Sora’s cancer story is long, frustrating, and also fortunate, in many ways, given that she is still with us today and otherwise healthy.
We first noticed her cancer in 2015 and it’s come back four times since. We have talked about it in bits and pieces as it happens on social media, but have never shared the full story.
Not even six months after her treatment, we saw yet another tumor growing over the same spot we had treated just months prior. Now living in Spain, we had the tumor removed surgically, the fourth time Sora has had to have such surgery over the course of three years. While veterinary surgical costs outside of the United States are far less expensive, the cancer treatment available for her is not.
After spending $2,000 last fall for electrochemotherapy, $1,200 to surgically remove the tumor in October, [the cost of having to return to the US two days after arriving in Spain for the death of Dave’s father, and the additional $4,200 that we just spent here in Spain to pay for the radiation therapy, we just weren’t prepared to spend this amount of money in such a short time. I break down the costs of her most recent radiation therapy treatment below.
Just before leaving our home, our friends, and our lives behind in Portland to take off on our bicycle tour in April 2015, we noticed a small, black growth protruding from the center of Sora’s right paw. Having just sent our dog Maxwell over the Rainbow Bridge, days before our departure, we weren’t keen on having another pet issue to handle.
We did ask our vet about it during Sora’s health check for her international flight, and to our relief, he dismissed it as nothing more than a corn. We had nothing to worry about.
About a month into our journey, while camping in a small lake town in Germany, Dave saw that the growth had begun to bleed. We took Sora to the one and only veterinarian in town and they recommended that we have it removed once we arrived in Berlin. Unlike our veterinarian from the States, this small town vet suspected the growth was a tumor.
Feeling like we had a lead weight in our bellies, we made an appointment with a veterinarian in Berlin, who thankfully spoke great English. We pedaled with haste toward down the Copenhagen Berlin bike path, some 150 kilometers to go before our arrival.
We dropped Sora off and left her in the hands of a man about whom we knew nothing in a city where we were strangers in a country that wasn’t ours. The time dragged on like a glacier melting in February as we impatiently refreshed our email inbox awaiting a message from the vet to pick up Sora.
She was still out from the sedative when we arrived, but awoke with fury when Dave squatted down next to her to pet her. She barked and growled with ferocity, not knowing where she was and who was touching her.
The vet told us to leave her alone for a bit until she was more aware and asked us to sit down. He suspected that what she did have was cancer, but that the biopsy would reveal the truth.
Waiting for the results of a tumor biopsy is like a scene from Waiting for Godot.
VLADIMIR: Nothing you can do about it.
ESTRAGON: No use struggling.
VLADIMIR: One is what one is.
ESTRAGON: No use wriggling.
VLADIMIR: The essential doesn’t change.
ESTRAGON: Nothing to be done.
Finally, the results came in. The doctor invited us to come by to discuss. We sat in our chairs, numb, as he threw out words and phrases like cancer, highly likely to return, fibrosarcoma, amputation.
How could this be happening to Sora?
We decided to wait and see if it would return before submitting her to any
And it did. One year later, like clockwork, just as the German veterinarian had predicted.
Related: Going to the Veterinarian Abroad
While pedaling (pushing, really) out of a remote part of the Carretera Austral in Patagonia one year later, devastated over having just learned that our cat at home, Nima had cancer and would require amputation of his hind leg, Dave noticed the growth on Sora’s paw. The tumor remained internal this time, but there was no mistaking the familiar lump that grew below and stretched the scar of her original tumor.
We broke down, right there on the steep, dusty road that stole our strength after pushing our loaded bikes up hill after slippery hill. First Nima, now Sora, again. And we had lost Maxwell only a year prior.
Pushing on (quite literally), we arrived to Coyhaique, Chile, the largest town along the Carretera Austral and scheduled another surgery to remove the tumor. We took time off to allow Sora to heal before continuing on our journey. We were getting used to this by now.
Now the waiting, endless waiting for the results.
ESTRAGON: He should be here.
VLADIMIR: He didn’t say for sure he’d come.
ESTRAGON: And if he doesn’t come?
VLADIMIR: We’ll come back tomorrow.
ESTRAGON: And then the day after tomorrow.
ESTRAGON: And so on.
VLADIMIR: The point is—
ESTRAGON: Until he comes.
The biopsy arrived several months later, having been lost at the lab and switched with another dog. The results indicated “dog acne,” but we knew better.
Around the same time that we received Sora’s results, we also learned that Nima’s cancer had spread and the time had come to end his suffering. We elected to amputate his leg and it didn’t even do anything except make his life more difficult and painful. We felt sickened and angry. But that’s why cancer sucks, right?
A year passed. Sora seemed to be in the clear, cancer-wise. We had finished our bicycle tour and had returned back home to the Pacific Northwest for an extended break, before deciding our next adventure.
By the end of August, I noticed a large, irregular lump growing out of her right wrist, just above her other cancer spot.
My heart dropped like a glass jar, smattering into a thousands pieces across the floor because I knew. I knew that the cancer was back.
I made her turmeric paste, homemade meals, gave her supplements, we ran and hiked, and gave her the best life imaginable, and still, the fucking beast returned.
We found an amazing veterinarian nearby who performed an aspiration and confirmed the thoughts that clouded my mind each day. Cancer.
The creature below her skin was growing rapidly, tangling its spindly legs among her tendons, muscles, and nerves. That, coupled with its location (on her leg, where there is little room to remove a radius larger than the assumed tumor size), extracting the entire medusa would be impossible, leaving us with one of four options:
- Amputation, looking back, we almost wished that we had gone with this option after the first go around. Hindsight, right?
- Radiation Therapy, which meant living in Pullman, WA five hours away for three weeks while we took Sora to daily, very costly, treatments.
- Metronomics, a pill that administers low doses of anticancer drugs over a long period of time (from months to years). The idea is that the treatment stops the growth of new blood vessels that the tumors need to grow.
- Electrochemotherapy (ECT), a relatively new and highly successful form of cancer therapy that inject chemotherapy directly into the tumor. Electric pulses open the cells of the pore to open, thus allowing higher doses of chemotherapy to enter the tumor cells.
Electrochemotherapy fairly quick and painless and this is the option we chose. It just so happened that we had one of the few animal oncology centers with ECT treatment options in the US located just 15 minutes away.
In November 2017 just over two years after her initial diagnosis, we took Sora to her two ECT sessions, spread three weeks apart. She handled them well, if a bit loopy the remainder of the day, but back to her usual self the following day.
In fact, she ran 17.5 miles with us on New Year’s Eve, just six weeks after her final treatment.
Sora, the trail running buddy I had always sought, could still keep up with me after nearly 13 years on Earth and three rounds of cancer. My incredible Energizer bunny, who just keeps going and going.
Our move to Spain was anything less than painless. Not only did we have the stress of moving across a continent and an ocean, finding a pet-friendly apartment in a town where we knew no one, finishing our visa process, which required no fewer than 8,765 visits to various governmental offices that close every afternoon for three hours, we also dealt with the death of Dave’s father, who died just two days after our arrival in Spain.
Not even a few weeks after returning, securing an apartment, and completing our visa paperwork, Dave noticed The Lump. We were about to head out for a trail run and the joy of propelling ourselves freely through the woods was diminished by our heartbreak.
We ran with tears in our eyes, Sora by our side, cursing this wretched disease wondering why it wouldn’t leave us the fuck alone.
ECT works in 85% of patients. Sora was among the remaining 15 percent.
We found a vet down the street from us, and not even showered after our run, took Sora in and explained her long history with cancer. They put us on the books for surgery the next day.
Sora wasn’t allowed to walk more than the distance she required to go potty for over two weeks. We carried her 45lbs up and down four flights of stairs several times each day. She wore a horrible plastic cone that seemed more useful as a means of contacting aliens than protecting her from licking. She bashed into walls, our legs, counters, doors. The thing was pocked with dents marks by the time her soft cone arrived in the mail.
Meanwhile, we wait. Wait for the biopsy results. I wonder what will happen to Sora. Each night I lie awake in bed with my phone, researching. Cancer in dogs. Cancer diets. Supplements. Mushrooms. Therapies. Fibrosarcoma. How cancer behaves.
I know a lot about cancer now.
ESTRAGON: It’s awful.
VLADIMIR: Worse than the pantomime.
ESTRAGON: The circus.
VLADIMIR: The music-hall.
ESTRAGON: The circus.
At long last, they arrive. Sora still can’t walk and we need to act fact. This wretched brute is back for revenge.
Six weeks after Sora’s fourth surgery, and after consulting our veterinarians here in Spain and back home in Washington, we came up with a plan: Radiation Therapy.
For those who have never gone through radiation therapy, it looks something like this: very expensive machines beam large amounts of energy into the affected area of the body. The energy is strong enough to enter cells and affect their molecules, essentially damaging the cell’s DNA.
It can take months for the cells to die off.
To minimize damage, the dose is divided into many small treatments. In our case, eleven. This means that we took Sora to her treatment every day. Each session requires sedation.
Radiation therapy is very expensive. The machines alone cost $1M to purchase and $200,000 annually to maintain. Most countries or states have just one machine, and we were fortunate that the one in Spain was relatively close. One of the main reasons we did not opt for radiation therapy last fall was due to cost. Our total for the 11 sessions came to nearly $4,500.
In Spain, we were quite fortunate that the nearest center was only 1.5 hours away.
Regardless, each day left us wiped. We would wake up, take the dogs out, try and fit in a workout, feed Laila because Sora must fast, then we’d walk to our car which is parked at the top of a steep hill and drive the 1.5 hours. Then we wait for 45 minutes before picking her up. We grab a coffee to stimulate the drive back home. By the time we got back to our door, it was already late afternoon.
The main side effect for Sora is radiation burn, which is similar to a bad sunburn. Her fur may fall out and/or it may even grow back a different color. Another side effect is possible ligament damage. Since Sora’s treatment is right on her wrist, she may have a some inflexibility there after some time.
Sora finished her final treatment and has been amazing throughout this entire ordeal. She doesn’t complain when she can’t walk or when we put the cone one her, even after weeks and weeks of wear. She tolerates the medications and creams I rub all over her legs, shaved from needles and surgery. She trotted merrily to each session, greeting the staff with love every day. We don’t know what the future will hold in terms of her cancer, but we refuse to give in.
Cancer, we do not want to see you again. You are not welcome here.