?Heidi the dog's sniffing leads to owner's cancer diagnosis

By Masaki Sugimoto

http://mctdirect.com/download.php?id=201512020801MCT_____NEWS_SVC_16914964_0000&type=TXT

By
Meredith Cohn

Tribune news service

BALTIMORE — Heidi finds things for a living. Lost pets, mostly. Sometimes drugs.

The
125-pound black shepherd-lab mix is a trained search and rescue animal.

So
one day in February when she began burying her snout into her owner’s chest and
pawing at her anxiously, and insistently, it was clear she thought she found
something important.

She
did. It turned out to be cancerous tumors in Anne Wills’ lungs.

“She
was physically barricading me on the couch,” said Wills, the 52-year-old
owner of the Arbutus, Md.-based Dogs Finding Dogs tracking service. “She
was drooling and scratching at my arms.”

At
first Wills thought the dog was sick, but when the vet cleared her, Wills
decided a few weeks later to get herself checked. A CT scan revealed the spots
in her chest.

Heidi
isn’t the first dog to appear to smell cancer in people. Anecdotes have been
circulating for years, and the animals’ super sniffers _ many thousands of
times stronger than human noses _also have been put to scientific scrutiny with
promising results.

Beginning
in 2004, published studies reported dogs appearing to find bladder, lung and
breast cancers with some reliability. In a study in 2014, dogs did even better
in finding prostate cancer.

Few
believe dogs will ever end up in doctors’ offices for routine screenings, or in
the labs with specimens, because of logistical and cost issues associated with
constantly identifying and training armies of pooches.

Scientists
don’t know exactly what chemicals the dogs are smelling and how early they can
detect them, which makes creating a machine to do the job a distant dream, said
Cindy Otto, a University of Pennsylvania veterinarian and founder and executive
director of the Penn Vet Working Dog Center, which trains dogs and conducts
research.

Otto
said most scientists began looking into olfactory possibilities after patients
like Wills swore their dogs found their cancer. They’ve run tests using
everything from patients’ urine and breath to blood.

“I
don’t think we should doubt dogs can do this, but how we translate it into
practical use is the question,” she said. “Maybe someday screening for
ovarian cancer will be routine like a pap smear” where a few cells are
scraped and tested for cervical cancer.

One
of Otto’s collaborators is Dr. Janos Tanyi, an assistant professor of
obstetrics, gynecology and oncology at the University of Pennsylvania, who
began participating in studies after his patients insisted their dogs
identified their cancers.

Tanyi
said he became a believer when research dogs, using his patients’ tissue, found
the cancer almost all the time. Some tumors were too small to show up in scans.

But
he also believes it’s only practical if scientists can develop an artificial
nose that could “test all night long,” he said.

“In
the long run, technology will get there,” Tanyi said. “It’s just not
as good as dogs yet.”

Early
detection tools would be most useful for ovarian and pancreatic cancers because
there are no such tests now, said Dr. Len Lichtenfeld, the American Cancer
Society’s deputy chief medical officer.

They
also could be useful in finding other cancers, such as breast, prostate and
lung, for which early screening tools exist but are imperfect, he said.

And
though he’s impressed with the research and the abilities of animals, he said
each time he’s been asked over the years what he thinks of the canine research
he hesitates a bit because advancement has been slow.

“I
wouldn’t say I’m skeptical,” Lichtenfeld said. “I’m cautiously
optimistic someday someone will find something able to be translated into
clinical use that is based on high quality evidence.”

In
the meantime, Wills’ doctor said he wouldn’t turn away a patient who came in
with a dog tale.

Three-quarters
of lung cancer patients who come to Saint Agnes Hospital in Baltimore aren’t
diagnosed until their disease is so advanced that it’s hard to treat, said Dr.
Enser Cole, the hospital’s chief of medical oncology.

That
has grim consequences: More people die of lung cancer than any other kind of
cancer, with almost 211,000 people diagnosed in the United States and more than
157,000 dying of lung cancer in 2012, according to the U.S. Centers for Disease
Control and Prevention.

In an
effort to find the cancers earlier, Saint Agnes has begun offering CT scans to
patients at high risk principally because they were tobacco smokers.

Wills’
cancer was caught when it was Stage IIIa, where the cancer had spread only to
nearby lymph nodes and still was curable, Cole said. It’s a lot tougher in the
next stages, IIIb, where the cancer has spread to lymph nodes farther afield,
and Stage IV, where it’s spread to other body parts.

Without
chemotherapy and radiation, Wills’ cancer likely would have advanced within a
few months, Cole said. The dog played an important role, he said, and so did
Will’s primary care doctor, who took Wills seriously when she described Heidi’s
behavior.

“You
trusted the dog and the doctor trusted you,” he said to Wills. “Good
thing. Early detection really changes your odds.”

Wills
had the largest and most accessible of her three tumors surgically removed. Two
others and any other diseased cells were targeted with chemotherapy and
radiation. (Some of her narcotics _ used for treating her pain and nausea _ had
to go in the freezer to keep Heidi from tracking them.)

Once
Wills’ treatment began, Heidi’s anxious pawing at her stopped. Her cancer is
now in remission, though she remains on maintenance chemotherapy.

At
about 9 years old, Heidi may soon retire as a search and rescue dog, work she
does for a ball and a scratch on her furry black ears.

On a
recent day in the lobby to the Saint Agnes Cancer Institute, she was splayed at
Wills’ feet, trying mightily to keep her eyes open even as other patients and
visitors fussed over her.

“I’m
so thankful for her,” Wills said. “But if she starts acting funny
again, I’ll be on Dr. Cole’s doorstep and I don’t care if it’s midnight.”