Chemotherapy and the surgery patient: principles and recent advances

Surgery is the mainstay of cancer therapy, yet there is mounting information demonstrating that chemotherapy is effective for the treatment of a wide variety of malignancies in dogs, cats and horses. Chemotherapy is not only being used to delay or eliminate metastatic disease, but also to enhance the local control of malignancies. New drugs and innovative combinations of chemotherapeutic agents are being evaluated at an ever increasing rate. Anticancer drugs are being delivered safer and more effectively because patients are being treated in new ways such as intralesionally or within body cavities. These agents are also being scheduled in more effective ways such as prior to, during, or after surgery. Techniques are being developed for drugs to be inhaled to reduce metastatic pulmonary disease. The purpose of this article is to review the general principals of cancer chemotherapy, the various toxicoses associated with these drugs, as well as examples of how chemotherapy has been used in combination with surgery.