Relationship-Centered Approach to Cancer Communication A Paradigm Shift: Paternalism to Partnership Relationship-Centered Care Core Communication Skills for Cancer Communication Gathering Information Identify the Client’s Full Agenda Elicit the Client’s Perspective Explaining and Planning Assess the Client’s Knowledge Level Give Information in Manageable Chunks and Checks Building Relationships Offer Partnership Ask Permission Express Empathy Demonstrate Appropriate Nonverbal Behavior Providing Structure Summarize “I Don’t Have Time for This...” Approaches to Cancer Conversations Delivering Bad News Discussing Prognosis Assessing Quality of Life Transitioning to Palliative Care Preparing Families for Euthanasia Providing Support for Grief and Loss Caring for Yourself Conclusion References 16 Complementary and Alternative Medicine for Cancer: Acupuncture What Is Acupuncture? How Does Acupuncture Work? How Might Acupuncture Benefit a Veterinary Patient with Cancer? The Importance of Approaching Acupuncture Scientifically Herbs Do Herbs Have Anticancer Benefits? How Do Herbs Work to Fight Cancer? Additional Issues with Herbs for Cancer Patients Examples of Herbs for Patients with Cancer Asian Mushrooms Curcumin Boswellia Milk Thistle Bloodroot Yunnan Baiyao Massage What Is Massage and How Can It Help Cancer Patients? How Does Massage Work? How Does Massage Benefit Cancer Patients? What Are the Risks of Massage for Cancer Patients? Laser Therapy What Is Laser Therapy? How Does Laser Therapy Work? How Might Laser Therapy Benefit Cancer Patients? How Might Laser Therapy Harm Cancer Patients? Homeopathy What Is Homeopathy? How Does Homeopathy Work? How Might Homeopathy Benefit Patients with Cancer? Can Homeopathy Harm Cancer Patients? Words of Caution General Considerations When Recommending Integrative Care for Oncology Patients References 17 Clinical Trials and Developmental Therapeutics Phase I Trials (Dose Finding) Phase II Trials (Activity/Efficacy Trials) Endpoints of Activity/Efficacy Phase III Trials (Pivotal/Confirming Trials) Sample Size and Power Randomization Phase IV Trials (Postregistration Trials) Good Manufacturing Practice/ Good Clinical Practice Criteria Effectiveness versus Efficacy Definitions Regulatory Oversight Veterinary Registration Trials Consortia Comparative Oncology Trials Consortium Animal Clinical Investigation Canine Comparative Oncology and Genomics Consortium Current Challenges and Opportunities in Oncology Drug Development New Trial Designs Adaptive Trial Designs and Stopping Rules Stopping Rules Bayesian (Continuous Learning) Adaptive Designs Randomized Discontinuation Trials Personalized Medicine Clinical Trial Ethics Conclusions References IV Specific Malignancies in the Small Animal 18 Tumors of the Skin and Subcutaneous Tissues Incidence Etiology Physical Factors Viral Factors Immune Status Genetic Abnormalities in Skin Cancer Basal Cell Carcinomas Squamous Cell Carcinomas Pathologic Classification of Skin Tumors History and Clinical Signs Diagnostic Techniques and Work-Up Treatment and Prognosis for Specific Tumor Types Epithelial Tumors Tumors of the Primitive Follicular Epithelium Basal Cell Carcinomas Basosquamous Cell Carcinomas Papillomas Squamous Cell Carcinoma in Situ Squamous Cell Carcinomas Tumors with Adnexal Differentiation Infundibular Keratinizing Acanthomas Tricholemmoma Trichoblastoma Trichoepitheliomas Malignant Trichoepithelioma Pilomatricomas Malignant Pilomatricomas Tumors of Glandular Origin Sebaceous Hyperplasia, Sebaceous Adenoma, Sebaceous Ductal Adenoma, and Sebaceous Epithelioma Sebaceous Gland Carcinomas Apocrine Gland Adenomas and Solid-Cystic Apocrine Ductal Adenomas Apocrine Gland Carcinomas Eccrine Adenomas and Carcinomas Neuroendocrine Carcinomas Renal Cystadenocarcinoma and Nodular Dermatofibrosis Tumors of the Ear Canal Ceruminous Gland Adenomas and Cysts Ceruminous Gland Adenocarcinomas Tumors of the Digit References 19 Melanoma Pathology and Molecular Biology Biologic Behavior and Prognostic Factors Size and Stage Staging Treatment Surgical Aspects Radiation Therapy Outcomes of Dogs and Cats Treated with Radiation Therapy for Oral Melanoma Combining Chemotherapy with Radiation Therapy Radiation-Associated Prognostic Factors Side Effects of Radiation Therapy Treatments Other than Surgery and Radiation References 20 Mast Cell Tumors Canine Mast Cell Tumors Biology of Canine Mast Cells Incidence and Risk Factors History and Clinical Signs Prognostic Factors Diagnostic Technique and Work-Up Treatment Feline Mast Cell Tumors Cutaneous Feline Mast Cell Tumors Splenic/Visceral Feline Mast Cell Tumors Feline Intestinal Mast Cell Tumor Comparative Aspects of Mast Cell Tumors References 21 Soft Tissue Sarcomas Incidence and Risk Factors Pathology and Natural History* Specific Tumor Types Tumors of Fibrous Origin Nodular Fasciitis (Fibromatosis, Pseudosarcomatous Fibromatosis) Fibrosarcoma Tumors of the Peripheral Nerves Peripheral Nerve Sheath Tumor (Neurofibrosarcoma, Malignant Schwannoma, Hemangiopericytoma) Histiocytic Disorders Tumors of Adipose Tissue Lipoma Intermuscular Lipoma Infiltrative Lipoma Liposarcoma Tumors of Smooth Muscle Leiomyoma and Leiomyosarcoma Tumors of Skeletal Muscle Rhabdomyosarcoma Tumors of Vascular and Lymphatic Tissue Lymphangiosarcoma Hemangioma Hemangiosarcoma Tumors of Synovial Tissue Synovial Cell Sarcoma Tumors of Uncertain Histogenesis Myxosarcoma Malignant Mesenchymoma History and Clinical Signs Diagnostic Techniques and Work-Up Clinical Staging Treatment Surgery Surgery and Radiation Therapy Radiation Therapy Chemotherapy Prognosis Feline Sarcomas and Vaccine-Associated Sarcomas Epidemiology and Risk Factors Pathology Diagnosis and Work-Up Treatment Surgery Surgery and Radiation Therapy Radiation Therapy Chemotherapy Prognosis Prevention Comparative Aspects References 22 Cancer of the Gastrointestinal Tract n Section A Oral Tumors Incidence and Risk Factors Pathology and Natural Behavior Malignant Melanoma Squamous Cell Carcinoma Fibrosarcoma Epulides Peripheral Odontogenic Fibroma Acanthomatous Ameloblastoma History and Clinical Signs Diagnostic Techniques and Work-Up Therapy Surgery Radiation Therapy Chemotherapy Prognosis Malignant Melanoma Squamous Cell Carcinoma Canine Oral Squamous Cell Carcinoma Feline Oral Squamous Cell Carcinoma Fibrosarcoma Osteosarcoma Epulides Peripheral Odontogenic Fibroma Acanthomatous Ameloblastoma Selected Sites or Cancer Conditions in the Oral Cavity Tonsillar Squamous Cell Carcinoma Tongue Undifferentiated Malignancy of Young Dogs Multilobular Osteochondrosarcoma Viral Papillomatosis Odontogenic Tumors Eosinophilic Granulomas Eosinophilic Granulomas in Dogs Eosinophilic Granuloma in the Cat Nasopharyngeal Polyps in Cats Comparative Aspects References  Section B Salivary Gland Cancer Incidence and Risk Factors Pathology History and Clinical Signs Diagnostic Techniques and Work-Up Therapy Prognosis Comparative Aspects References  Section C Esophageal Cancer Incidence and Risk Factors Pathology and Natural Behavior History and Clinical Signs Diagnostic Techniques and Work-Up Therapy Prognosis Comparative Aspects References  Section D Exocrine Pancreatic Cancer Incidence and Risk Factors Pathology and Natural Behavior History and Clinical Signs Diagnostic Techniques and Work-Up Therapy Prognosis Comparative Aspects References  Section E Gastric Cancer Incidence and Risk Factors Pathology and Natural Behavior History and Clinical Signs Diagnostic Techniques and Work-Up Therapy Prognosis Comparative Aspects References  Section F Hepatobiliary Tumors Incidence and Risk Factors Pathology and Natural Behavior Hepatocellular Tumors Bile Duct Tumors Bile Duct Adenoma (Biliary Cystadenoma) Bile Duct Carcinoma (Cholangiocarcinoma) Neuroendocrine Tumors Sarcomas Other Primary Hepatic Tumors History and Clinical Signs Diagnostic Techniques and Work-Up Laboratory Tests Imaging Therapy and Prognosis Hepatocellular Tumors Bile Duct Tumors Neuroendocrine Tumors Sarcomas Other Primary Hepatic Tumors Comparative Aspects References  Section G Intestinal Tumors Incidence and Risk Factors Pathology and Natural Behavior Molecular Aspects History and Clinical Signs Paraneoplastic Syndromes Diagnostic Techniques and Work-Up Physical Examination Clinical Pathology Complete Blood Count Chemistry Profile Cytology and Histopathology Imaging Plain and Contrast Abdominal Radiographs Thoracic Radiographs Abdominal Ultrasound Endoscopy and Laparoscopy Exploratory Laparotomy Therapy and Prognosis Surgery Chemotherapy Radiation Therapy Prognostic Factors Comparative Aspects References  Section H Perianal Tumors Incidence and Risk Factors Pathology and Natural Behavior History and Clinical Signs Diagnostic Techniques and Work-Up Therapy and Prognosis Comparative Aspects References 23 Tumors of the Respiratory System  Section A Cancer of the Nasal Planum Incidence and Risk Factors Pathology and Natural Behavior History and Clinical Signs Diagnostic Techniques and Work-Up Therapy Prognosis Comparative Aspects References  Section B Nasosinal Tumors Canine Nasosinal Tumors Incidence and Risk Factors Pathology and Natural Behavior History and Clinical Signs Diagnosis and Staging Treatment and Prognosis Feline Nasosinal Tumors Comparative Aspects References  Section C Cancer of the Larynx and Trachea Incidence and Risk Factors Pathology and Natural Behavior History and Clinical Signs Diagnostic Techniques and Work-Up Therapy Prognosis Comparative Aspects References  Section D Pulmonary Neoplasia Incidence and Risk Factors Pathology and Natural Behavior Clinical Signs and Physical Examination Findings Diagnostic Techniques and Work-Up Clinical Laboratory Findings Fine-Needle Aspiration Treatment Prognosis Comparative Aspects Miscellaneous Lung Conditions Canine Pulmonary Lymphomatoid Granulomatosis Histiocytic Sarcoma References 24 Tumors of the Skeletal System Osteosarcoma in Dogs Incidence and Risk Factors Etiology Physical Factors Genetic Factors Molecular Factors Pathology and Natural Behavior History and Clinical Signs Systemic Alterations Diagnostic Techniques and Work-Up Radiology Tissue Biopsy Staging and Patient Assessment Systemic Staging Surgical Staging Patient Assessment Known or Suggested Prognostic Factors Anatomic Location and Signalment Serum Alkaline Phosphatase Molecular, Genetic, and Immunologic Indices of Prognosis Therapy Directed at the Primary Tumor Surgery Amputation Limb-Sparing Surgery Allograft Limb Sparing Metal Endoprosthesis Limb Sparing. Pasteurized Tumoral Autograft. Longitudinal Bone Transport Osteogenesis. Ulna Transposition Limb Sparing. Nonsurgical Alternative Methods of Limb Salvage Intraoperative Radiation Therapy and Extracorporeal Intraoperative Radiation Therapy Stereotactic Radiosurgery Isolation of Limb Circulation and Perfusion Summary of Outcome Following Limb Salvage for Dogs with Osteosarcoma Surgery for Nonappendicular and Less Common Appendicular Sites of OS Radiation Radioisotopes Systemic Adjuvant Therapy for Dogs with Osteosarcoma Chemotherapy Cisplatin: Single Agent Carboplatin: Single Agent Lobaplatin: Single Agent Doxorubicin: Single Agent Doxorubicin/Cisplatin: Concurrent Combination Doxorubicin/Carboplatin: Concurrent Combination Doxorubicin/Cisplatin: Alternating Combination Doxorubicin/Carboplatin: Alternating Combination Carboplatin/Gemcitabine: Concurrent Combination Preliminary Agents Immunotherapy Molecular-Targeted Therapies for Dogs with Osteosarcoma Micrometastatic Adjuvant Setting Treating Gross Metastatic Disease Surgery Chemotherapy and Receptor Tyrosine Kinase Inhibitors for Gross (Macroscopic) Osteosarcoma Investigational Therapies for Gross Metastatic Disease Aerosol Drug Delivery Augmentation of Antitumor Immunity Palliative Treatment: Primary and Metastatic Bone Cancer Pain Bone Cancer Pain Physiology Palliative Radiation Therapy Radiopharmaceuticals Aminobisphosphonates Comparative Aspects Bone Surface Osteosarcoma Other Primary Bone Tumors of Dogs Chondrosarcoma Hemangiosarcoma Fibrosarcoma Multilobular Osteochondrosarcoma Metastatic Tumors of Bone Benign Tumors of Bone Osteomas Multiple Cartilaginous Exostosis Bone Cysts Primary Bone Tumors of Cats Incidence and Risk Factors Pathology and Natural Behavior History and Clinical Signs Diagnostic Work-Up Therapy and Prognosis Fibrosarcoma, Chondrosarcoma,

Considered the definitive reference on canine and feline oncology, Withrow & MacEwen's Small Animal Clinical Oncology, 6th Edition focuses on the most effective, cutting-edge techniques. This comprehensive textbook gives you a complete understanding of cancer in dogs and cats — what it is, how to diagnose it, and how to treat many of the most common cancers encountered in clinical practice today. The thoroughly updated sixth edition includes information on the complications of cancer, pain management, and the latest treatment modalities — preparing general practitioners to diagnose and treat pets rather than referring them to a specialist. With important updates on recently approved and in-development drugs, and new co-authors adding their own unique perspectives, this user-friendly text is a must-have resource for current, evidence-based therapeutic strategies on canine and feline oncology.

• Cutting-edge information on the complications of cancer, pain management, and the latest treatment modalities prepares you to diagnose and treat pets with cancer rather than refer cases to a specialist.
• Each contributor is a recognized expert in his or her specialty, reflecting the most current information by highly respected experts in the field of veterinary oncology.
• Full-color format provides you with accurate visual depictions of specific diseases and procedures, enhances visual appeal, and is used functionally in tables and boxes to highlight key information.
• A systems approach to the diagnosis and management of cancer facilitates access to information about the many malignancies affecting small animal patients.
• Discussion of compassion and supportive care for the management of pain, nutritional needs, and grief includes methods for handling the pet’s pain and nutritional complications as well as the pet owner’s grief when treatment is not successful.
• Comprehensive references at the end of each chapter and topic ensures you can be confident the information provided is accurate and up to date.
• Helpful drug formularies provide quick access to information on indications, toxicities, and recommended dosages for chemotherapeutic and analgesic drugs used in cancer treatment.
• Chemotherapy protocols are included when case studies prove clinical efficacy.
• Information on the best interventional techniques is quickly accessible all in one chapter.
• Nearly 400 color images provide accurate depictions of specific diseases and procedures.
• Focus on the most effective treatment options saves time by emphasizing proven treatment options that have been vetted by experts in the field.

• NEW! Expert co-authors and contributors bring a valuable perspective with research experience.
• NEW! Thoroughly UPDATED content includes important updates on recently approved and in-development veterinary cancer drugs, and critical advances in radiation delivery.