Since the cancer had spread, Johnson opted for a definitive protocol, taking both a medical and radiation oncology approach to treat Logan. He continued on toceranib phosphate, a medication to slow tumor growth and decrease the risk of further spread to other areas of his body. Anal sac cancer without metastatic spread typically has a prognosis of two years, and sometimes can be cured with surgery, as these tumors tend to grow slowly.
"Logan developed recurrence and then was found to have a metastatic lymph node. When that happens, the prognosis is typically shorter because the cancer has already spread," says Dr. Kathryn Shaffert, V23 (she/her), small animal oncology resident at FHSA.
Logan underwent 12 radiation treatments at FHSA in early 2024, targeting the anal sac mass and lymph node.
"This is a less traditional approach based on a study involving a small number of dogs treated in Europe. It decreases the number of visits compared to the traditional 18 treatments under repeated general anesthesia that are required for every pet undergoing radiation therapy. The outcomes and side effect profiles were similar to the traditional 18 treatments. We thought Logan was a good candidate for the 12 treatments," says Morimoto.
Logan remained in good spirits throughout his treatments. "When he comes in, he's giving kisses, rolling for belly rubs. Logan enjoys seeing his oncology team. We love when our patients are excited to see us too," says Shaffert.
Logan participated in obedience and rally classes throughout his radiation therapy, and after completing all 12 treatments, started competing again in events. Together as a team with Johnson as his handler, Logan performs tasks in obedience trials, such as retrieving an object and jumping, and in rally courses, demonstrating teamwork as dog and handler move through a course of ten to 20 signs with skills to be performed.
"He never knew anything was wrong with him; he still doesn't," says Johnson. "His quality of life is the same as it's always been. He gets to run, go on walks, play, and learn new things. He's such a great little dog, I wouldn't have him if not for Tufts [Cummings School]."
Since his last radiation treatment in February 2024, the masses have not grown.
"They showed partial shrinking, but they did not completely resolve, which we call stable disease," says Morimoto. "This is a very positive outcome and expected response to many tumors from radiation therapy, because there is no 'cutting' involved. In other words, tumors may not disappear, but the goal is to stop them from growing."
"Logan's had a really exceptional response long-term in the fact that his tumors have stayed stable in size, and he hasn't had further spread of the cancer," adds Shaffert, who also notes Johnson's dedication to Logan, staying on top of his medications and re-checks. Logan takes medication daily and returns to FHSA every six to eight weeks for bloodwork and twice a year for a CT scan of the masses.
Johnson is grateful to the team at Cummings School and her veterinarian for conducting the rectal exam as part of Logan's annual appointment. If the tumor had not been found at such an early stage, the cancer may have progressed too far along for treatment to be effective.
"I can't say enough good things about the experience at Tufts [Cummings School]," says Johnson. "Not only has Logan gotten better, but he's happy to go. Everybody's been wonderful. He has been stable for a year and a half, thanks to Tufts [Cummings School] and radiation treatment."
The Oncology team is thrilled with Logan's response to treatment.
“Logan has a really active lifestyle, which is something owners don't always expect after a cancer diagnosis—he's still doing all the things that he loved to do beforehand,” says Shaffert. “Logan's always happy to be here, and that's always our goal. We try to maintain their good quality of life as long as possible with their cancer diagnosis, and Logan definitely exceeds that.”