Dogs Give Love, Improve Outcomes in Cancer Study

Nick Mulcahy

February 06, 2015

Emotional and social well-being scores increased when cancer patients interacted with dogs during concurrent chemotherapy and radiation therapy sessions, a single-group study has shown.

Predictably, functional and physical well-being scores plummeted during this "horrible" time for patients, said lead investigator Stewart Fleishman, MD, from the Continuum Cancer Centers of New York at Beth Israel Medical Center in New York City.

"Usually, all four of these [well-being] scores track together and everything goes down," Dr Fleishman told Medscape Medical News in an interview.

Anecdotally, patients said they were boosted by the "unconditional love" from the pets and the "friendly dedication" of the pet handlers who brought the animals to the clinic, the investigators report.

One patient told Dr Fleishman, "I would have stopped treatment a few weeks ago, but I wanted to see the dog."

The study was published in January issue of the Journal of Community and Supportive Oncology.

The multimodality treatment was "intense" and rough on the patients, who all had head and neck cancers, and caused adverse effects such as pain, fatigue, skin lesions, and the inability to swallow solid food or speak, he said.

During the pet visits, "the patient and dog interacted in the usual ways," the investigators explain, "by petting, talking, and playing."

The visits took place in the radiation therapy waiting area, chemotherapy suite, or hospital rooms.

All 37 patients were treated at Beth Israel. The head and neck malignancies included oropharyngeal cancer (62%), hypopharynx cancer (11%), and esophageal cancer (8%). Most patients (81%) had stage IV disease.

The average number of clinic visits was 18 (for either chemotherapy or radiation). The average patient was 57 years of age, and 68% of the study cohort was male.

Over the 7-week study period, patients underwent "marked and significant" declines in physical well-being (P < .001) and functional well-being (P = .003), as measured by the standard Functional Assessment of Cancer Therapy–General scale, the investigators report.

However, social well-being increased significantly (P = .03), as did emotional well-being (P = .004), after declines in physical well-being at the assessment timepoints (baseline, 3 weeks, and 7 weeks) were controlled for.

"We were amazed at the effect size," Dr Fleishman said.

 
We were amazed at the effect size.
 

Bonding with animals has "long been recognized" by healthcare providers as being beneficial to human life, but "little research has been able to substantiate those claims with data," said Mary Jo Gilmer, PhD, RN, from the Vanderbilt University School of Nursing in Nashville, Tennessee, who was not involved in the study.

"This study begins to address an important gap in the literature," she told Medscape Medical News in an email.

 
This study begins to address an important gap in the literature.
 

On the first day of treatment, study participants met their certified therapy dog, which had been trained by The Good Dog Foundation, a New York–based animal-assisted therapy organization.

Before each "animal-assisted visit" (AAV), the dog is bathed and groomed. In addition, for health and safety reasons, the handler wipes a dog's paws before entering the waiting or treatment room.

"The dog's paws are the most significant issue," Dr Fleishman explained. "We use antibacterial wipes that are not too drying on their paws."

The patients are not the only beneficiaries. "Even the staff enjoys it. Instead of seeing glum patients, they see good cheer in the midst of a horrible time," he reported.

It is difficult to do a randomized clinical trial with the dogs, Dr Fleishman noted. For one thing, there is the problem of "crossover" in a single-clinic design, because the dogs typically interact with multiple patients in waiting rooms.

However, a randomized trial is currently looking at the effect of dog visits on children with cancer.

The Canines and Childhood Cancer study is examining the impact of animal-assisted therapy on children newly diagnosed with cancer, their families, and even the therapy dogs who visit them, as reported by Medscape Medical News. The trial involves about 30 dogs and more than 100 children from five pediatric hospitals in the United States. Dr Gilmer is one of that trial's investigators.

There has been a long history of using animals to improve human health.

The first documented study suggesting a beneficial effect of animals on human well-being was conducted in the 18th century at the York Retreat, a psychiatric facility started by Quakers in the United Kingdom, "where residents wandered freely around courtyards stocked with animals and birds," Dr Fleishman and colleagues write.

They conclude that their study "justifies the formation of community cancer center partnerships to make the use of AAVs a viable option."

"Most cancer centers" now have animal visits, Dr Fleishman said. He explained that in his work as a surveyor for accreditation for the American College of Surgeons Commission on Cancer, he has visited about 50 cancer centers, and the majority have AAVs.

This study was supported by grants from The Good Dog Foundation and Zoetis Animal Health. Dr Fleishman and Dr Gilmer have disclosed no relevant financial relationships.

J Community Support Oncol. 2015;13:22-26. Abstract

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