This year, Dr Rod Straw of Brisbane turns 60. He tells that he wanted to be a vet from the age of five, and since graduating from the University of Melbourne 35 years ago, has been.
Those intervening years have done nothing to dampen Dr Straw’s approach to medicine, which he practices in his clinic, the Brisbane Veterinary Specialist Centre. “I’ve got the best job in the world, and I still really love it,” the veteran practitioner cheerily admits. It has been in recent years that Dr Straw’s work in treating cancers in animals has gained the most attention.
He is a specialist in the field, and a dedicated advocate for further research. In 2012, his work resulted in a nomination for the Pride of Australia award. Dr Straw spends his days immersed in various areas of oncology treatment, and believes the more awareness devoted to it, the better. That commitment, however, occasionally attracts surprise reactions. “I have had people say, ‘Oh, you work in cancer, that must be so depressing,’ and the reality is it is the absolute opposite,” he says. “Certainly, it is emotional and can be very difficult, but win or lose with the outcomes, it is always a very satisfying field.
Although winning is ultimately what we want when treating an animal.” It is with a palpable sense of achievement in his voice as Dr Straw makes the claim, “Easily 50 per cent of the cancers that we now diagnose are survivable—and that is a world away from when I started. “And I believe that figure could be even higher if we all get on board with this understanding to share knowledge and expertise, and refer and consult as a veterinary community. Australia has a lot of really good people to participate in this revolution of cancer management.” When Dr Straw graduated from the University of Melbourne in 1979, the most common approach to cancer in an animal was what he referred to as ‘test, diagnose, do not treat, slaughter’, with most study done on the post-mortem floor. He says the advances made since—in the way a diagnosis is approached—reveals just how much of a revolution has taken place. “Not only do we now expect to diagnose a cancer, but we also know whether it is a sarcoma or carcinoma, and we also need to know what is the histological type, what grade of tumour it is and what are the molecular differences of these cancer cells to normal cells.” As a result, cancer treatment plans are no longer a one approach fits all. “We can tailor treatment from just surgery to surgery/radiation, surgery/radiation/chemotherapy, chemotherapy alone and some of the molecular switches like Palladia. We’ll also have other drugs able to interface at a molecular level and change how these animals, as well as people, survive their cancers.
This is a great time in cancer research.” The range of cancers Dr Straw sees in animals include solar-related skin cancers, lung, bone, brain, bowel and other GI cancers, nasal, with the most common malignancy being lymphosarcoma. “Skin and subcutaneous mast cell tumours are what we see very often in dogs, as well as soft tissue sarcomas and everything in between,” says the veterinarian. “There are certain breeds having a higher incidence of cancers and as cancer is a genetic disease, we know there will be oncogenes that may be passed on through families and breeds.” It is no understatement to claim the attitude towards treating animals for cancer rather than euthanasing has shifted not only in veterinary practice but also in the wider community.
While the chance to treat an ill family pet so they have a chance of survival is embraced by most pet owners, there are others who deem the process too cruel to inflict upon a beloved animal. This is why, Dr Straw says, medical practitioners need to be cautious about the treatments they consider, but also about making guarantees. “The treatment should not be worse than the disease and the tenets of medicine and our responsibility as health professionals still remains,” Dr Straw insists. “There is nothing appropriate about a treatment that is a triumph of technology over reason—I absolutely agree with that. You must balance what is available with what is fair, ethical and in the best interest of the animal. “We look at the things that we can do to extend the good quality of life, rather than just pushing the toxicity to the limit, just for the sake of knowing we have done everything possible. It is a matter of explaining that to the owner.”
While pursuing such a line of treatment once may have attracted claims of cruelty or pursuing unnecessary treatment, Dr Straw says with the significant improvements in the effectiveness of the treatments, he has never encountered such direct accusations. “I don’t get that,” he states. “There have been settings where there has been toxicity and complications and hasn’t been an outcome I expected. I am not a deity. “There are some trial-and-error things, but nowadays, with properly defined projects and animal ethics committees, I still believes we can make headway without causing the undue toxicity.”
While he has been acclaimed for his good work, Dr Straw also knows what the other side of the experience can be like. A few years back, his practice was mentioned in newspaper reports that put veterinary fees under tough scrutiny. One report questioned why, ‘Some pet owners have spent six-figure sums on cancer treatment at the (BVSC) facility’. “I do think it’s understandable,” Dr Straw responds. “People might think, ‘Why spend that much on an animal and vets charge way too much’. “But I can defend that we are doing this in an ethical way for the best of the community and for the animals, but it does come at a cost.Everyone has their own fee structures and I know what our overheads are and I know what our cost of service is.” One aspect of research that Dr Straw is especially committed to is the correlation in the way some cancers behave in animals and humans, and how effective research can lead to better treatment options to benefit both species.
Particularly from the work he began as a research project at the Colorado State University in 1986, Dr Straw has seen such a significant development that some cancer survival rates have gone from 25 per cent to 95 per cent. “We were looking at bone cancer, osteosarcoma,” he explains. “It’s a disease that, particularly back in the 1980s, was devastating for kids. If they had a bone tumour in their leg, the leg had to be cut off and then given the probability of 25 per cent to survive five years. A horrible, horrible disease. “Humans get exactly this same disease that dogs get, although dogs tend to be of older age. So there were large animal models with the same disease in humans. So I got involved with the limb preservation project and we figured out that the platinum drugs were potent anti-cancer drugs for both humans and animals.” The National Cancer Institute funded the research project and Dr Straw collaborated with Duke University, Massachusetts General Hospital, the University of California in Los Angeles, the Mayo Clinic, the Mile High Transplant Bank and the Children’s Hospital at Denver. “By the late 1990s, the translational research took limb-sparing from a futuristic thought to something that now is mainstream.
A lot of that work and information came from doing the work in dogs.” While Melbourne-born Dr Straw has spent a great deal of his career working and studying in the US, it was 10 years ago he opened the Brisbane Veterinary Specialist Centre—The Animal Hospital. The BVSC marks its 10th anniversary later this year with a fundraising celebration for the Australian Animal Cancer Foundation, a not-for-profit research charity founded by Dr Straw. He is also an Academic Associate with University of Melbourne, works with the University of Queensland Diamantina Institute, and helps train students from universities in five states.
Now, Dr Straw wants to focus on more research in areas like metastatic breast, prostate, osteosarcoma and hemangiosarcoma cancers. He also wants to set up better models so all the research and experience he and other clinics are gaining are funnelled into one knowledge base. “We are desperately under-utilising the tremendous number of spontaneous animal tumour models that come through the door each day,” he explains. “We aren’t putting them into a clinical trial setting or in a way that we can map the outcome of all these animals, even if it’s collaborative prospective studies to look at what happens to the dogs we treat with mast cell tumours. “There’s a tonne of knowledge that’s just going out the window. We’re just not recording it or putting it all together. If we had the resources and funds, I would love to set up something like a tumour registry in Australia.” Which is why, he adds, Dr Rod Straw has no intention of even considering retiring from a field he is still in love with. “No, not even close,” he adds with a laugh. “The relay race is still being run and you don’t slow down before you pass it on. I’ve still got a lot, lot more to do.”