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Cancer with cats
Cats, just like people, can have cancer. The diagnosis “cancer” often evokes overwhelming feelings of fear, the feeling to loose control and the most devastating is the lost of hope. It doesn’t matter if the patient is a human being or a pet. If your beloved pet is faced with the diagnosis cancer, the situation might even be more difficult, since important and radical decisions have to be made for pets whose well-being fully depends on this. These cats don’t only live in our house. They are an inextricable part of our life and our daily activities, but above all we have given them a place in our heart. Every time we notice again that they love us unconditionally and we must therefore give everything to give them a worthy and good life. They deserve that. The least we can do to answer their love and affection is to make sure that they get the best care they need.
A large group of diseases which vary in the average age of the cat in developing these diseases, in development speed, in state of cell differentiation, in diagnosis possibilities, in traceability, in penetration, in spread possibilities, in effect of and on treatment methods and in prognosis possibilities, belong to clinical cancer. Cancer is a general term which indicates all kinds of tumors in the cat’s body. A tumor arises due to cell growth because of the fact that normal cells start to divide themselves purposeless and stubbornly. The body’s defense mechanism doesn’t function against it since it concerns body’s own cells. Out of each cell in the cat’s body a tumor might arise, due to which a cat can suffer from tumors in each tissue or organ.
Tumors are called benign or malignant, depending on their appearance and the way they grow. Benign tumors grow slowly and don’t spread to the surrounding tissues. They are usually less serious than the aggressive malignant tumors. They tend to spread in the surrounding tissues and to other, distant organs.
Malignant tumors on the skin start ulcerating or bleeding and get infected. Almost a third of the cat’s tumors concern a lymphoma. These are tumors which are caused by cancerous changes of certain cells of the immune system. Lymphomas can affect a part of the cat’s body or a number of parts at the same time. Unfortunately, three out of four cats die within a year upon the diagnosis. It can also be linked to leakaemia or blood defects. This kind of cancer can occur in:
• The thymus. This organ is located in the chest. Primary complaint: breathing problems like tightness of the chest and coughing. This form is especially seen with cats of about 2,5 years old.
• The intestines. Primary complaints: Weight loss and chronic diarrhoea. Often anaemia is also present. Especially cats of about 8 years old get this form.
• The bone marrow. The leukaemia form. Symptoms: Fever now and then, increase of white blood cells in the blood and shortage of red blood cells (anaemia). Usually, the spleen and liver are enlarged.
• The so-called multi-centric form: all tissues which have lymph gland tissue are affected: Symptoms: enlarged lymph glands, liver or spleen
Other types of tumors which often occur with cats are:
Skin tumors
Skin tumors are tumors which are located on the skin surface. These tumors can often be removed pretty simply by means of surgery. Since these tumors are located outside the body, they are often discovered early which enlarges the survival probabilities.
Tumors in the soft tissues
The squamous-cell carcinoma of the rhinoscope and ear edges are tumors which occur rather often. This type of cancer arises due to the ultraviolet sunrays and usually starts as an ulcer at one of the nostrils or ear edges and then spreads to the surroundings. We almost often notice the tumor on parts of the rhinoscope or ear edges which don’t have pigment. Spreads to other places in the body almost don’t take place. In case of an affected rhinoscope the treatment consists of surgical removal. This is a reasonable mutilating surgery, although cosmetically very acceptable after healing. In case of affected ear edges, which can be recognized by a red color, a thickened and irregular shape, the only treatment possibility consists of a complete amputation of the affected auricle. This therefore is a reasonable mutilating surgery.
Breast tumors
Mamma tumors are the most occurring tumors with the cat. You feel lumps under the belly, around the teats. The complaint is especially seen with female cats. It often concerns middle-aged animals by the time the first lumps arise. Hormones play a huge role in the development of mamma tumors. That is why cats which have been sterilized at a young age almost never have mamma tumors. On the contrary, female cats which haven’t been sterilized will have a 25% chance on development of these tumors. Giving extra hormones (the cat’s pill) heavily increases this risk. For this reason it is often advised to have the female cat sterilized at a young age and not giving them the cat’s pill. Having a nest with kittens fortunately doesn’t influence the development of breast cancer.
Unfortunately, breast cancer is malignant in 80% of the cases, especially with older animals which have had the cat’s pill. The best treatment of mamma tumors consists of a surgery. The sooner these kinds of tumors are removed, the larger the survival chance. This surgery will only be useful if there aren’t any spreads yet. The spreads cannot be seen in an early stage. During the surgery all teats with accompanying mamma glands are largely removed. The prospects for the cat after surgery depend on the kind of tumor which has been removed. An useful judgment can only be given if the tissue is sent for tissue examination. In case of a benign tumor the prospects are well. In case of a malignant tumor there is always a chance on spreads or on tumor growth (if it hasn’t been removed completely). If there are spreads, the prospects are not favorable. A cure isn’t possible then and the cat will not have much time left.
Mouth- or oral tumors
The squamous-cell carcinoma is the most occurring tumor in the cat’s oral cavity. This type of cancer especially occurs with cats which are 11-12 years old and is seen with all breeds. The tumor is often located on the basis, so the bottom side, of the tongue. The tumor can however also occur on other spots of the mouth and can affect the gums and the jaw bone. The symptoms which might vary depending on the spot in the mouth and the extensiveness of the tumor are: saliva lost mixed with or without blood, swallowing problems, loose teeth or molars, not wanting to eat and finally weight loss.
In the initial stage this tumor resembles a local inflammation of the mucous membrane of the mouth or the gums. The difference with a “normal” inflammation, for example as a result of a tooth problem, can hardly be recognized. In a later stage the cancer is accompanied by tissue loss and it is spread aggressively in the surroundings. A thickening of a part of the jaw bone might occur. Spreads usually take place later on in the development of the disease but chewing problems, additional inflammations and pain almost always lead to the decision to carry out euthanasia. Unfortunately cats are usually brought to the veterinarian for an examination in a too late stage. The tumor has then already become too large to have it removed by means of a surgery. Radical jaw amputation is more often seen as a surgery which causes a lot of trouble for the cat and cannot be justified ethically. In the meantime it has become clear that treatment by means of chemotherapy and/or radiotherapy isn’t effective anymore in such an advanced stadium, in contrary to the same tumor type on the cat’s rhinoscope. Early discovery of the squamous-cell carcinoma in the oral cavity of cats can be the beginning of a successful treatment.
Bone tumors
Bone tumors often refer to arthrosis in the beginning, they might even lead to bone ruptures. X-rays can confirm if it concerns a joint defect or for example growing pains or a bone tumor. Usually these kinds of tumors don’t grow that fast. These tumors can’t often we removed by means of a surgery, due to which the prognosis for a (medium) long period isn’t always well.
Tumors in the digestive system
The symptoms usually indicate an obstruction of the digestive system (vomiting) or a bad absorption (weight loss, no appetite, diarrhoea). A lymphoma of the digestive system can occur in each area of the entrails (stomach, small intestine, large intestine) and a local disease can include some masses of cancer cells or several masses of cancer cells. Clinical research during medial examination can find masses in the stomach or enlarged lymph glands by means of touching and tapping the body.
Causes
Almost all lymphomas with cats are caused by feline leukaemia. Normal cells start developing tumors spontaneously or tumors grow influenced by factors like not-identified viruses, chemicals or radiation/sunlight. A change in a cell’s behavior is enough to develop a tumor.
General symptoms
The symptoms which refer to a tumor depend on various factors, amongst others: size and spot of the tumor, if the tumor disturbs body functions and if the tumor is benign or malignant. Some tumors, like the tumors on skin and beak, are already visible in an early stage. Tumors in the body are only observed if they are advanced.
Diagnostics
Before we can start treating a tumor, it is important to characterize the tumor. Taking a biopsy is an important means. This means that the veterinarian removes some tissue and will have examined it by a pathologist. It is important to realize that even with the most modern examination techniques very small spreads cannot be made visible.
After having characterized the tumor it must be decided if and if yes which additional examination is required to stagnate the process. By characterizing the tumor, his biological behavior has been determined actually. Stagnating a tumor often requires a general blood examination.
Complete documentation of the process development and the general clinical state of the cat is very important in order to be able to make a justified treatment plan. The examination methods which are required sometimes seem to be time-consuming and expensive, but they supply essential information in order to be able to make rational decisions concerning whether to treat the cat or not and in which way the best treatment can be executed. On a long term this might be Money-saving. It isn’t only the veterinarian who decides if a certain examination or treatment must take place or not, but this decision must be taken in consultation. Especially concerning the financial aspects it will be the owner who takes the final decision.
Treatment methods
The following treatment methods are available:
Surgery;
Often, small tumors/lumps can be removed through a surgery. If the result of the tumor is known, we can judge whether a further treatment has to take place or not. One of the additional treatments might be: chemotherapy, radiotherapy and/or hormonal therapy. In some cases surgery isn’t possible or the tumor has already been spread. Other treatment possibilities must then be considered.
Chemotherapy (Treatment with cytostatics);
This treatment still causes a discussion within zoo therapy. The most important group of patients which is treated with chemotherapy is cats with malignant lymphoma (lymph gland cancer). In general there are only few side-effects of these means and cannot be compared to the treatment with human beings, while the results are hopeful. A successful treatment, with at least a significant life prolongation takes places with amongst others:
• adenoma carcinoma of the large intestine (in combination with surgery)
• anal carcinoma (in combination with surgery)
• Certain leukaemia forms;
• Bladder neck tumors (Transition epithelium cell carcinoma)
• Chronic lymphocyte leukaemia
• Metastasized haemangioma sarcoma.
• Tumor of a blood vessel or spleen
• Brain tumors (in combination with surgery)
• Malignant lymph gland cancer
• Mastocyte degree II and mastocyte degree III (in combination with surgery)
• plasma cell tumor
• squamous-cell carcinoma in the oral cavity (in combination with surgery)
• Squamous-cell carcinoma of the rhinoscope with the cat
At the moment the treatment of cats with cytostatics, suffering from mamma carcinomas, is more hopeful. We can also think of treatment of animals with brain tumors.
Most owners think that their pet will become very sick of chemotherapy and that it will have hair loss. Baldness is only seen with the trim breeds and with cats usually only the whiskers will fall out. These nasty side-effects fail to occur thanks to the fact that lower doses are given to cats compared to human beings. If side-effects occur, the complaints are the consequence of the effect of the medicines on all fast dividing tissues in the body. The bone marrow cells are also damaged due to which anaemia might be one of the complaints. The defense system functions less well due to which the cat might have inflammations sooner. In case intervention doesn’t take place in time, it might lead to death.
Chemotherapy usually is a therapy which lasts long. The costs may certainly not be underestimated; some treatments can cost thousands of Euros yearly. The treatment with chemotherapy usually consists of a combination of various products and various administering ways. We work with both drips and tablets (oral administration).
Radiotherapy;
In the Netherlands this type of treatment is only possible to a limited extent in two centres, where they work with X-rays. The maximum energy level is in the skin then, due to which only superficially located processes are qualified for this therapy
Tumors which are qualified for these therapy are amongst others: Squamous-cell carcinoma and fibro sarcomas after surgical removal of a part of the organ, in the head/neck area; - not completely removable mastocytes in an extremity, which requires paw-saving surgery; - mastocytes on other spots, which probably cannot be removed completely; you can distinguish pre- and post surgical radiotherapy; - strongly localized lymphomas; - perianal tumors; - tumors in the nasal cavity; radiotherapy without surgery in advance is possible with tumors < 2-3 cm3, otherwise surgery in advance is required, osteo sarcoma of the distal radius, prior to paw-sparing surgery, for example by replacing the affected bone part by a donor bone or artificial bone; - acanthomateuse epulis; - brain tumors;
hormonal therapy;
Hormonal therapies often refer to therapies which try to relieve the pain. In case of brain tumors fluid ends up around the tumor. By using corticosteroids this fluid can be reduced heavily. The animal will start to feel more comfortable which improves the life quality.
In general, corticosteroids are used in combination protocols for example in order to treat malignant lymphomas, leukaemia and multiple myeloma. Using corticosteroids to relieve the pain takes places amongst others with tumors of the central nervous system and inoperable insulinome. In the first case the present inflammation of the tumor is stopped peripherically, which reduces the pressure on the surrounding tissue and will reduce the complaints temporarily. In the second case the gluco corticosteroid functioning is used, with an increase of the glucose concentration in the blood as a consequence.
Immunotherapy (stimulation of defense mechanism of the own body); this especially includes experimental treatments.
Cancer prevention
First of all it is very important that each lump on the body is considered to be a potential tumor. Never decide to “wait and see”. The sooner you remove a lump or treat it the better your pet’s prospect. An other advise in order to prevent having cancer is the protection of skin parts which don’t have pigment and aren’t very hairy against ultraviolet light with a sun cream with a high protection factor.
The veterinarian will start playing a more important role in the cancer prevention by means of education. The point of departure of each treatment of the tumor patient must be that the quality of the rest of the cat’s life is guaranteed.