He Erin,
Sounds like you've gotten some good advise already from this group, but I'll add my 2¢ worth...
We have used both a local, well-respected oncologist (from Purdue) and also the vet teaching hospital at UC Davis... here's the pros and cons of each for us so far...
First some quick background: Jake was dx'd with bladder TCC 10/09, had the tumor surgically removed and then started chemo, Mitoxanthrone, at our local onc. Had 5 treatments before tumor recurred and cancer became resistant to Mitoxanthrone (it is, unfortunately, common for the cancer to become resistant to the chemo.) In Dec.09, he was also dx'd with toe melanoma, had his toe removed and began the melanoma vaccine. It was also discovered in Mar.2010 that one of the two cancers had spread to the lungs (no way of knowing which.) So we were trying to figure out what to do next and contacted many oncologists for phone consultation, including CSU (Colorado), Purdue (which specialized in TCC) and UC Davis. We ended up switching to UC Davis. We then began Carboplatin chemo and Jake had 5 treatments at UC Davis before the tumors again became resistant and began growing again. So now we are again at at crossroads, wondering what to do next.
Pros of vet school/ UC Davis:
1) MUCH cheaper! Even though a 5-hr drive, round-trip, it saved us $1000/treatment every 3 weeks to drive to Davis, for Jake's Carboplatin chemo (local onc = $1300 vs.
US Davis = $300) We would not have been able to afford to continue with our local vet. Everything else is 1/2-2/3rds less expensive as well -- ultrasounds, xrays, Rx's...
2) Access to latest treatments and, sometimes, clinical trials (this can also be a negative...see under cons)
3) Team of students, residents and board-certified oncologists/professors all working together to come up with the best method of treatment for your dog.
Cons of vet school/UC Davis:
1) Treatments can take several hours to all day. Jake never had to spend the night, however... at the worst, he was there from 8am - 3pm, but usually 3-4 hours.
2) When we began Carboplatin, UC Davis had no trials going on that Jake would have qualified for, so we got a host of different chemo options, similar to the ones our local onc was recommending. However, now that we're looking for an alternative treatment, now that the Carboplatin is no longer working, they are steering us towards 2 trials they currently have going, even though there's no history of using either with TCC and little success rate to date (they are in early stages of study, however.) No other more conventional treatments were discussed. So we're not sure they have Jake's best interest at heart, or if they're just looking for 'guinea pigs' to get into their trials. We're losing the "trust issue" which is very important in your relationship with whatever onc you choose.
Pros of local onc (from Purdue):
1) She's not biased towards one treatment over another...she's not involved in a trial or writing a research paper on one or another, just trying to give each dog the best care based on her own experience. She does seem to stay informed on latest treatments, attends conferences, stays up-to-date...
Cons:
2) She's way more expensive than UC Davis (which gets government subsidies to offset the costs.)
Pro for Purdue:
I have to say, also, that I have been talking to Purdue and think they're fantastic! If we were closer to Indiana, we would definitely get Jake into a trial they have going that is specific to TCC, I believe. They are having promising results, so they say. I speak with Patty Bonney, Dr. Knapp's nurse/vet tech (I can give you the number if you like.) She has always been very informative and super sweet and knowledgeable about all varieties of treatment options (chemos, radiation, surgery, etc.)
Of course, it also sounds like your local onc, being from Purdue, is equally a good choice...at least we're both lucky in that respect.
I wish you well in your decision and Meeve well in her treatment and fight,
JoAnn & Jake
(10-yr-old black lab, bladder TCC dx'd 10/09, toe melanoma dx'd 12/09)
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