CancerCare aids cancer patients in caring for their pets It’s only fair—didn’t Misho, Sully, Franklin, and Lily pitch in to help their humans? – The Cancer Letter

The Cancer Letter
Inside information on cancer research and drug development
The Cancer Letter
Inside information on cancer research and drug development
Bianca Ilich will always remember Dec. 12, 2018. 
In the morning, she went to ASPCA, brought home a tabby cat with moon-sized green eyes, and named him Misho. 
Ilich had grown up with pets in Sofia, Bulgaria. As a lone transplant to the U.S., she thought of Misho as more than an ordinary felis catus—Misho was family. 
That evening, Ilich’s doctor called with bad news: she had HER2/neu-positive, stage I breast cancer. Ahead of Ilich lay a bilateral mastectomy, 36 rounds of chemotherapy, and 10 years of hormone therapy—if all went well.
“My oncologist advised me that this is not the right time to have a cat. If the cat scratches you, it could become an infection. You’re immunocompromised. So, it’s not very smart,” Ilich said. “At the same time, he said, it could be a big help for emotional support. We looked at both sides of the coin.”
According to the 2021-2022 American Pet Products Association National Pet Owners Survey, pets can be found in 70% of U.S. households. That’s 90.5 million homes. Results from a 2018 survey by CancerCare, a nonprofit that provides free, professional support services to cancer patients, are consistent with these national demographics—almost 60% of respondents in the CancerCare survey had a pet at home.

CancerCare conducted its survey for a reason. The New York City-based nonprofit was considering setting up a program aimed at helping cancer patients keep their pets. How common are cancer patients like Illich? How many of them are struggling with the distinct challenges of pet ownership while receiving cancer care?
The results: 
Nearly half of respondents reported that pet-related physical activities became difficult or impossible to perform since their diagnosis. Challenges included dog walking (46%), shopping for pet food (65%), cleaning the litter (43%), and taking pets to the vet (53%). Almost 70% of respondents rated financial responsibilities associated with pets, such as paying for their pet food (68%) or visits to the vet (68%), as difficult or impossible since diagnosis.
Strain, physical limitations, and the amount of effort and work required were the primary challenges of pet ownership due to a cancer diagnosis. Nearly all the respondents (~90%) said that a program dedicated to helping cancer patients care for their pets would be beneficial.
​​CancerCare’s new Pet Assistance and Wellness (PAW) program offers financial assistance for pet-sitting, walking, food and boarding to cancer patients with a pet who meet CancerCare’s eligibility requirements. Veterinarian expenses, too, may be covered by a PAW financial assistance grant for eligible patients. Also, there is a CancerCare downloadable, comprehensive question guide, among other educational resources that can be found on the PAW Program webpage.  
“There are real unanswered questions in terms of what is the best way of caring for your pet. What happens if you have unmet needs for your pet? What happens if you are too tired to take care of your pet? Or are there any dangers from your pet during cancer treatment? Or do you present any dangers to them?” Fumiko Chino, member of the PAW program advisory board, and a radiation oncologist and co-lead of the Affordability Working Group at Memorial Sloan Kettering Cancer Center, said to The Cancer Letter.
When it comes to the subject of pets and cancer, Chino is the opposite of a detached observer. She credits her cat, Franklin, with helping her cope with her husband’s cancer care and the years of grief that followed his death.
“We adopted Franklin on the very last day that my husband felt well enough to leave the house for anything other than a cancer appointment,” Chino said. “Franklin really did rescue me from some dark times during my husband’s illness. And, also, when I was just alone. I was a new widow, alone, and he provided a lot of comfort for me. He got me through medical school.”
Chino has brought this personal understanding into her research, which is focused on financial toxicity, health care disparities, access, patient-reported outcomes, shared decision-making, survivorship, and end-of-life care. 
“People don’t quite understand how an animal is a therapeutic agent for people with cancer. It’s more effective for some of my patients than an anti-nausea pill or a pain pill,” Chino said. “And yet, sometimes we don’t respect that, as clinicians.”
Chino’s data say that attention must be paid. 
On Oct. 1, at the ASCO Quality Care Symposium, Chino and her team presented the results of a survey that showed that 98% of patients said their pets were extremely or very important in their recovery from cancer treatment, yet nearly half had to rely on others to help with pet care and expenses during their treatment—and 15% of patients had no help at all.  
“Animals are touchstones for our lives,” Chino said. “If you are an animal person, you understand that immediately.”
Here is how it began. In 2016, Patricia Goldsmith, chief executive officer of CancerCare, came upon a young woman and her dog sitting in CancerCare’s offices.
Goldsmith initiated a conversation. As a dog-crazy person, it’s what she does. 
“She was a 28-year-old radiation oncologist who had a very aggressive form of cancer. She thanked me profusely for allowing her to bring the dog into her counseling session along with her,” Goldsmith said.
“She explained to me that that dog gave her more support than her employer did. She talked about how that dog was the thing that made her want to live. And I thought about that, and I thought about how many of our clients are in a similar circumstance,” Goldsmith said. “I knew then and there that I wanted to create a program that would help cancer patients undergoing treatment keep their pet.”
Like Chino, Goldsmith isn’t guessing when she talks about the comfort an animal companion provides to a cancer survivor. Recently, she lost her “canine soulmate.” His name was Sully, and he was a Great Pyrenees. You can find Goldsmith’s ongoing appreciation of Sully on LinkedIn.
Sully provided comfort and support for Goldsmith through her cancer diagnosis and treatment, and was a source of inspiration for the PAW program. 
Two years after the program’s inception in 2020, Ilich is one of over 1,800 clients to whom PAW has provided financial assistance. 
Goldsmith doesn’t plan on slowing down:
“We will build a national database of resources for cancer patients caring for their pets. We will continue to build additional robust educational content and videos. We will create partnerships to help raise awareness and funding for this program.
“We will never waiver from our mission of supporting cancer patients and their beloved pets.”
In 2013, James Gullekson saw a photo of a Yorkie-Chinese Crested mix on the Good Karma adoption website and didn’t think twice.
“I saw one picture of her face and I didn’t even read all the stuff about her. I just immediately went to the application page and filled it out.”
Six years later, Gullekson was diagnosed with lung cancer. After overcoming his initial shock and fear, his “next worry was, oh my gosh, how am I going to get to the store?” Gullekson said. 
Like many patients, Gullekson suffered extreme fatigue while undergoing chemotherapy. “All the time—tired. I couldn’t sleep enough,” he said. 
“People don’t consider the labor that goes into caring for an animal,” Gullekson said. “Because it was hard. It was tough enough for me to get to chemo and radiation all the time; that was hard on me, you know, just having to drive.”
The PAW program sent Gullekson virtual gift cards so that he could purchase Lily’s food online. This way, her food was delivered to Gullekson’s door, saving him that extra trip out of the house. 
Lack of pet support can have more insidious effects than fatigue. Patients who are the sole owners of pets can be forced to choose between their animals’ well-being and their own. 
Lidia Schapira, professor of medicine (oncology) at Stanford University School of Medicine, director of the Cancer Survivorship Program at Stanford Cancer Institute, and associate director of the Office of Cancer Health Equity and Community Engagement,  has seen cases where a lack of pet support can be a barrier to care. 
“I distinctly remember a conversation with a patient in my clinic many years ago. She had metastatic cancer and a new problem that required immediate hospitalization,” Schapira said. “Her first thought was, ‘I can’t, because I’ve got to go home and take care of my dog.’ So we problem-solved together and found a solution that was acceptable to my patient. She found somebody who could tend to her pet so that she could get the care she needed. We must do everything in our power so that the bond between the person and their pet is preserved.”
Schapira is a member of the PAW advisory board and owner of a nine-month-old Goldendoodle named Oakley. 
“I’ve definitely had patients that have, for example, been unable to travel,” said MSK’s Chino. Patients have told her, “I have a dog and I’m the only person taking care of that animal, so I can’t come for my cancer treatment right now.”
“As a society, even though we get so much benefit from our animals, we still don’t think about these things when we’re actually thinking about care delivery,” Chino said. “We probably should, because many people consider their animals as members of their families, and you would never leave grandma in the house alone, either.”
The initial money for the PAW program came from the Patricia A. O’Callaghan Animal Care Foundation, a Philadelphia-based charity that, according to its 2020 tax filing accessed by The Cancer Letter, declared assets with a fair market value of just under $6.2 million. 
In 2019, the O’Callaghan Foundation gave the PAW program its first grant, and has provided additional grant funding over the years. On Sept. 6, the foundation gave its largest grant yet, an additional $1 million, structured to assist with support to the PAW program until 2030, including $500,000 slated to establish the program’s endowment. 
Goldsmith didn’t go out to find the money for PAW. Like a dog that finds his owners, the money found her.
I think that if it wasn’t for her, I probably never would’ve got off the couch. It made me feel better that somebody still needed me, even though I was so sick. And I was relying on her, too.
“I heard, from a couple offices down, a woman saying, ‘Yes! Yes! That’s it!’” Goldsmith said.” I ran down, and here was this woman sitting with our director of philanthropy at CancerCare.”
The woman voicing this enthusiastic approval was the executor of the estate of Patricia A. O’Callaghan. 
“The estate had two areas that they wanted to support,” Goldsmith said. “The first was the church. And the second was pets.” When the executor heard of the idea for the PAW program that was in the works at CancerCare, she knew it was a match for the estate.
The PAW program also found support through Amie’s Place Foundation, a non-profit that specializes in funding organizations which keep families and pets together safely at times of crisis. 
Amie’s Place initially provided the PAW program $167,125 in 2019, and renewed its support in Sept. 2022, granting an additional $346,000.
“Thanks to the generous support from the O’Callaghan Foundation and the Amie’s Place Foundation, the PAW program is now a reality,” Goldsmith said. “They made this program possible.”
The 2019 grant from Amie’s Place paid for the development of online educational materials and the establishment of an advisory board, made up of oncologists, veterinarians, and social workers who volunteer their time and knowledge to inform the PAW program. 
Among the advisory board members is Camille DeSantis, executive vice president, group head of corporate and biotech, and U.S. lead in Health Brand Development and Branding at Edelman, an integrated communications and PR firm.
DeSantis, a two-time cancer survivor, has a passion for dogs—particularly Welsh Terriers. She is the owner of a Welsh Terrier named Lucy, and is the president of the Glyndwr Welsh Terrier Club, a social group for owners of Welsh Terriers in the northeastern U.S. 
“This PAW program, to me, was sort of the Holy Grail of bringing my two passions together,” DeSantis said. “So, I went and volunteered on the PAW program from its very inception.”
DeSantis brought her expertise to the PAW program. She was involved in developing the original survey of CancerCare clients and helped to put together the initial messaging for the program.
So, when Edelman called on employees to pitch local nonprofit businesses in a “Shark Tank for Good” competition in the fall of 2019, DeSantis immediately thought of the PAW program. 
“I know they’ve helped me in the past personally. So, I was more than happy to try my darndest to get them as much program help as I could,” DeSantis said. 
When pitching to the Edelman Shark Tank, DeSantis made the issue personal. 
“I basically said, ‘How many of you own pets?’ And the hands flew up, because so many people have pets. And then I said, ‘How many people in this room have either personally been impacted by cancer or had a close friend or relative?’ And then more hands went up.” DeSantis said. 
“That’s when I said, ‘There’s a problem here. And if it hasn’t already, it’s going to affect everybody in this room,” DeSantis said. “It suddenly became very tangible.”
DeSantis and the PAW program were selected as one of the winners of the Shark Tank for Good competition. When the time came to begin the partnership between Edelman and the PAW program, DeSantis found that many of her colleagues were eager to volunteer to help with the project.
“I had to turn people away, because so many people wanted to touch this program,” DeSantis said.
The PAW program, as one of the winners, received a year of pro bono work, including strategy and message development. During the year, DeSantis’s team at Edelman designed and developed a video narrated by the television newscaster, advocate, and cancer survivor Katie Couric to communicate the purpose of the PAW program. 
DeSantis continues to work with the PAW program as a volunteer and advisor, conducting focus groups, reviewing content, helping with messaging and strategy.
Just as Gullekson finished treatment for his lung cancer, he noticed that he was experiencing frequent urination. A prostate-specific antigen test confirmed that Gullekson had prostate cancer. 
For his lung cancer treatment, Gullekson received chemotherapy and radiation therapy, followed by immunotherapy every other Monday for 12 months. His prostate cancer treatment was similarly grueling.
“I had to have 40 freaking treatments of radiation for the prostate cancer,” Gullekson said. “I had to do all this twice.” 
Animals are touchstones for our lives. If you are an animal person, you understand that immediately.
“Lily is not much of a snuggler, but I’ll tell you, when I was going through all that, she must have known, you know? They say that dogs can pick things up; they can sense things. So, it was funny because she would sit with me for hours,” Gullekson said. “She kept me in a good mood all the time.
“People are always concerned about making sure that the patient—the person who’s got cancer and going through all that—they all want to make sure that they’re okay. Emotionally, physically, and financially, they all want to help out those things,” Gullekson said. “They never think about how part of those people’s lives is their pet.”
Chino considers pet ownership part of the full socio-demographic background of a patient. “A true social history documents everything that’s important to the patient, and sometimes it’s their dog, Fifi,” Chino said. 
Despite the potential risks, Ilich kept these benefits front of mind. She decided to keep Misho. 
“At the end of the day, I said, you know what, it’s important to have somebody next to me, to help me, to give me a kiss,” Ilich said. 
“He was the only one staying next to me the entire time. He didn’t move from the bathroom while I was vomiting. When I lost my hair, he was always next to me. Even in the moments that I couldn’t stop crying, he was right next to me. I mean, he was feeling all my tears. He was next to me, cuddling, hugging me, basically the entire time. Every time when I was anxious, and I was crying, and out of breath, he was right next to me.”
Despite the relatively few studies examining the relationship between pet ownership and cancer, the effects can be extrapolated from inpatient pet therapy studies, which show overwhelmingly positive health benefits as a result of pet ownership and animal-assisted therapy, Chino said. 
One study published in the Journal of Pediatric Oncology Nursing demonstrated that in pediatric cancer patients, therapy dog visits led to lower distress and significant decreases in worry, tiredness, fear, sadness, and pain. 
“It’s not just the emotional support of the pet. I think a lot of people go to the warm and fuzzy place, and that’s wonderful, of course, but there are health benefits of having a pet that are particularly important to those undergoing cancer treatments” DeSantis said.
“There are so many impacts on blood pressure, impacts on stress hormones. Just petting an animal can bring your blood pressure and your stress hormones down. We all know the impact of the stress hormones on the immune system,” DeSantis said. “The ability to get up and take care of something other than yourself, the motivation that’s there. The ability to walk, even a little bit, while undergoing treatment.”
She talked about how that dog was the thing that made her want to live. I knew then and there that I wanted to create a program that would help cancer patients undergoing treatment keep their pet.
Gullekson had to climb six flights of stairs to take Lily out of his apartment building for walks. It was his only form of exercise throughout his treatment.
“I’ll tell you what, I think that if it wasn’t for her, I probably never would’ve got off the couch,” Gullekson said. “It made me feel better that somebody still needed me, even though I was so sick. And I was relying on her, too.”
After his father’s death, Gullekson had moved back to his hometown of Minneapolis after living for 30 years in central Illinois. He left behind his entire support system—all his friends.
“The only person I had, familywise, in the Minneapolis area, was my sister. Well, she works full time. So, it’s not like she could come over all the time. So, Lily—and I could cry right now—she’s the one who kind of helped me through all that, because I felt like I couldn’t leave her.
“It’s bad enough having cancer and going through the treatments, but whoever would’ve thought about their pets? Whoever did deserves a medal.” 
Gullekson is in remission as of August 2022. “Now that I’m in a good mood, Lily’s in a better mood—and she still sits right near me.”
October 28, 2022 | Vol. 48 No.39
“Your work makes the rest of it work,” NCI Director Bertagnolli says to clinical trialists at ECOG-ACRIN meeting
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