The case of Mimmy Oshima

An unexpected cancer diagnosis.”

J-ARM（Hereinafter J）：Today we are talking with Dr. Yagura, director of Yagura Veterinary Hospital in Hashimoto City, Wakayama Prefecture, and the owner, Ms. Oshima.
The doctor started his practice 24 years ago in Hashimoto City, Wakayama Prefecture, and has been using our cell therapy for about 5 years.
He was the first hospital in Wakayama Prefecture to introduce cell therapy. Ms. Oshima, who will cooperate with our interview this time, welcomed Mimmy into her family,
She has been a patient at Yagura Veterinary Hospital for about 13 years, since she brought Mimmy into her family at the age of 2 months.
Please tell us about Mimmy and her family.

Ms. Oshima (hereafter Oshima)：Mimmy is a 13 year old miniature dachshund girl. She is so energetic that we have never seen her sick and limp. She went to the hospital every time she had an itch on her body, which she often complained of.
Now that I think about it, I often gave him meat in his diet at that time and that might have been the cause. I rarely went to the hospital except for itching.
She rarely went to the hospital except for itching. When Mimmy was 10 years old, I noticed a black spot on her stomach and at first I was worried that she had swallowed something strange, but she panicked and went to the hospital.
I was worried that she had swallowed something strange and rushed to the hospital. I went to the hospital in a panic. When the doctor saw me, he told me that the growth was a mammary tumor, which surprised me.
I was surprised to hear that it was a mammary tumor. I was really surprised to hear that the tumor was malignant, and I wanted to do everything I could for her.
I wanted to do everything I could for her, but I also did not want to see her suffer from the side effects of the medication. Then, the doctor suggested immunotherapy.
I was told that immunotherapy has relatively few side effects, so I decided to give it to Mimmy.
We decided to give immunotherapy to Mimi. This month will be the 36th session, and the doctor says that there is a good chance that she will be fine even if we stop the treatment, but to relieve our anxiety, we decided to give Mimmy a little immunotherapy.
I would like to continue the treatment in order to keep Mimmy healthy and with us for as long as possible. I am very happy that Mimmy is doing well now.
I am very grateful to the doctor and the immunotherapy because Mimmy is doing very well now.

J：Thank you very much. Next, I would like to ask the doctor.

J：How did you come to offer immunotherapy to Ms. Oshima? 

Dr. Yakura (hereinafter Yagura)：When we first saw Mimmy's lump, we knew it was a mammary tumor, so we proposed that the first course of treatment would be surgical resection followed by pathological examination for a definitive diagnosis, and surgical operation was performed. Since the pathological test result was malignant, we proposed two treatment options to Ms. Oshima: (1) anticancer agents and (2) immunotherapy. I told her that, based on my own experience, if Mimmy's lymphatic metastasis was caused by either anticancer drug or immunotherapy with fewer side effects, she could choose either of them as her future treatment. Within a week, Mr. Oshima came to the hospital and immediately decided to give her immunotherapy, so we immediately started immunotherapy by drawing blood. 



J：You said you made an immediate decision. Did you have any concerns about immunotherapy? 

Oshima：I was not anxious. The doctor's explanations made sense to me, and I was able to make an immediate decision because I wanted the treatment to be less stressful for Mimmy.
 
J：I see that you did. Thank you very much. 
 Has Mimmy ever had any relapses?

Oshima：She actually had a recurrence a year after the first resection. 

J：So it was. What was the nature of that recurrence? 

Yagura：She had lumps in her left mammary gland and in the remaining mammary gland on the right side. The lumps were removed and sent to pathology, which showed that the one on the left side was benign and the remaining one on the right side had lymphatic metastasis. Because of these results, we decided to continue immunotherapy for the rest of her life. There was a child who had a mammary tumor and the same lymphatic metastasis at the same time as Mimmy, but she completed one course of immunotherapy and died within a year or so, so I feel that the long-term continuation of the treatment has allowed Mimmy to have a high quality of life.

"Cellular Therapy as a Habit.” J：Mimmy is not receiving any other treatment, is she?

Oshima：Yes, I do. I think she is thinking that the monthly lymphocyte therapy is already a habit, so if she go to the hospital, and she goes to the hospital, they're going to take her blood. LOL.

Yagura：She does not like it when she takes her blood a little bit, but she is mature about it, like there is no one left to help her when her mother (Ms. Oshima) is gone, so there is nothing she can do. LOL. I want to avoid the risk of bacteria entering the bloodstream, so I sedate her when I take her blood. 

J：It seems to be a glimpse of a funny side. How is she doing during the infusion? 

Yagura：When I give an IV, she is not in a bad mood like when I draw blood. When we do IV drips, she moves, so I basically have the owner hold her during that time. I have never had any problems during the infusion, but I ask the owner to call me when something goes wrong so that I can see the pet immediately. 

Oshima：When I first put an IV in her, she would fall asleep in my arms, and as I watched her sleeping, I knew that one day I would have to say goodbye to her. I was really sad when my old dog passed away, and I thought I would never have another dog, but my child wanted one, so I met Mimmy 13 years ago. She's been with me since she was two months old, and I can't imagine parting with her. As an owner, I am happy to feel like I am treating her together. 
J：Are there any particular things that you are careful about in cell management? 

Yagura： Mimmy's lymphocyte count is a little low to begin with, so I imagine that it will take about 2 days longer than other patient to reach a good count. I change the date depending on the increase in the number of lymphocytes. I always make an appointment for the infusion in two weeks, check the increase at the beginning of the week, and contact you later to confirm the date. Ms. Oshima comes in the afternoon, so I start making cells about an hour before his appointment so that I can administer fresh cells as much as possible. When he comes in the morning, I come early in the morning to make cells. I try to administer fresh cells as much as possible.

"I want this to go on for as long as possible.” 
J：Is there anything that you keep in mind in order to tell owners about this treatment? 

Yagura：The treatment should be considered in the long term as much as possible. Normally, the number of doses is 6, but I am a little worried that the tumor may recur. I am a little concerned about the possibility of recurrence, because in the past, Mimmy and I had a dachshund who had the same lymphatic metastasis and a pathologically similar tumor at about the same time, but she was given 6 doses and then forfeited the treatment. However, when I see that Mimmy has lived a long and healthy life despite two surgeries, I feel that it makes sense to continue the treatment. I think it would be a waste to quit after 6 surgeries, though I would like the owners to think about it when the first course is over. I think it would be a waste if they quit after 6 sessions. 

J：In fact, I have heard reports from human societies that there tended to be a difference in life expectancy between patients who received six or more doses of lymphocytes and those who received less.

Yagura：There is a lot of data that shows that anti-cancer drugs have prolonged life, but the question is the condition there. Are they living in good health or are they living in bed? Considering such things, children undergoing lymphocyte therapy lead normal lives and are unlikely to have side effects such as vomiting and not being able to eat food, so I try my best to explain such things to them. If there is an established method for some diseases, such as anticancer therapy for lymphoma, I will recommend it. If not, we are careful because anticancer drugs may not work if given half-heartedly. From our standpoint, we ask the owner to make the final decision by choosing which method he or she would like to choose after explaining the past treatment experience and data.

 J：I had Mimmy sit with me during the interview, and she doesn't look 13 years old. She also has such good hair that it is hard to believe that she has had cancer. She is moving around in Oshima-sama's arms very well, and she is very energetic. 

Oshima：I see. That being said, maybe I look young for my age. Perhaps it is the effect of lymphocytes.

J：Finally, what would you like to say to the owners who are suffering from cancer in their families? 

Oshima：It is not an eternal life, so for me, the time I have to live with this dog, even a little, is more important than anything else. If there is something I can do by putting up with a little myself, I would like to continue the treatment as much as possible for this dog. I would like to be able to do that. I would like to recommend immuno-cell therapy to those who can manage the cost. I would like to recommend immuno-cell therapy to those who can afford it. 

J：Ms. Oshima has been with Mimmy for 13 years and has battled a major illness, cancer, together with her. 
I felt that she has given Mimmy a lot of love and affection. 
Mimmy, I hope you continue to live a long life. Thank you very much. 

Yagura Animal Hospital  184-4 Mikotsuji, Hashimoto City, Wakayama Prefecture, 648-0096, Japan http://www.yagura-ah.com/