The Heart Behind the Science:  A Veterinarian’s Journey to Advancing Pet Cancer Care

How did your passion and engagement for the veterinary field emerge?

Since a very young age, I’ve been captivated by nature and curious about all living creatures, from pets to plants and insects. Throughout my childhood, I kept various pets—hamsters, chickens, rabbits, guinea pigs, fish, turtles and, naturally, cats and dogs. Inspired by my father’s background in biology, I always knew I wanted to pursue a similar path.

However, it was when I adopted my first dog at the age of 14 that my passion for veterinary medicine truly started. Witnessing his illness and the compassionate care provided by our local veterinarian, I realised that my calling was to help animals.

Describe your career path and current role.

I graduated with honours in 2007 in Italy and worked for a couple of years as a general veterinarian while studying for a master's degree in Oncology. I moved to the UK in 2009, where I worked for a few years in general practice. A few years later, I completed a rotating internship and two certificates in medicine and oncology. Later on, I started an oncology internship, followed by a residency at the University of Cambridge. After finishing my oncology specialization, I stayed at Cambridge University for another year as an oncology clinician.

For 3 years, I was appointed Associate clinical professor in Oncology at the College of Veterinary Medicine at City University of Hong Kong, and currently, I work at one of the most advanced Oncology referral centres in Asia, Harvest Veterinary Oncology Centre (HVOC) in Hong Kong.

What first triggered your interest in oncology, and why do you find this area of veterinary practice so interesting?

Like most veterinarians worldwide, when I graduated, I did not receive an adequate amount of lectures/teaching/training in medical oncology. As a new graduate, I discovered how common cancer is in pets, yet my knowledge of oncology was very poor. Even more experienced colleagues had very poor knowledge of this specific subject.

I was a bit frustrated; despite having spent so many years studying at university and achieving the best marks, I was still not able to help cancer patients.

I started to study both veterinary and human oncology books, and I became so fascinated by both cancer biology and medical oncology that I have not stopped studying oncology since!

When people ask me why I chose oncology, I am always a bit surprised by the question!

How can you not be interested in the most common cause of death in pets and people? Why would you not want to know everything about treating cancer so you can help the pets in need?

Furthermore, oncology in both human and veterinary patients is in continuous evolution; new discoveries, new technologies, new diagnostic tools, and new drugs/treatments are discovered every year. How can this not be so exciting?

Last but not the least, there is no bigger reward than to cure a pet suffering from cancer or just make them feel better, even if only for a few years or a few extra months!

The appreciation and gratitude of their owners is always another big reward for me.

Could you describe your ‘day job’?

As a small animal oncologist, I see cancer patients referred by veterinarians from all around HK. I see both newly diagnosed oncology cases for consultation, assessment, and treatment, as well as suspected cancer patients for further investigation and final diagnosis.

I often see challenging cases with various comorbidities, multiple cancer types and/or cancer at an advanced stage.

Communication with the owner is very important in Oncology, and it can be challenging in HK, where not everyone can speak fluent English. I am lucky to work with talented veterinary nurses who help me with communication and daily tasks.

What is your vision for the future of veterinary oncology, and what changes and challenges still remain?

The future of veterinary care is promising, particularly in the field of veterinary oncology. Thanks to the continued advancement in medical research and technologies, I believe we will continue to enhance the quality of life for pets diagnosed with cancer and provide them with the best possible care.

• Early Detection of cancer: My hope and view for      the future relies on the early detection of cancer in pets. Recent developments      in advanced diagnostic tools, such as liquid biopsies and genetic testing,      are already able to identify cancer at its earliest stages, allowing for early      and more effective treatment. However, more studies are needed to validate      these new tests.

• Personalized Treatment: Just as in human      medicine, personalized treatment plans based on an individual pet's      genetic makeup and specific cancer type are already available. This      approach enables us to tailor therapies to each patient, maximizing      efficacy and minimizing side effects. However, more studies are needed to validate and maximize the efficacy of this approach.

• Innovative Therapies: The future of      veterinary oncology will soon see the introduction of cutting-edge      therapies, including new types of immunotherapies, targeted therapies, and      multimodal approaches. These treatments are likely to revolutionize how we approach cancer care, offering new hope for pets and their families.

• Holistic and Integrative Care: We recognize the importance of holistic and integrative approaches in cancer care. Combining conventional treatments with complementary therapies, such as nutritional support and palliative care, will improve the overall well-being of our patients.

Despite the promising advancements, several challenges remain in the field of veterinary oncology and veterinary care as a whole:

• Access to Specialized Care: Access to specialized oncology care can be limited, particularly in rural or underserved areas or low-income countries. Expanding the reach of specialized services and training more veterinarinas will be crucial to addressing this disparity.

• Cost of Treatment: Cancer treatment can be costly, and not all pet owners have the financial means to afford advanced therapies. Efforts to promote medical insurance for pets and make cancer treatments more affordable and accessible will be essential to ensure that all pets receive the care they need.

• Emotional Toll on Pet Owners and Veterinarians: A cancer diagnosis can be emotionally overwhelming for pet owners. Veterinarians also face emotional challenges in delivering difficult news and managing end-of-life care. Providing support and resources for both pet owners and veterinarians is vital.

• Research and Funding: Continued research and funding are necessary to drive innovation and develop new treatments.

• Collaborative efforts: between veterinary institutions, researchers, and pharmaceutical companies will be essential to advance the field of veterinary oncology.

How does veterinary care in your daily practice impact local communities and the broader local veterinary system?

• Owner Education: By educating pet      owners about specialized care, I empower them to make informed decisions      about their pets' health, leading to better outcomes and increased trust      in the veterinary profession.

• Veterinary Education: I am actively involved in continuing education for local and international veterinarians. By volunteering for talks and seminars and speaking at global conferences, I bridge the knowledge gap between specialists and veterinarians. This is especially vital in low-income countries. In developed regions like HK, collaboration with veterinarians improves the quality of veterinary care, ensuring pets receive the best possible treatment and enhancing the local veterinary community's reputation.

• Research and Innovation: By engaging in research and staying updated with the latest advancements in veterinary oncology, I contribute to the field. Sharing my research findings and clinical experience with local and worldwide veterinarians helps improve standards of care across HK and Asia, especially where      access to specialized care is lacking.

• WSAVA Oncology Committee Member: As      a proud member of the World Veterinary Small Animal Association (WSAVA)  Oncology Committee, my colleagues and I contribute to:

• Advancing veterinary oncology through educational resources and collaborations.

• Raising awareness about various pet tumors and supporting veterinary teams and pet owners.

• Promoting the One Health concept, recognizing pets as "sentinels" for shared environmental factors.

• Asian Oncology Specialist De Facto Member: As a member of the Asian Oncology Specialists, I am dedicated to promoting and establishing specialized veterinary training across Asia. This effort aims to enhance global cancer care for pets by equipping new veterinarians with specialized skills.

By integrating these efforts, I hope to help elevate the standards of veterinary care and contribute to the well-being of pets.

In your view, what role do companion animals play in the well-being and prosperity of human communities?

In my opinion, the advancement of a country or society can be measured by the attention that their people, government, and laws give to the rights of animals. This includes advanced veterinary treatment and considering pets as part of the family rather than just animals. I assess the progress of a country and society on a broader scale by how people think about and treat animals and the environment, including how well they care for and treat pets.

On the other hand, the rewards for the people from the pets are multiple:

• Emotional Support and Mental Health: Pets provide unconditional love and companionship, which can significantly reduce stress, anxiety, and depression in their owners. Pets also improve social interaction as they often help people connect with others in their community, which can enhance social bonds and support networks. Animal therapy is also a well-recognised field and plays a crucial role in hospitals, schools, and nursing homes, contributing to the well-being of vulnerable people. 

• Physical Health Benefits: Dog owners, for instance, are more likely to engage in regular physical activity with their pets, leading to better overall health. Additionally, pets can potentially detect health issues in their owners, such as predicting seizures or low blood sugar levels.

• Economic and Social Contribution: The pet care industry, encompassing veterinary services, pet food, and accessories, plays a significant role in improving the local economy. Veterinary practices, including specialized clinics, create employment opportunities. Additionally, dogs contribute profoundly to society by being deployed in various working settings, such as searching for missing people, assisting in solving crimes, participating in police and rescue operations, and helping locate individuals in natural disasters and war zones.

Conclusion

I am a proud veterinary oncologist and a passionate animal lover advocating for animal rights and well-being. My mission extends beyond treating pets with cancer to educating pet owners and veterinarians and advancing veterinary oncology.

Pets play a pivotal role in our society, far beyond mere companionship. By educating pet owners and veterinarians and improving veterinary practices, we ensure pets receive the best care. This enhances their health and well-being, strengthens human-animal bonds, and contributes to our communities' prosperity. Recognizing pets' emotional and physical benefits reflects societal progress. Together, we can create a world where pets are cherished family members and their impact is fully appreciated.

ABOUT Dr. Antonio Giuliano

Dr. Antonio Giuliano graduated cum laude (with honors) from The Veterinary University of Messina, Italy in 2007. While working in general practice, he completed a master's degree in Small Animal Oncology from the University of Pisa, a postgraduate certificate in cancer therapeutic at Barts Cancer Institute London, UK, and the GpCert (SAM) in internal medicine in the UK.

He completed a rotating internship in a busy referral practice in the UK and an oncology internship and residency at the Queen Veterinary School Teaching Hospital (QVSH), at the University of Cambridge.

After completing the residency, he worked for one year as an oncology clinician at the QVSH in Cambridge. For the past five years, he has worked as an oncology clinician at CityU VMC and later on as an associate professor in small animal oncology at the Department of Veterinary Clinical Science, JCC College of Veterinary Medicine at City University of Hong Kong.

Antonio currently works at Harvest Oncology Centre, Asia's most advanced cancer treatment center.

Dr Antonio Giuliano is a recognized European, RCVS, HK, and Asian Companion Animals (Oncology) specialist.

He is an editor for the Scientific Veterinary Journals, Frontiers in Veterinary Medicine, and BMC Veterinary Research. He is a member of the oncology committee at WSAVA (World Small Animal Veterinary Association) and the ECVIM (European College of Veterinary Internal Medicine) final exam Committee.

Dr Antonio has achieved certifications in immunotherapy and continued education in nutrition, and alternative and integrative cancer treatment.

He has published over 40 scientific articles in international peer-reviewed journals and presented his clinical experience and research at many international conferences.

Antonio Giuliano,

EBVS® European Specialist in Veterinary Oncology

RCVS Specialist in Small Animal Oncology

Asian Specialist in Small Animal Oncology
Former Clinical Associate Professor

DVM, MS, PgCert(CT), GpCert(SAM), AiCVIM (onc)
Dip. ECVIM(Oncology), MRCVS