Question Details
Grade 2 Mast Cell Tumor
by meowwmeow - September 9, 2009
Hi Steve,

We recently removed a huge mass from the hindleg of a 12yo dog and the labs confirmed it was a Grade 2 mast cell tumor. Due to the location of the tumor, we could not excise with wide margins so the owners were warned of the possibility of recurrence. My question is whether it is possible to prevent such a recurrence using the modified XFZYT mentioned in previous posts for treatment of mast cell tumors. Thank you.

Felicia
Replies
by bannink
September 9, 2009
Felecia,

It is possible to prevent local recurrence with the modified Xue Fu Zhu Yu Tang and I have had several cases respond favorably to that treatment. With cancer, as we all know, there are never any guarantees but if they are not interested in additional conventional treatment such as radiation, modified XFZYT would be appropriate in most cases. For cases in which there is a lot of local inflammation, bleeding or poor healing post-operatively due to degranulation, I have used Xian Fang Huo Ming Yin (indicated for Blood stasis tumors with Heat, Phlegm), which clears Wind, Damp and Heat in addition to moving Blood.

Erin
by naturevet
September 9, 2009
Hi Felicia,

You won't get a better reply with more experience behind it than that. Erin is boarded in oncology.

Good luck!

Steve
by meowwmeow
September 9, 2009
Hi Erin,
thank you for the reply. unfortunately we do not have access to radiation therapy here so its just chemotherapy or alternative therapies.
btw, do you use XFHMY together with the modified XFZYT or in place of?

felicia
by naturevet
September 10, 2009
I think it would be XFHMY in place of XFZYT. Unless the dog has a lot of Damp Heat symptoms in its past, I'd start with XFZYT.

S
by bannink
September 10, 2009
Felicia,

Yes, I use one or the other. And, as Steve said, modified XFZYT is usually my first choice. I mentioned the XFHMY because you had said the mass was quite large and a lot of times these don't heal well post-op due to residual disease and larger tumors can often be quite erythematous and inflamed so I didn't know your patient's particular situation. If the surgery site looks good, I would go with XFZYT. Don't be afraid to use a generous dose if you are concerned about a more aggressive tumor based on rapid growth rate or lymph node metastasis. Some of these grade II tumors can behave more like grade III tumors, others are more benign in behavior.

Michigan State University has a "mast cell tumor proliferation panel" that can help predict behavior of grade II tumors if these owners are interested in being more aggressive with therapy. In cases that have high proliferation indices or c-kit mutation, they may elect to use chemotherapy in addition to herbs. I'd be happy to help you with interpretation of those results if they would consider chemotherapy in a more aggressive tumor. I have used XFZYT with chemotherapy. They seem to tolerate it well, although I have had a couple severely blood deficient dogs that have become quite neutropenic at normal chemotherapy doses. So I tend to be more cautious in those patients and use Vinblastine rather than CCNU/Lomustine.

Erin
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