NSAIDS for Cancer Therapy
Dear OncoLink "Ask The Experts,"
My wheaten terrier (11 yrs old) was diagnosed with TCC yesterday. She is prescribed Deramaxx. Is there any better treatment? Is this the same as Piroxicam?
Lili Duda, VMD, Section Editor of the OncoLink Veterinary Oncology Menu, responds:
Piroxicam, an NSAID, is a non-selective Cox-1 and Cox-2 inhibitor and has anti-cancer effects for both transitional cell carcinoma and squamous cell carcinoma in dogs, which is supported by the veterinary literature. Since those papers, veterinarians have prescribed other NSAIDS such as Deramaxx, in lieu of Piroxicam, because these newer selective Cox-2 inhibitors are associated with lower rates of side-effects, such as GI ulceration and upset. It is assumed (but not known) that the anti-tumor effects are due to the Cox-2 inhibition, so it is also assumed that cox-2 selective NSAIDs should work as well as piroxicam.
However, this remains to be supported in the veterinary literature. Chemotherapy is currently recommended as first-line treatment for canine transitional cell carcinoma, but Piroxicam (or possibly other NSAIDS) remains a reasonable palliative option. Please see our previously answered questions for more information on TCC treatment.