Scrappy McDaniel fights off cancer

By Mindy Quigley
Illustrations by Megan Quesenberry

Scrappy McDaniel is every bit as feisty and determined as his name suggests. Since he was first diagnosed with a sarcoma in his spleen more than six years ago, the 11-year-old miniature schnauzer has fought cancer three times.

Scrappy’s owner, Jeremy McDaniel, a nurse practitioner from Hurricane, West Virginia, was already equipped with medical knowledge and so became Scrappy’s staunchest ally during the pet’s long treatment journey.

“With the first tumor, Scrappy did really well after the chemotherapy and basically returned back to his normal self,” said McDaniel. “It was a slower-growing sarcoma, so we were hoping that surgical removal and follow-up chemotherapy would cure it.”

But the sarcomahad other ideas. Three years after that initial surgery, the cancer cells popped up again, this time as two tumors in Scrappy’s liver. Another round of surgery and chemotherapy beat the cancer back once again.

That time, however, doctors were armed with another cancer-fighting tool in the form of a new drug: the human chemotherapy agent oxaliplatin. According to oncologist and lead study investigator Shawna Klahn, associate professor of oncology in the Department of Small Animal Clinical Sciences, “Given Scrappy’s history of tolerating chemotherapy well, we felt that he would be a good candidate for our Phase I clinical trial of oxaliplatin.” (See “Stages of a Clinical Trial”).

“The drug is in widespread use in human chemotherapy,” Klahn added, “and with the help of Scrappy and the other dogs in our study, we found that it was safe to administer to our canine patients.” Following the clinical trial and the new round of treatment, Scrappy and his owner enjoyed two more cancer-free years.

Now, doctors suspect that the sarcoma is back, in the form of a nodule on Scrappy’s lungs. For the time being, the tumor’s size has remained stable, and McDaniel has elected watchful waiting. “Scrappy will have another CT scan soon to monitor another spot in his lungs,” he said. “We’ve been lucky so far, so we’re hopeful that the lung mass won’t become a problem.”

Klahn feels that there’s reason to be hopeful. “Scrappy has beaten the odds time and again,” she said. “With newer, better treatments coming available all the time, we hope cancer success stories like his will become more common.”

New weapons for the battle

Radiation: The newest weapon in our utility belt!

Although radiation therapy has long been part of the standard-of-care treatment options for many forms of human cancer, this therapy has never before been available for veterinary patients in Southwest Virginia.

Beginning in summer 2020, however, the veterinary college’s Comparative Oncology Research Center (CORC) will offer radiation therapy for pets.

The center, which is currently under construction on the Virginia Tech Carilion Health Sciences and Technology Campus in Roanoke, Virginia, will have a state-of-the-art linear accelerator that can provide stereotactic radiation therapy with extreme precision, meeting criteria that certify it for human use.

The facility where the linear accelerator will be housed — nicknamed “The Vault” — will feature concrete walls with an average thickness of 6 feet, special shielding, and other elements designed to allow this powerful therapy to be delivered safely. More than 400 cubic yards of concrete were used for the floor and foundations of the treatment facility.

Safety measures for chemotherapy

It’s commonly known that chemotherapy can be hard on a patient’s body; in both humans and animals, the range of side effects can include gastrointestinal problems and fatigue. Less frequently discussed are the potential risks faced by those who administer these powerful agents.

As more veterinary practices have begun to offer chemotherapeutic treatment, Klahn felt that it was important to raise awareness about the potential risks to care providers. “Compared to the kind of high-dose exposure that cancer patients receive, research has shown that chronic low-level exposure to chemotherapy actually may have increased risk,” she explained.

In response, not only did Klahn collaborate with six experts nationwide to draft a consensus statement for the American College of Veterinary Internal Medicine, she has been working closely with the CORC construction team to ensure that the chemotherapy delivery suite will meet stringent safety guidelines.

Even though the college’s Veterinary Teaching Hospital already has safety guidelines in place, the purpose-built space at the Roanoke facility will advance the safety protocol, and Klahn is confident that CORC will be a national model for the safe handling and administration of chemotherapy. “Everything from the physical space to policies for training staff, storage and disposal of drugs, and the way we discharge pets will be rock-solid,” she said.

Novel devices in the anti-cancer arsenal

Virginia Tech researchers have been at the forefront of anti-cancer therapies, using a host of new devices that are designed to be more effective and cause fewer side effects.

In an ongoing clinical trial at the college, veterinarians have treated 14 dogs with High-Intensity Focused Ultrasound (HIFU), a non-invasive technology that uses ultrasound waves to target cancer. In humans, HIFU has been shown to activate the immune system, which can prompt the destruction of cancer cells. In turn, the veterinary trial is testing whether focused ultrasound will also activate the immune system in dogs with solid tumors, such as carcinomas and sarcomas.

In partnership with Virginia Tech’s Department of Biomedical Engineering and Mechanics, veterinary oncologists have helped lead the development of high-frequency irreversible electroporation (H-FIRE), a technique that uses electrical pulses to kill cancer cells. Less invasive and disruptive than traditional surgical methods, H-FIRE has been used successfully in equine and canine studies across a variety of tumor types. Tech researchers plan to continue this work with a new round of funding next year.

Vet Med's newest cancer fighters

Two new faculty members have joined the veterinary college’s cancer-fighting team. Joanne Tuohy, an oncologic surgeon with a background in integrative cancer care and translational research, was recruited to Virginia Tech to develop an oncology surgery service, which will move to CORC in 2020. Ilektra Athanasiadi, a radiation oncologist, will helm the new Varian Edge linear accelerator that will be housed at CORC. They join the college’s current oncology team of more than a dozen specialist faculty, residents, interns, laboratory researchers, and technicians.

Joanne Tuohy

Assistant professor of surgical oncology

Special skills

• Research expertise in extending survival time in dogs with osteosarcoma
• Ph.D. in comparative biomedical sciences (immunology)
• Bachelor’s degree in Greek and Latin, magna cum laude

Toolkit

Positron emission tomography–computed tomography (PET-CT), which provides sophisticated imaging that can help in diagnosis and surgical planning

Why she fights

“Veterinary oncology has tremendous comparative, translational potential to benefit human cancer patients, as well as pets.”

Ilektra Athanasiadi

Assistant professor of radiation oncology

Special skills

•  Studying radiation-induced brain injury to find drugs that can protect normal brain tissue during irradiation
• Palliative radiation therapy protocols to alleviate pain and maintain quality of life
• Stereotactic radiation therapy

Toolkit

Linear accelerator  

Why she fights

“My mother, a veterinarian who owns a small animal practice in Greece, taught me that veterinary medicine is a devotion to and passion for animals, not just a job.”

CORC on the horizon

Illustrative of the veterinary college’s dedication to working across disciplines to achieve optimal health for people, animals, and the environment, the Comparative Oncology Research Center (CORC) will be a vital part of the Virginia Tech Carilion Health Sciences and Technology Campus, which is adjacent to the Virginia Tech Carilion School of Medicine in Roanoke.

A state-of-the-art clinical and research hub, the new center stands to capitalize on a strikingly rare opportunity to integrate researchers across disciplines investigating animal and human health, conducting translational oncology research, and advancing comprehensive cancer care in pets and people alike.

Stages of a clinical trial

If a new therapy completes all phases of this lifecycle in veterinary medicine, the findings can provide good preclinical data to begin a Phase I human clinical trial.