G-Dog was taken off the clinical trial today.
It sounds so cold, so medical to say that, and yet that’s basically what happened. His Week 4 x-rays revealed progression of the cancer: the largest tumor had increased slightly in size, which apparently in and of itself would not have disqualified him from the trial because the increase was relatively slight, but more significantly, two new nodules appeared that weren’t there before. That was what concerned the clinical trial staff, and that is what tolled the bell.
The vet (Dr. C.) and I had a long discussion about our next steps, and ultimately decided that the best course of action for now would be to get him back on his previous chemotherapy protocol (doxorubicin), and then evaluate him again 3 weeks after his first dose. When he’d gone through that treatment when we still lived in our hometown, he had shown some improvement after 3 rounds, which was unexpected and most welcome, so we figured it wouldn’t hurt to try it again.
If, during the 3-week evaluation period, the cancer showed continued progression, then we would move him to a different chemotherapy protocol called metronomic chemotherapy using a combination of a drug called Palladia and another drug called Losartan. Metronomic chemotherapy has had good results in dogs with osteosarcoma, and while G-Dog has chondrosarcoma, Dr. C. thought he might still get considerable benefit from it.
Dr. C. was careful to emphasize that even if G-Dog did get significant benefit from either or both protocol, we’re not talking about longevity here but rather quality of life. Although we did not discuss a specific prognosis, I know that we would be incredibly lucky if G-Dog were to make it to Christmas.
And in a way, we are lucky. Almost exactly two years ago, G-Dog’s original radiologist had said that, with a carefully monitored treatment protocol — including extensive radiation — G-Dog should be able to live at least a couple more years. And here we are. A couple more years later. Twenty-four months of a beautiful, happy, active, playful life. We are lucky.
G-Dog and I will be making the long drive home tomorrow, through green mountain passes and deep canyons and probably a bit of rain here and there. We’ll stop for coffee, a cup of Puppaccino for him, and maybe a brisk walk through some forest. We won’t have to come back to the Major City for another 3 weeks, when he returns for his next round of chemotherapy — the clinic was able to get his first round done today — so in the meantime we’ll make sure we get lots of hikes, lots of treats, and maybe a few more Puppaccinos thrown in for good measure.
I barely kept it together while I was discussing G-Dog’s options at the clinic today, but I realized not long after that grief will always be there, waiting for the fall, and that in the meantime we can keep it at bay for as long as possible, and cherish the days as they come. Denial gets a bad rap in therapy, but can’t it also be a useful tool for survival and grace through trauma? I know the truth, and maybe in his own way, G-Dog does too, but the true miracle of dogs is that they embrace only the now. For them, time only exists in the present, and always and ever will.
So I’ll take my cue from G-Dog and lean into the day. Every day.