Prostate carcinoma (PC) is a prevalent cancer in men worldwide, with millions currently living with the disease. While routine screening and effective treatment strategies have improved survival rates in humans, the management of PC in dogs has posed significant challenges. However, recent advancements in less invasive treatment modalities offer promising alternatives. We will look at information from a review study regarding the current treatment options available for both dogs and humans, explore the potential of interventional oncology (IO) in canine PC, and discuss future trends in managing this disease.
Current Treatment Landscape: Dogs and Humans
Historically, treatment options for canine PC have been limited in efficacy and associated with high morbidity. In contrast, human PC has benefited from various successful treatment approaches, including radiation therapy, prostatectomy, and hormone therapy. The effectiveness of these interventions has contributed to high survival rates in men. In veterinary medicine, however, progress has been hindered by the lack of robust trials comparing treatment modalities and long-term outcomes in dogs with PC.
Exploring Interventional Oncology for Canine PC
Interventional oncology techniques are minimally morbid and offer advantages in the treatment of PC in dogs. These techniques include percutaneous access (such as prostate artery embolization and intra-arterial chemotherapy) or natural orifice access (such as urethral and ureteral stenting). While long-term data on these approaches are limited, studies have shown encouraging results in terms of tumor volume reduction and locoregional effectiveness.
The Advantages of IO
When considering IO techniques for canine PC, practitioners must evaluate each patient individually, taking into account disease burden, stage, and other patient and owner factors. IO procedures, such as embolization and intra-arterial chemotherapy, are less invasive and highly tolerable, making them appealing treatment options for localized prostatic disease. Urethral and ureteral stenting can also alleviate complications associated with progressive obstructive disease in the lower urinary tract, improving the quality of life for affected dogs.
Treatment Selection and Challenges
Factors such as owner finances, available resources (such as fluoroscopy), and procedural experience play a crucial role in determining appropriate treatment options for canine PC. Thorough evaluation of disease burden using imaging modalities like ultrasound, computed tomography angiography, cystoscopy, and cystourethrography is essential for treatment planning. While surgery and radiotherapy remain valid locoregional therapies, the associated morbidity and limited long-term outcomes may impact their acceptance.
Emerging Therapies Show Promise
Canine PC continues to present diagnostic and therapeutic challenges, with a guarded long-term prognosis. However, the translation of emerging therapies to veterinary clinical practice, such as stenting for malignant obstruction and prostate artery embolization, shows promise. IO techniques, both in the palliative setting (percutaneous or transurethral stenting procedures) and for direct treatment of PC (embolization, intra-arterial chemotherapy), offer exciting possibilities for canine PC management. Ongoing research is needed to optimize treatment approaches and improve outcomes for both dogs and humans.
In conclusion, the field of canine PC treatment is evolving, driven by advancements in interventional oncology. While surgical and radiotherapy options remain viable, the potential for less invasive techniques and improved quality of life for affected dogs is encouraging. With ongoing research and focus on therapeutic developments, veterinarians can optimize the management of PC in dogs, ultimately improving the prognosis and well-being of their patients.
