Posted by Joyce Harman DVM, MRCVS on Apr 29th 2022
Cancer in the Equine
Disclosure
Joyce Harman was a consultant for Thorne Research and Natural Path. Though these companies are not specifically mentioned in the article, they do make products that can be used to treat cancer.
Introduction
Equine cancers are less common than in other species, and usually more expensive to treat. Few allopathic options are available for most cancers. Homeopathic, nutritional and herbal (Chinese and western) alternatives are useful and can be combined for effective treatments. One of the biggest problems in equine medicine is recognizing cancers before they are systemic and in the late stages. Skin tumors are more common and can be amenable to topical treatment as well as systemic therapies. Melanomas are a more difficult tumor to treat in many horses, as they seem to be almost a normal occurrence in grey horses.
General approach to cancer
An invasive cancer is one of the deepest aberrations of the immune system, consequently can be difficult to treat. The horse’s vital force or innate strength plays an important role in the outcome. The younger the animal is when the cancer is found, the harder it may be treat, since the inherited genetics or Energy is likely poor quality.
To begin treatment, the diet needs to be made as unprocessed as possible. Whole foods (vegetables and fruits) should form the foundation. In boarding situations this is often difficult, though owners can bring fresh foods as treats. Foods are best selected based on Chinese Food therapy energetics if possible. Green food powder extracts are useful for horses with limited access to healthy pasture and fresh grass.
Supplementation and treatments should be as targeted as possible, unless money is no object with the owner. Many immune system compounds and antioxidant formulas are expensive. In this author’s experience, Chinese herbal medicine and homeopathy are the modalities that have the deepest action and the best chance of bringing about a cure or successful palliation.
A factor to be aware of is the amount and type of other supplementation the animal is receiving. Owners are justifiably scared by the diagnosis of cancer and easily fall victim to the latest and greatest “cure-all” from the internet or their friends. Many of the products available are poor quality and supported mainly with hype, not science. There are also many products that help support the immune system and are valuable additions to a holistic treatment program.
If chemotherapies or an overload of supplements occur, it will be important to detoxify the liver and help it to function optimally. Equally as important is not to overload the system trying to accomplish a detox regime.
Homeopathic approach to cancer
The homeopathic approach to cancer begins with taking the case as one would with any dis-ease. The closer to the similimum the practitioner can be, the more likely to bring about a cure. However, the cases where a single remedy has brought about a complete cure are few.
A single remedy case example: A 10 year old Rottweiler with confirmed Lymphoma and a tumor on her neck several inches in diameter, one dose of Lycopodium and she lived another 2 years without any signs of a tumor. She died from acute pancreatitis. Was that suppression? Was it unrelated to the tumor? Was it the tumor progressing to a deeper level? Does it matter? She had a wonderful, normal 2 years, a quick death and by that time she was at least 12 years old, plenty old enough for that breed.
A big question arises when giving homeopathic remedies at the same time as powerful nutritional or herbal supplements. The perfect answer to this was spoken by Dr. Nicola Henriques, a human homeopath, at an Academy of Veterinary Homeopathy meeting, summarized: “I live in California, the land of the fruits and nuts, of course my patients take all sorts of stuff, but as they get healthier they need to take less and less”. She did not pay any attention or direct any worry to the supplements, since the correct remedy will work despite concurrent supplement therapy. However, the weaker the vital force the more the liver and the body’s energy has to process the supplements, leaving less energy directed at healing the immune system.
Dr. Ramakrishnan from India has had the opportunity to treat many cancer patients, since there is less control over the patients by our medical oncology machine. Over time he has developed an approach to treating cancer that is based upon classical homeopathy but uses the remedies on a repeated basis. He uses mostly higher potencies (200 and up) diluted in water, which seems well tolerated.
Ramakrishnan’s approach is to alternate between a cancer nosode and an organ or tumor-based remedy that was selected in part though the principles of classical homeopathy. He also has selected a group of remedies that he has found successful in treating the various cancers and within that group the practitioner selects the one that fits the patient.
In the equine this approach has been quite successful for some cases and offers an option when the similimum is hard to find. The similimum or the best that one can select is used for one remedy and the other would be one of the cancer nosodes. Remedies are changed as needed based upon the presenting signs.
Chinese herbal medicine (CHM), acupuncture
Traditional Chinese veterinary medicine (TCVM) needs to be prescribed constitutionally, since many cancer patients present with different TCVM diagnoses. Many are Qi deficient underneath their presenting imbalance.
Research has clearly shown that CHM has anticancer effects on cells by inducing apoptosis and cell differentiation, enhancing the immune system, and inhibiting angiogenesis. Other research has shown that CHM’s can improve survival, increase tumor response, improve quality of life, or reduce chemotherapy toxicity and in some cases enhance the effects of chemotherapy.
Tumors are stagnant Qi, often where Damp has accumulated until it forms a nodule. Toxins may accumulate in the Stagnant area, and stay there because the Qi does not flow to carry them out. Herbs are then needed to move stagnation. Drug therapy can increase the toxicity. The protective Wei Qi is usually deficient, so herbs to enhance immunity and protection are needed. With stagnation often comes poor absorption of food and elimination through the gut. Herbs to improve digestion help strengthen the Qi and carry toxins out. And finally herbs that have known anti-cancer effects are needed. Some of these move stagnation, some have known cytotoxic effects on cancer cells.
Acupuncture can be used as an adjunctive or a main part of the therapy. Experience is needed since poorly applied acupuncture could in theory stimulate a tumor growth. Well-applied acupuncture addresses the stagnation and TCVM imbalance, however, so it can help speed the process along.
Hyperthermia to treat tumors is commonly practiced in human medicine in Germany. Localized hyperthermia can be used with acupuncture needles to heat the tumor directly. This deserves exploration for veterinary applications. A few papers have been presented on thermochemotherapy, the combination of chemotherapy and hyperthermia. Several papers are being presented in the veterinary literature making use of this combination (Phillips). This may not be acupuncture directly, but makes use of a combination of modalities.
Nutritional and herbal supplements
Many compounds are available to support the cancer patient. Research has been done to define the ability of many compounds to cause apoptosis of cancer cells or to support the immune system. This author’s favorite compounds include many medicinal mushrooms (Reishi, Maitake, Cordyceps and Trametes versicolor), Milk Thistle, Turmeric, Noni, and Artemisinin. Resveratrol, Glutathione, Antioxidants including berry extracts (as whole food extracts), vitamins A, D3, E, and C are also useful.
Common tumors in horses
Sarcoids
Sarcoids are the most common tumor in the equine. In many cases they are benign and non-metastatic. Some cases are aggressive locally and a few can spread over a large area. There is evidence that the bovine papilloma virus is involved. Many sarcoids occur in areas of trauma, either in an area of an obvious wound after it heals, or in the girth area possibly from the pressure of the girth. There may be a genetic basis as well, though it can be hard to find out if the sire and dam were affected. Vaccination appears to trigger the development or progression of sarcoids.
Topical treatments can be used to remove the tumor. The most common, used conventionally as well as holistically, is a Black salve, a bloodroot preparation mixed with zinc chloride and other herbs (Chaparral, Red Clover, Galanga and others). This compound primarily attacks neoplastic cells and does little damage to normal cells. If a tumor is invasive the salve can undermine healthy tissue as it works on the diseased tissue, leaving a large open wound. It is best used for large areas during a season where flies are less. Clients need to be warned about the possibility of large open wound. These salves can also be painful when applied and during the first few days and are not safe for use around the eyes. Pain medication may be needed if the area is large or deep. The wound that appears afterwards can be treated with honey, Noni or many other topical herbal wound preparations.
Topical treatment does not necessarily remove the imbalance that caused the lesion. Steps need to be taken to improve the health of the immune system to prevent recurrences. Homeopathics such as Thuja, Causticum, Sulphur, and constitutional prescribing can correct the imbalance and vacccinosis that is behind this type of lesion. Nutritional and herbs supplements can be used.
Squamous cell carcinoma
Squamous cell carcinomas (SCC) are relatively common especially in horses with non-pigmented patches of skin and appear to be triggered by sun exposure. The use of non-toxic sun blocks and fly masks to shade the face can be helpful. These tumors usually affect the eyelids, conjunctivae, nictitating membrane, and limbal regions, but can also be found around the penis and sheath. SCC’s seldom metastasize, but can be locally invasive and persistent. Since many are near or in the structures of the eye, most topical applications are unusable. Careful constitutional prescribing with homeopathics or Chinese herbs can be used. Formulas that work to remove the stasis can be directed to the eye with herbs such as Chrysanthemum, which move the Energy up towards the eye.
Lymphosarcoma
Many internal cancers, with Lymphosarcoma being the most common, are often difficult to diagnose until large pieces of the organ system are compromised. In many cases the first sign is weight loss, which can come from many management issues, so time usually passes before cancer is considered. If the disease can be caught early, it may be treatable. A few suspected cases (diagnosed with thickened gut wall, weight loss, higher than normal blood calcium levels and young to middle age) have been treated homeopathically with some success.
Melanoma
Melanomas appear in at least 80% of grey horses, however in most they are not metastatic or aggressively invasive. Generally horses who have small lesions into their early teens do not develop any life-threatening tumors later in life. Rapidly growing tumors in horses under 12 years old seem to become larger and interfere more. Only a few percent of those become internally invasive and are the cause of death. Clients tend to worry when they see any size tumor, so it is common to be asked to treat these.
In this author’s experience, melanomas, especially slow growing ones, seem to be poorly responsive to treatment. One theory is that the melanoma is a normal abnormality in the melanocyte. If something is normal for a particular cell, it seems to have no reason to change. For the more rapidly growing tumors and younger horses, it is worthwhile to treat them, and a better response is seen.
Homeopathics, mushrooms and Noni appear to have the best effects at reducing the spread and growth. Seldom do they shrink and disappear, but if growth is slowed or stopped, the treatment is considered successful.
Ovarian cancers
The percentage of ovarian tumors is low compared to other types, about 2.5 percent of all equine cancers but higher than most other domestic animals. The most common is the granulosa-theca cell tumors that tend to cause reproductive dysfunction, and they may be aggressive. Behavior changes are common due in part to the alteration in various hormone levels. Mares can have elevated levels of testosterone, estrogen, both or neither or become anestrus. Other mares can have continual estrous behavior or will have extended cycles with short periods of non-responsiveness that do not follow any pattern. Some mares can become aggressive and show stallion-like behavior.
A very valid approach to treating tumors in general, holistically, is to debulk a tumor, then treat the imbalances in the immune system. This can be a useful approach here, as the ovaries are relatively easy to remove. Due to the aggressive nature of some of these tumors, homeopathic or Chinese herbal treatments should be done aggressively, and good immune system support is important also.
Lipomas
Lipomas in horses usually are internal and not visible externally. They may palpable on rectal exam. When pedunculated internally, the most serious problem is strangulation of the small bowel, which is usually fatal. Horses who tend to be obese as they enter their late teens, obese ponies and donkeys are at the highest risk. Phlegm moving Chinese formulas can be used to soften lipomas, though there is no way to tell ho well they work internally. Usually this author gauges the texture and health of the fat externally. If there is a great deal of hard, lumpy fat externally, there is more concern about internal lipomas. Soft, pliable external fat may be healthier internally. Diet and insulin resistance control may be the most important aspect of preventing a strangulation. The selection of an herbal formula would be based on the presenting pattern.
©This article is not to be reprinted or copied unless given permission by the author.
References
Boudreaux, M. Traditional Chinese Food Therapy. AHVMA, Tulsa, 2007.
Pitchford P. Healing With Whole Foods. North Atlantic Books, Berkeley CA. 1993.
Harman, J. Energetics of Food, Feeding for Optimal Health in the Equine. AHVMA, 2008.
J. Phillips. Thermochemotherapy for the treatment of solid tumors. 2010 ACVIM Forum Program.