Exclusive Interview with Dr Noopur Desai Founder of The Cancer VET: Revolutionizing Pet Cancer Care in India

1. What motivated you to become a board-certified veterinary radiation oncologist, and how did you decide to specialise in this field?

Dr.Noopur Desai: While pursuing Master's in Surgery at Bombay Veterinary College, I encountered numerous patients diagnosed with cancer but lacking adequate treatment options. There were no specialised veterinary oncologists in India at the time. It was disheartening to see pets and pet parents suffer due to this gap in healthcare. Therefore, I decided to delve deeper into Oncology with a goal to bring the knowledge back to India. After completing a Fellowship in Medical Oncology from Michigan State University, I pursued a residency in Radiation Oncology from the University of Madison-Wisconsin and obtained American Board Certification. 

After teaching Oncology at The Ohio State University- College of Veterinary Medicine, it was time to return to India. I worked for almost 4 years as an Oncologist in India before co-founding “The Cancer Vet” (TCV) in Mumbai and Pune. The goal of TCV is not only to provide comprehensive, easily accessible, quality care for pets diagnosed with cancer but also to train the next generation of oncology specialists in India. I find immense satisfaction in collaborating with dedicated veterinarians, whose shared expertise allows us to provide the best care for our patients.

2. Can you discuss some of the challenges you face as a veterinary oncologist in India, and how you and your team at The Cancer Vet are working to overcome them?

Dr.Noopur Desai: Working as a veterinary oncologist in India presents distinct challenges. Chief among these is the absence of standardisation in pathology and radiology reports used for diagnosing cancer. This lack of uniformity can lead to difficulties in accurately interpreting these results, impacting our ability to devise effective treatment strategies. In response to this issue, we at The Cancer Vet are initiating a training program in pathology and radiology. This training aims to address this knowledge gap, promoting improved accuracy and consistency in diagnostic reporting throughout India.

A further challenge lies in the accessibility of specific diagnostic tests, such as the BRAF mutation test—a urine test used to diagnose bladder cancer—and others like Flow Cytometry and PARR, which are crucial for diagnosing certain types of cancers. The lack of these tests can hamper the process of accurate cancer diagnosis, and we're actively exploring ways to make these essential tests more widely available.

Additionally, we face hurdles in sourcing certain essential cancer drugs like Palladia (for Mast Cell Tumours), Lavardia, Tenovia (for lymphoma), and the melanoma vaccine (for oral melanoma). These drugs are not easily obtainable in India, which significantly complicates treatment planning. Despite the willingness of many pet parents to travel internationally to procure these drugs, they remain challenging to source. Therefore, a significant part of our future strategy involves collaborating with pharmaceutical companies to make these critical medications more accessible in India.

Our most substantial challenge, however, is the limited access to radiation therapy for pets. This essential treatment is currently only available in Mumbai, restricting access for many pets in need. To address this, we're reaching out to radiation therapy facilities in hopes of expanding this treatment to other cities across India.

Overcoming these challenges is a significant task, but we are committed to enhancing the standard of veterinary oncology in India. We believe that these steps will help improve the overall landscape of pet cancer care in our country.

State-of-the-art cancer care - The Cancer VET

3. What is your vision for the future of cancer care for pets in India, and how do you see The Cancer Vet contributing to this vision?

Dr.Noopur Desai: At The Cancer Vet, we envisage a future where every pet in India has access to state-of-the-art cancer care. Our aspiration is to elevate the standard of veterinary oncology in the country to match, or even surpass, the level of care available in developed nations.

One significant challenge to achieving this vision is the current scarcity of specialised oncology training within the country. As a solution, we are investing in rigorous training programs and professional development opportunities to cultivate a new generation of veterinary oncologists. Our aim is not only to increase the number of practitioners proficient in oncology, but also to continuously raise the standard of care offered. We believe that by empowering more veterinarians with the skills and knowledge to provide specialised cancer treatments, we can make a significant contribution towards bettering pet cancer care in India.

Furthermore, to address the issue of accessibility, we have plans to broaden our geographic reach. While quality care is of paramount importance, we also understand that proximity to such services is crucial. Currently, specialised veterinary oncology care is limited to certain urban areas, leaving many pets in other cities or rural regions underserved. Hence, we're in the process of expanding our services to other major cities across the country. Our expansion plan aims to establish branches of The Cancer Vet in all major cities in India over the next three years.

We also intend to leverage digital technologies to extend our reach and deliver our services more efficiently. By offering teleconsultation and remote monitoring services, we can support pets and their parents even if they can't physically visit our centres.

Ultimately, our vision for the future of cancer care for pets in India is one of accessibility, quality, and compassionate service. We're committed to playing a pivotal role in this evolution, continually pushing the boundaries of what's possible in pet cancer care.

5. How does The Cancer Vet work with pet parents to ensure they have access to affordable cancer treatment options, and what resources are available to them to help manage the treatment costs?

Dr.Noopur Desai: The Cancer Vet is committed to ensuring that pet parents have access to affordable cancer treatment options. The clinic offers discounts on treatments and explores alternative paths that are effective and less expensive. Additionally, we assist pet parents in exploring financial resources available through charities and non-profit organisations that provide assistance for pet medical care. The goal is to manage treatment costs effectively and ensure that financial concerns do not hinder pets from receiving the necessary care. I would really encourage pet parents to get insurance for their pets which significantly helps with managing these costs.

 6. How do you work with pet owners to develop personalized treatment plans for their pets, and what factors do you take into consideration when making these recommendations?

Dr.Noopur Desai: We believe that each pet is unique, and so should be their treatment plan. Through detailed consultations, we understand the pet's individual needs, lifestyle, and the family's capabilities and desires. Factors considered in treatment recommendations include the type and stage of cancer, the pet's overall health, age, and underlying conditions. We discuss viable options, explain potential benefits and risks, and empower pet parents to make informed decisions. Our focus is on maximising dignity, minimising suffering, and enhancing the quality of life for pets with cancer while providing emotional support and guidance to their families.

7. Can you discuss some of the different treatment options available to pet owners at The Cancer Vet, and how you help them choose the right treatment for their pet's specific needs?

Dr.Noopur Desai: At The Cancer Vet, we provide a comprehensive range of treatment options to cater to various cancer types and stages. Our array of treatments includes surgical procedures, chemotherapy, and radiation therapy. Each of these treatment modalities has its strengths, and they can be used individually or in combination depending on the specifics of a pet's condition.

Surgical removal is often an effective treatment for many types of cancer. If the disease is localized and hasn't spread to other parts of the body, surgery can sometimes entirely eliminate the tumor. Moreover, we utilize cutting-edge surgical techniques to minimize discomfort and promote swift recovery.

Chemotherapy, on the other hand, is used when the cancer has spread, or there is a high risk of it spreading. We administer chemotherapy in a manner that minimizes side effects while effectively targeting and killing cancer cells. It's also important to note that pets generally handle chemotherapy better than humans do, as we use lower doses and prioritize the pet's quality of life.

Radiation therapy is typically used to target specific areas where the cancer is present. It's especially beneficial when the tumor is in a location that makes surgical removal challenging or if the tumor cannot be entirely removed with surgery. Radiation can reduce the size of the tumor and alleviate associated symptoms, improving the pet's quality of life.

The decision on which treatment to pursue is made based on a multitude of factors. These include the type of cancer, its location in the body, its stage and rate of growth, and the overall health and age of the pet. We work in close consultation with make an informed decision that best suits their pet's needs and circumstances. 

It's important to remember that while our primary aim is always to eradicate the cancer, in situations where a complete cure may not be possible, we focus on palliative care. This involves managing symptoms, reducing pain, and improving the pet's quality of life. The wellbeing of our furry patients is at the heart of everything we do.

We work closely with pet parents to help them choose the right treatment by considering factors such as the type and stage of cancer, the pet's overall health, age, and the potential side effects of the treatment. We have detailed consultations with pet parents to understand their preferences and provide them with comprehensive information about the treatment options, enabling them to make informed decisions. It's important to remember that while our primary aim is always to eradicate the cancer, in situations where a complete cure may not be possible, we focus on palliative care. This involves managing symptoms, reducing pain, and improving the pet's quality of life. 

 8. How do you emotionally support pet owners throughout the treatment process, and what resources are available to help them cope with the challenges of caring for a pet with cancer?

Dr.Noopur Desai: At The Cancer Vet, we provide emotional support to pet parents throughout the treatment process. We prioritise clear and compassionate communication to help alleviate anxiety and provide a sense of empowerment. We also facilitate support groups where pet parents can connect with others facing similar experiences. Additionally, we provide resources on self-care and stress management techniques. Our focus is on supporting pet parents in managing the emotional impact of their pet's illness while offering practical guidance and comprehensive care

9. What advice would you give to pet parents who are struggling to decide whether to pursue cancer treatment for their pet, and how do you help them navigate this difficult decision?

Dr.Noopur Desai: Making the decision to pursue cancer treatment for a pet can be an incredibly challenging process. As professionals in veterinary oncology, we understand the emotional complexity involved and strive to guide pet parents in navigating this difficult decision.

Firstly, it's essential for pet parents to understand that the primary objective of cancer treatment in pets differs from that in humans. While human oncology often focuses on lifespan extension, our primary concern in veterinary oncology is maintaining or improving the pet's quality of life. We use lower doses of chemotherapy and fewer sessions of radiation therapy compared to human treatments, which significantly reduces the side effects experienced by the pet. Our treatments are designed to be as gentle as possible, aiming to reduce discomfort, control symptoms, and, most importantly, allow the pet to live a happy, comfortable life.

Furthermore, we encourage pet parents to have an open dialogue with us about their concerns, hopes, and expectations. We believe in shared decision-making and want pet parents to feel comfortable voicing their thoughts and asking questions. It's crucial to remember that there's no universally right or wrong decision when it comes to pursuing cancer treatment. Every situation is unique, and what matters most is making a decision that aligns with the best interests of the pet and the pet's family.

Lastly, we're here to provide support throughout the entire process. Whether it's explaining treatment options, discussing potential side effects, or offering emotional support, our role extends beyond merely administering treatment. We see ourselves as partners in your pet's care, working together with you to provide the best possible outcome. As you navigate this difficult decision, know that you're not alone and that we're here to help in any way we can.

10. How do you involve pet owners in their pet's treatment plan, and what role do they play in helping to monitor their pet's progress throughout the treatment process?

Dr.Noopur Desai: Pet parents are an integral part of their pet's care team, and their involvement is crucial to successful cancer treatment. They provide valuable insights into their pet's behavior, habits, and overall well-being, which can significantly inform the treatment process.

Initially, we engage in a comprehensive discussion with pet parents to develop a personalized treatment plan. We strive to ensure that they fully understand the diagnosis, potential treatment options, associated side effects, and expected outcomes. We believe that by empowering pet parents with knowledge, we enable them to make informed decisions regarding their pet's care.

During the treatment process, pet parents play a vital role in monitoring their pet's progress and reporting any changes. They are often the first to notice subtle alterations in their pet's behavior, appetites, energy levels, or physical condition, such as reactions to medication or the development of new symptoms. These observations are vital for us as they can indicate whether the treatment is working or if adjustments need to be made.

Furthermore, pet parents are responsible for administering medications, adhering to dietary plans, and ensuring their pet's overall comfort during the treatment process. This requires ongoing communication and education to ensure that they feel confident in their role.

Post-treatment, pet parents continue their essential role in monitoring their pets. They observe for any signs of recurrence and maintain follow-up appointments to ensure their pet's continued health. Regular check-ups, often including diagnostic tests, are critical for monitoring the pet’s condition and catching any potential problems early.

Overall, we see pet parents as active partners in their pet's healthcare journey. Their involvement not only influences the course of the treatment but also contributes significantly to the overall well-being and quality of life of their pets. Their commitment and dedication are invaluable in the fight against cancer in their beloved pets.

Pet parents play an integral role in their pet's treatment plan and monitoring their progress. We involve them from the beginning, discussing treatment options and ensuring they understand the diagnosis, treatment process, and expected outcomes. Pet parents are vital in monitoring their pet's progress, as they provide valuable insights into their pet's behaviour and well-being. They observe and report any changes or reactions to medication, allowing us to make adjustments if necessary. Pet parents are responsible for administering medications, following dietary plans, and ensuring their pet's comfort. They continue to monitor their pet's condition post-treatment and maintain regular check-ups to ensure their pet's ongoing health. Their active involvement is crucial for successful cancer treatment and the overall well-being of their pets.

11. Can you discuss some of the follow-up care and monitoring that is required after a pet completes cancer treatment at The Cancer Vet, and how you work with pet owners to ensure that their pet remains healthy and happy?

Dr.Noopur Desai: After completing cancer treatment, pets require comprehensive follow-up care and monitoring. We schedule regular follow-up visits, usually every three months, to monitor their health and maintain communication with the primary veterinarian. These visits involve detailed physical examinations and additional diagnostic tests like chest x rays, CT scans or abdominal ultrasound, if necessary, to detect any signs of recurrence or spread of cancer. Pet parents play a crucial role in this process, reporting any changes in their pet's behaviour or physical condition. We collaborate with the primary veterinarian to manage ongoing care needs, ensuring pets remain healthy and happy long after treatment.

Training the next generation of oncology specialists in India

12. Can you share an example of a pet owner who was particularly involved in their pet's treatment at The Cancer Vet, and how their involvement impacted their pet's outcome?

Dr.Noopur Desai: There are multiple examples where pet parents' involvement has significantly impacted their pet’s cancer outcome. To mention one, Sam, suffered from bladder cancer as well as a brain tumor. He received chemotherapy for the bladder tumor and radiation therapy for the brain tumor. The pet parent was incredibly involved in his treatment, consistently following up with us about his progress and promptly reporting any changes in his behaviour or physical condition. This enabled us to adjust his treatment plan effectively, leading to successful remission and prolonged quality of life. 

13. What advice would you give to pet owners who want to be proactive about their pet's health and potentially prevent cancer from developing in the first place? Is it possible?

Dr.Noopur Desai: Approximately 1 in 4 dogs and 1 in 5 in cats will receive a cancer diagnosis in their lifetime. Regrettably, our pets are subjected to many of the same carcinogens that impact human health. While complete prevention of cancer is not possible, significant preventative measures include spaying cats and dogs; doing so before their first heat can decrease the chances of developing mammary cancer due to the reduction of hormonal influence. Furthermore, if your male dog has a retained testicle, it's crucial to surgically remove it, as there's a high likelihood of this turning cancerous in later years. Specific breeds are more prone to cancer than others, researching breed-specific cancer risks can help pet parents make informed decisions when selecting a purebred dog. Avoiding environmental factors like secondhand smoke and pesticides can also reduce cancer risk. Early detection and immediate treatment remain crucial and can have a huge impact on the treatment and prognosis, and TCV will be launching a training program to improve cancer diagnosis in primary care settings.

14. Finally, how do you see the role of pet parents evolving in the field of veterinary oncology, and what opportunities do you see for pet parents to become more involved in the care of their pets?

Dr.Noopur Desai: Pet parents contribute to early detection by recognizing subtle changes in their pet's behaviour and promptly consulting with veterinary professionals. They are more involved in ongoing care, managing medication, dietary needs, and post-treatment recovery. Advancements in telemedicine and digital health monitoring offer opportunities for pet parents to monitor their pets' health and personalise treatment. There may be chances to participate in clinical trials, providing valuable insights. Pet parents' involvement enhances care quality, fosters a sense of community and support, and improves outcomes for pets affected by cancer.