Established in 1973, the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins has been committed to advancing the understanding of human cancers and developing more effective treatments.The National Cancer Institute (NCI) recognizes this Center as a Comprehensive Cancer Center, highlighting its involvement in clinical and laboratory research, education, community outreach, and cancer prevention.
In this video, specialists from the Johns Hopkins Kimmel Cancer Center offer a nutritional guide for patients with a pancreatic cancer diagnosis.
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostics.
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s pick: “Do no harm” – does that also mean waiting to start HT? Good debate ensues! (rd)
Topics Discussed:
All good with The General; TP53 and radiation; best combos with which to start HT on recurrence; pre-treatment PSMA reveals Nx and changes treatment decision; stopping Orgovyx after 13 months may prove a good move; switching to 3 mo. from 6 mo. LHRH Depot; weight gain on LHRH; spot too close to bladder for safe RT – stick with HT alone; more rowers than just ardee; our mountain climber’s doing very well and happy with his GU MO; slow albeit steady climb in PSA shows no source – intervene with HT or wait?; starting HT on Lupron and testicular pain – any connection?
Chat Log
APOLOGIES but a GoTo glitch only downloaded these 2 posts – who knows why??? If anyone who attended has entire Chat transcript, please forward to rd@ancan.org
Jeff Marchi: Withings Body+ Scale. Synchs to your phone
Hi-Risk/Recurrent/Advanced PCa Video Chat, June 11, 2024
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostics.
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s pick: Two men with metastasis sites that raise thorny questions (bn).
Topics Discussed:
His de novo metastasis was discovered less than a week ago — family rallies to his side as he weighs who to see and how to treat; midway through Provenge — leukapheresis yesterday, infusion in two days — what to expect?; radiating a spot near his clavicle means a tricky tradeoff; insurance cutover puts Orgovyx so near yet so far; will node radiation reignite bad radiation prostatitis?; at a treatment crossroads, but his spirits are too low to act; testosterone rising after ADT — why gynecomastia now?; Pluvicto’s been great and he wishes it could last.
From the Provenge website: Eat calcium-rich foods, such as dairy products and dark leafy greens, or take supplements; Eat a hearty meal within 4 hours of your appointment
AnCan – rick · 7:13 PM
Good suggestion, Dr. Jeff
AnCan – rick · 7:14 PM
But Ben has a good point too.
Ken Doyle · 7:29 PM
Prostate removed in 2009 and PSA has slowly increased to 4 but has accelerated some to about an increase of about 1 per year.
My 2018 Axumin scan showed two hotspots in prostate bed.
Then 2023 PSMA did not show hotspots due to distended bladder with tracer in it.
1. Should the scan provider have made sure that my bladder was empty and should I expect them to do a do over of the PSMA scan?
2. At age 80 and 14 years out with PSA increase of 1 per yr should I just “forget about it”?
AnCan – rick · 7:30 PM
Tx ken – for sure we’llg et to you!
Dr. Jeff · 7:31 PM
ImagingWest
Dr. Jeff · 7:31 PM
Hawthorne NY
Dr. Jeff · 7:32 PM
https://www.imagingwest.com/about
Ben Nathanson · 7:32 PM
thanks!
G – Denver · 7:34 PM
Need to drop – looking forward to our next session!
Matt M – Sac · 7:44 PM
Good evening gents! Have a great night andweek!
eric · 7:51 PM
I was going to say that there are exercises you can do from your chair.
eric · 7:52 PM
I do them expecailly when I’m in the office
AnCan – rick · 7:53 PM
He’s a big exerciser… we have to change attitudes
Adam · 7:59 PM
Gotta drop. Thanks for another great session!
Adam · 7:59 PM
You should!
Kirt Schaper · 8:07 PM
gotta drop
Steve Roux, MI · 8:11 PM
Good night gents! Time for some pills and a slice of pie. Have a GREAT week all!
Transperineal Biopsies – AnCan’s favorite Standard Bearer explains!
If you’ve been around AnCan’s prostate cancer programming, and for sure our Active Surveillance and Low/Intermediate Groups, you are certain to know AnCan moderator and medical journalist Howard Wolinsky. He has campaigned on many issues impacting men like him with very low, low and intermediate risk prostate cancer. The list is long – and included below!
Howard has three signature campaigns. He has worked ceaselessly to expand the number of men diagnosed with very low, low and low/intermediate risk prostate cancer who are treated with the active surveillance protocol. He is a founding member of the medical group advocating to rename very low grade prostate cancer something other than cancer. It recently dawned on us that AnCan, one of Howard’s ever present platforms, had never blogged on TPs.
TPs avoid the germy rectum and virtually never cause infections or potentially deadly and disabling sepsis, although nothing is 100%. The biopsy needle is placed through the perineum, the space between the rectum and the testicles. This is not only patently more hygienic avoiding all fecal material, but also allows access to posterior areas of the prostate that cannot be reached with the TR protocol. Here’s an excellent short video to better explain.
Over 800 people—fellow patients and some leading physicians—have signed his petition to phase out transrectal biopsies. Wolinsky called on Medicare and Congress to intervene after a scandal in Norway caused the European Association of Urology to take on the issue in 2021 when a Norwegian died from sepsis following a prostate biopsy. The policy head of EAU told Wolinsky that transrectal biopsies were tantamount to “malpractice” in Europe. Wolinsky moderated a debate on TP vs. TR at AnCan in 2022 AnCan also ran two webinars on the topic in 2022:
So what did the American Urological Association do?
You might expect some resistance to a major change in practice that’ would cost urologists time to be trained and up to $40,000 in equipment to set up this new approach. That’s what happened. Wolinsky, representing AnCan, as a consumer reviewer, told the AUA Early Detection Guidelines in 2023 that they should recommend transperineal biopsies as the preferred method. He said men were dying while they were debating which end of the egg is better to break first.
AUA still put TP on par with TR in its guidelines. A small step for men, as Neil Armstrong said on the first moon landing. The AUA is conservative and says it requires high levels of evidence from research before changing its guidelines—even though EAU counterparts consider TP their preferred method. Daniel Lin, MD, vice chair of the AUA committee, said in 2023 that randomized clinical trials would be the key to resolving the issue and several were coming in the next year.
Dr. Badar Mian’s single-center RCT at the University of Albany showed TR and TP essentially had the same results in terms of infections. It was widely criticized for not having enough patients to reveal rates for sepsis.
Dr. Jim Hu’s multi-center study based at Weill-Cornell “almost” showed a statistical benefit to TP in a paper presented last January. But no cigar. The study was expanded and it is clear that TP wins in this research. Hu told the recent AUA meeting about it, but won’t talk about the results until the study is published.
But TP, meanwhile, is in increasing demand. A poll of 145 AS-educated readers of TheActiveSurveillor.comfound that 36% had undergone a TP biopsy – far above the national average of 15% now and 10% two years ago. 54% of respondents expect to undergo transperineal procedures in their next biopsies.
None of this is say biopsies should be eliminated, just that they should be done as necessary and as infrequently as possible. A decade ago, urologists recommended annual biopsies. As their confidence in AS has increased, the frequency varies by practice: from every other year to three to five years as in Dr. Klotz’s practice in Toronto. Wolinsky’s own care as a peer in this Active Surveillance cohort has de-intensified with annual visits to his doctor, Dr. Brian T. Helfand | NorthShore He has not had an MRI or biopsy in eight years–though his doctor still considers Wolinsky on AS. At age 76, he is considering hopping off the AS train.
Just in case you think Howard is a one-track (or even three-track) pony, here are a few other issues he has undertaken on behalf of men living with very low, low and intermediate prostate cancer.
Where in the world is best for a radical prostatectomy?
Ever wondered whether medical tourism makes sense for a radial prostatectomy? After all, most of us are well aware that a RP comes with significant expectations for erectile dysfunction and incontinence. A recent paper in JCO Global Oncology analyses surgical outcomes in 10 countries covering almost 22,000 men, although by far the most (72%) come from Germany. Notably none are Scandinavian where we already know Active Surveillance (AS) for men with Low/Intermediate risk prostate cancer (PCa) is highest.
If you’ve been paying attention to our AS Mods, in particular Howard Wolinsky, you will already know that the US lags far behind when it comes to treating suitable men with AS. This study confirms 84% of men treated in the US were Stage 1 and 26% were Grade Group 1. Only the Barbers of Seville performed more aggressively treating 88% of T1 and 27% in GG1. The Brits were way out ahead treating just 13% of men with T1, 9% in GG1. G-d Bless the National Health Service and its cost saving measures.
Sexual dysfunction reported a fairly tight band between 40-53%. The happiest campers were those singing Waltzing Matilda in Oz, while the Brits were the loudest complainers, although Canada was slightly higher when weighted. US was in the middle.
Those Spanish toreadors caused the most urinary bother at 54% (33% when weighted) albeit 29% reported issues going in. The Italians only reported 1% after surgery and 10% before… either those Italian surgeons are true maestros, or the Signore are not being honest. USA was right around average at 9%.
The main caveats in the study are the huge variance in respondent numbers between countries with a heavy bias to Germany. The researchers also recognize that men in different countries may answer the survey referencing different standards. All told, this is the fist ever comparative study… and for me personally, I’d stick to the beaches and the Prado when visiting Spain!
There are a lot of numbers to plough through here, and a Mike Wyn deserves a big shout out for helping us get through them. If you want to dig into them yourselves, you’ll find the link at https://ascopubs.org/doi/pdfdirect/10.1200/GO.23.00420
AnCan and The Marsh (well renown, long-established theater company with a large following in the Bay Area and venues in San Francisco and Oakland) collaborateevery 4th Wednesday of the month for Solo Arts Heal.
Friends, it was my absolute privilege to choose, produce, and host May’s guest – Karen Broder. A wordsmith, singer, musician, performance artist, raconteur, provocateur. “I’ve been called all kind of names and most of them are true. But that doesn’t tell the whole story.”Karen’s inimitable humor creatively crafts an arsenal of anecdotes to battle the forces of frustration — both real or Imagined.
You will absolutely love this show, the only disappointing part is it doesn’t go on longer! Karen will regale and reveal some of the stories she spins to throw shade at serious, if not, trivial irritations. Enjoy a dose of home grown ‘Humor Infusion’ to whet your psyche with laughter, art, and song.
Karen is one of our very first art friends, and a beloved member of our community. It has been a pleasure getting to know Karen, and you’ll get to know her even better after this show.
Hi-Risk/Recurrent/Advanced PCa Video Chat, May 28, 2024
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostics.
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s Pick: Buzz (and cautions) on oxybutynin for hot flashes (bn)
Topics discussed
Diagnosed de novo and now crossing into hormone resistance — it’s time to update somatic tests and PSMA before new treatment; pancreatic cancer, multiple myeloma, and now a PSA uptick – but our low/intermediate group might be a better fit; his diagnosis mirrors Rick’s from 2007, as does his treatment plan — he may have Rick’s great outcome, too; don’t let weight gain get a head start on ADT; MSK’s “not so fast” disrupts treatment plan and angers his local radoc; what’s it like getting spot radiation?; surprised to hear Dr. E recommend whole-body MRI; hyperbaric oxygen for his prostatitis — what’s the cataract risk?; urine flow getting worse — suspect radiation-induced strictures; ignoring urination problems risks kidney complication; strictures have him self-catheterizing daily; hot flashes with a vengeance on Orgovyx as drug holiday ends; buzz over oxybutynin for hot flashes — but beware contraindications (including the lutamides!) and side effects; ADT fatigue mounting as the months roll on — only solution is to be strong-willed and exercise anyway; a bit of renewed discussion of the Embr Wave hot flash device; don’t overlook depression as a factor in ADT fatigue; probiotics might help mood — check your blood, too.
Chat Log
John A · 8:20 PM
odd Yezefski, patients like him, Tufts medical school, u of Washington fellowship and residency, specializes in GU
Mark Perloe, Sherman Oaks, CA · 8:48 PM
I don’t have the link, but I found a series of exercise videos on YouTube created by Hutch. They had a few that utilized bands are were quite easy to but into my regimen. I also got Peloton.
Mark Perloe, Sherman Oaks, CA · 9:22 PM
No, I’m pretty tied in to UCLA. Dr. Kishan is a leader in radiation and if planning RT, they have MRIdian SBRT. I would not advise anyone to seriously consider surgery. My bias, but I’ve spent the last three years online hearing about people with complications.
Wang Gao Shan – PANAMA · 9:25 PM
ASCO
Cheap Drug Eases Hot Flashes in Men With Prostate Cancer
— Anticholinergic oxybutynin for patients taking ADT also improved quality of life in the process
Mark Perloe, Sherman Oaks, CA · 9:25 PM
Darn 405 though.
Mark Perloe, Sherman Oaks, CA · 9:28 PM
I think MRIdian is the safest SBRT and the entire team is very experienced just doing prostates.
Mark Perloe, Sherman Oaks, CA · 9:29 PM
If you go to YouTube and search SBRT Kishan, there are numerous lectures he has recorded.
Mark Perloe, Sherman Oaks, CA · 9:31 PM
I would only go to a radiation oncologist who solely does prostate, bladder and kidney.
Frank Fabish Columbus OH · 9:35 PM
Thanks for the discussions guys. See you Tuesday.
Alan Babcock · 9:36 PM
I have to leave early
Joe Comanda (Philadelphia) · 9:40 PM
Need to leave right now. I’ll ask my question another time.
AnCan – rick · 9:40 PM
Did you ask for time??
Steve Schuler · 9:43 PM
F150 or smart car?
Adam · 9:48 PM
Gotta hit the rack guys. Thank you for the informed discussion. Remember, ANYTHING IS POSSIBLE!
Peter · 9:50 PM
Goodnight all!
Matt – Sac · 9:58 PM
Goodnight all, great info as always. Be well!
AnCan – rick · 10:08 PM
Embr Wave
AnCan – rick · 10:09 PM
From Len
AnCan – rick · 10:09 PM
https://embrlabs.com/products/embr-wave-2
Steve Schuler · 10:15 PM
Thought I’d mention, the estradiol has helped my hot flashes, with fatigue, and also my “dizziness”, which is not really dizziness but this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5732995/
Steve Schuler · 10:17 PM
Benign Paroxysmal Positional Vertigo
Norm Pollock · 10:18 PM
Life Extension: Mood Improve and L-Theanine XR. Heard a doc talking about the probiotic who said they were using it for Bipolar
Hi-Risk/Recurrent/Advanced PCa Video Chat, May 28, 2024
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostics.
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s pick: Hot takes on hot flashes; many thoughts on healthy eating. (bn)
Topics discussed
Mysterious hormone issue means he needs to take hydrocortisone on top of his Lupron — any problem?; off ADT, but hot flashes linger; Veozah might help, if you can get it — Dr. E is looking into a trial; tofu and ground flax tame his hot flashes; and then there’s estradiol — see our webinar with Richard Wassersug; disappointed by doc’s change of heart on a drug holiday — and her prediction that his testosterone will never exceed 100; holding off on prostatectomy while he amasses data; how to stay away from unhealthy “ultraprocessed” food; there isn’t just one healthy diet — it depends on what you need; more thoughts on a paper that appears to advocate wider chemo use; despite stellar author lists, some papers are the work of a hired medical writer; he’s on the borderline of chemo eligibility and not eager to cross over.
Chat Log
[Waiting for name] · 6:17 PM
camera won’t work now. going to try leaving and coming back
Dr. Jeff · 6:30 PM
fezolinetant
AnCan – rick · 6:32 PM
Veozah is commercial name
Jerry Grimes, Brighton, MI · 6:38 PM
low dose estradiol patches can also help reduce hot flashes, but that’s usually in the setting of very low, to no, testosterone. 0.025 to 0.05 mg/day patches. Look up Dr . Wassersug for more.
Unknown · 6:40 PM
Soy Isoflavones by Life Extension
THOMAS Matica · 6:44 PM
Sage tea (and others) for hot flashes from the Canadian College of Naturopathic Medicine https://ccnmicc.ca/hot-flash-support-prostate-cancer It does have some side effects, so do your research. Thomas
Julian – Houston · 7:03 PM
https://www.mskcc.org/nomograms/prostate
AnCan – rick · 7:04 PM
Tx Julian – you beat me to it.
Dr. Jeff · 7:15 PM
Yuka – Food & Cosmetic Scanner 4+
Check What’s in Your Products
Yuca
#2 in Health & Fitness
4.8 • 50.4K Ratings
Free
Offers In-App Purchases
Richard Fiske · 7:17 PM
Thanks.
Unknown · 7:22 PM
Hack Your Health: The Secrets of Your Gut is a great Netflix documentary
If you were walking down E. Luray Avenue in Alexandria, Virginia, maybe you saw this house ….
In front of that house was a table…..
… not, just any table but one bedecked with a white tablecloth, candle, red rose in a vase, wineglass, empty chair and more …
As you may have guessed, this is not just any house. Captain Jim Marshall (USAF Rtd) lives here with his good wife, Gail. It was Gail who came up with the idea to set up this symbolic table
On This Memorial Day We Honor The Fallen Soldier ★★
This table is reserved to honor our brave and selfless American military members who have perished on the battlefield, those who have not been returned to us after being taken prisoner on foreign soil, and for those who went missing and have not found their way back home.
The table is round- to show our everlasting concern for our fallen and our missing, and set for one, it is small, symbolizing the frailty of one prisoner alone against his or her suppressors.
The white tablecloth – symbolizing the purity of their intentions to respond to their country’s call to arms.
The single red rose– reminds us of the life of each of our fallen, and the loved ones and friends who miss them each and every day.
The vase is tied with a red ribbon – a symbol of our continued determination to remember our fallen and find our missing.
The slices of lemon – on the plate is to remind us of the bitter fate of those who will never return.
A pinch of salt– symbolizes the tears endured by the friends and families of those who have fallen and of those who have not returned.
The inverted wine glass– they cannot toast with us at this time.
The empty chair– they are no longer with us.
The candle – is reminiscent of the light of hope which lives in our hearts to illuminate their way home from their captors, to the open arms of a grateful nation.
Thank you Jim and Gail from all of us at AnCan Foundation on this National Memorial Day holiday!
Summarizing a webinar: Pet Aging, Illness, and Loss
Here at AnCan, we like to consider all aspects of our community’s livelihood. Whilst juggling our various illnesses with the demands of everyday life, some of us have the honor and privilege of sharing our lives with animals that love just as deeply as we do. Many have been there for us during the most difficult times of our lives. Through diagnosis, treatment, recovery, daily living, grief – you name it.
Trigger warning: Pet loss
I recently got the chance to listen to a webinar about grieving and end-of-life care for pets. This webinar, titled “Pet Aging, Illness, and Loss”, was hosted by Mettle Health. I’ll link it down below. Their guest speakers were veterinarian Mary Gardner & host BJ Miller. Mary Gardner specializes in end-of-life care for animals and euthanasia. It would seem to me that she also specializes in compassion; compassion for the pets she encounters and for their human caregivers.
I’m actually typing part of this blog post one-handed, as a newly rescued kitten purrs in one of my arms. We found her underneath a car just the other day. The life of an animal lover can leave our hearts so full. As cherished members of our families, pets provide love, comfort, and even health benefits – making their end-of-life care an equally crucial and compassionate endeavor.
I had to prepare myself for this one. Anyone who knows me or who’s taken a class with me will know how much my pets mean to me. And when you’ve had as many pets and emotional support animals as I have, you’ll know what it’s like to grieve them. It can be just as painful as losing a human loved one; and for me, the impact of the loss of a pet and the loss of a human are exactly the same.
Mary addresses an important question that doesn’t have a clear answer.
“How do I know when it’s ‘time’?”
They start by talking about the role of pets in our lives and how it’s changed over time. These days when people come to her for help, their pets have lived their lives in the lap of luxury, with all the pillows and modern comforts they could want. That’s an exaggeration, but you get the picture!
I remember a time when it was common for dogs to be chained up outside. Honestly, that’s still the case in some homes. Cats did, and still do, aimlessly roam the streets. The first dog I ever grew up with was named Jack. He was an absolutely sweet & protective German Shepherd mixed breed dog who lived his life often, but not always, chained to my grandparent’s front yard in the inner west side of San Antonio, TX. It was a different time, with a different attitude towards pets. I spent as much time outside with him as a 6-7-8-9-10-year-old could.
Working animals have their place, too, and no judgment at all for people whose animals/pets are working pets. The grand takeaway from this, however, is that no matter what, we still want them to have as happy and pain-free of a life as possible. It’s about compassion and care.
There are so many reasons to euthanize. Quality of life for the pet & caregiver fatigue are probably the biggest things to consider. Think about your “monetary budget, your physical budget, and your emotional budget”. I thought that was a great way to phrase it.
The entire point of euthanasia (and of this webinar) is to be able to minimize suffering, no matter their role in our lives. It’s a gift, really.
Quality of life
So, how can you tell if a pet is near its “time”? Gardner gives examples based on breed and ailment. Arthritis in big dogs, breathing problems, and more. Then she sprinkles in answers as to how she might assess the quality of life of this pet. She will go through a list of questions with clients that give her an idea of how to guide them. Consider this: How do they live? Is it living?
Sometimes their physical body is ready, but their mentality may not be. It can be hard to judge when it’s time because of that.
One thing Gardner stresses is that “It will always seem too soon until it’s too late”. Euthanasia is not about giving up. “It’s about ensuring that their goodbye is good.” Here’s something that hit home for me: if you know for sure it’s time, they’re usually really suffering.
When I heard that, I had flashbacks of moments where I regretted waiting too long. If only I’d had someone to tell me that the kindest thing to do would be to euthanize my pets before it was too much for them. My beloved Green Spotted Puffer fish, Puffy, comes to mind. I regret euthanizing when I did, and wish I’d proceeded sooner. I still feel a tinge of sadness every time I think about him. I’ve got to remember, though: he lived a very long, full life for a pufferfish in captivity. The happy, blissful days, far outweigh and outnumber that time in our lives. Hold on to those memories. Don’t put yourself down for feeling like you didn’t make the right call at the right time.
Quality of life continues to be a question that doesn’t have a clear answer. You’ve probably heard the reassurance, “Don’t worry, you’ll know when it’s time”. Well, actually, it isn’t that easy. You may even hear that sentence from veterinarians themselves. Unlike their human counterparts, veterinarians are typically not trained to have these end-of-life conversations. They may know the ins and outs of veterinary care, but they may be a little bit lacking in the palliative care and hospice departments. Of course, this doesn’t apply to all vets.
For Gardner, some people call her saying “We’ve had such a terrible week, I think it’s time”. Or, the opposite – “We had such an amazing week, I think it’s time”.
Caregivers
The webinar also talks about the role of caregivers. Human caregiving and animal caregiving have the very same symptoms. Anyone surprised? Not me. Gardner noticed this when she went to a conference about end-of-life care for humans. Caregivers for animals express the very same issues. It’s an emotional, physical, and monetary toll. This can be especially true for people in our AnCan community – those of us who are also living with cancer or chronic illnesses, or who are also caregivers to a beloved human.
I remember times when I declined to go out with friends on trips, or even a single night out when I had my rat, Pokka. Rats have a shockingly short lifespan, and this little rat and my pufferfish were my world at the time. I felt so bad leaving Pokka in his cage for too long, as he couldn’t live with any other rats. For 2.5 years, I just needed to be home for him. Although I felt bad for declining so many invitations from family and friends, I don’t regret spending a single second with my Pokka. I knew that my time with him was limited – especially as he got older, and his body started to deteriorate. For me, it helps to remember that those 2.5 years are just a drop in the bucket compared to how long my life could potentially be. It was all worth it.
It’s ok to feel frustrated at the situation. You may be feeling emotionally and physically tired. It’s possible to simultaneously be tired of the burden of all your pet’s problems, and want nothing more than to be there for them. Try to get support. Respite care is ok to ask for, even for pets. No judgment, whatever your situation is. It just is hard.
As with human care, hospice and palliative care are different (but related). Gardner works with clients to navigate both forms of care. Both she and BJ talked about how hospice and palliative care have negative connotations in the eyes of many people. Palliative care is the pursuit of a good quality of life. Hospice is all of that, but when the end is in sight. Have these conversations about palliative care and hospice if you feel your pet needs it.
Overall, this was a wonderful listen. Check out the full webinar here:
Mettle Health is dedicated to helping those with illnesses and conditions navigate their lives in a meaningful way. Take a look at the rest of their YouTube videos here:
There are some support groups you can find online, in addition to Facebook groups. I’m personally part of a private pet loss group on Facebook. Here are some resources I found just with a quick Google search:
above all, to make biopsies safer. He started this campaign with an article entitled
Ever wondered whether medical tourism makes sense for a radial prostatectomy? After all, most of us are well aware that a RP comes with significant expectations for erectile dysfunction and incontinence. A recent paper in JCO Global Oncology analyses surgical outcomes in 10 countries covering almost 22,000 men, although by far the most (72%) come from Germany. Notably none are Scandinavian where we already know Active Surveillance (AS) for men with Low/Intermediate risk prostate cancer (PCa) is highest.
If you were walking down E. Luray Avenue in Alexandria, Virginia, maybe you saw this house ….
In front of that house was a table…..
On This Memorial Day We Honor The Fallen Soldier ★★