Chemotherapy is the therapeutic use of chemical agents to destroy, or inhibit the growth and division of cancer cells. Chemotherapy is usually used when tumors are widespread or when there is significant or immediate risk of spread from the primary location. It is often used following the surgical removal of tumors. In some cases, chemotherapy is started prior to surgery. Different protocols are used depending on the drug and the type of cancer being treated. The side effects of chemotherapy are related to the effects of chemotherapy on normal – as well as cancerous – cells. The principal goal with cancer care in pets is to provide cancer control without reducing quality of life. With pets, chemotherapy protocols are purposefully designed so the treatment does not become worse than the disease.
Chondrosarcomas arise from cartilage, which is a connective tissue primarily found where bones meet with joints, as well as at other locations in the body (such as the nasal cavity, ribs, etc.). Chondrosarcoma is a rare tumor in cats, but it can occur. The reason why a particular pet may develop this, or any tumor or cancer, is not straightforward. Clinical signs of chondrosarcoma may vary significantly, depending upon where the tumor arises. Although the mass may grow rapidly, less than 20% of feline chondrosarcoma cases metastasize to other parts of the body. Therefore, surgical removal is curative in many cases.
Skin cancers are fairly common in cats, but cutaneous lymphoma is quite uncommon. Only about 3% of lymphoma cases in cats occur in the skin. There may be a linkage between feline leukemia virus (FeLV) and feline cutaneous lymphoma. Unfortunately, feline cutaneous lymphoma is considered incurable.
Esophageal tumors are extremely rare in dogs and cats. There are many kinds, including squamous cell carcinomas, leiomyosarcomas, fibrosarcomas, osteosarcomas, and undifferentiated sarcomas (all malignant); and leiomyomas and plasmacytomas (benign). Most tumors are malignant. These tumors occur mostly in the upper esophagus in cats and the lower esophagus in dogs. In dogs, most cases of esophageal sarcoma are associated with spirocercosis. Esophageal cancer causes progressive signs of regurgitation, difficulty swallowing, excessive salivation, weight loss, and lack of appetite. It is diagnosed with imaging, endoscopic or surgical biopsy, and histopathology. Surgery is a treatment option, with the possibility of radiation therapy for tumors of the upper esophagus. Avermectins may be used with benign spirocercosis. Palliative care may be possible with the placement of a feeding tube.
Intestinal tumors are uncommon in dogs and cats. There are many kinds, including leiomyosarcomas, lymphomas, adenocarcinomas, mast cell tumors, GISTs, plasmacytomas, carcinoids, and osteosarcomas (all malignant) and leiomyomas, adenomatous polyps, and adenomas (all benign). Most intestinal tumors are malignant. Intestinal tumors are more prevalent in older animals, males, and certain breeds. The signs of intestinal tumors vary according to the area of the intestinal tract that is affected, and can include vomiting, lack of appetite, lethargy and weight loss for the upper bowel and difficulty defecating, ribbon-like stools, and rectal prolapse with the lower bowel. Sometimes tumor ulceration causes anemia. Paraneoplastic syndromes are possible with the muscle tumors. Intestinal tumors may be diagnosed with imaging, endoscopy, or surgery, with a biopsy. Treatment may involve surgery, chemotherapy, or radiation therapy.
Lymphoma is a cancer of the lymphocytes. Lymphocytes are cells that are involved in the immune system. Lymphoma is connected with feline leukemia, a viral infection. Feline lymphoma most commonly affects the intestines. Therefore, clinical signs of lymphoma are often similar to other intestinal diseases. Diagnosing lymphoma requires finding cancerous cells on microscopic examination. Lymphoma cannot be prevented, but the likelihood of a cat developing lymphoma can be decreased by preventing feline leukemia virus infection.
Mammary tumors in cats are not very common in North America due to routine spay procedures. Hormones play a role in tumor development in cats. Cats spayed prior to 6 months of age have a reduced risk of developing mammary tumors. Siamese Cats appear to be predisposed to developing mammary tumors. Mammary tumors are typically not painful and are usually discovered during a routine physical examination. Staging is recommended in all cases due to the tendency for these tumors to metastasize. Surgery is typically the treatment of choice and chemotherapy may be recommended after surgery.
A mast cell tumor (MCT) is a type of tumor consisting of mast cells. Mast cell tumors can form nodules or masses in the skin (and other organs), and cause enlargement of the spleen and intestine. Most mast cell tumors are seen as firm plaques or nodules in the skin. If your cat has the splenic form of the disease, the most commonly observed signs are weight loss, vomiting, and loss of appetite. The intestinal form, depending on how severe the disease is, may cause vomiting, diarrhea, fresh red blood in the stool, or black/tar-colored stool. This cancer is typically diagnosed via fine needle aspiration or biopsy. Surgical removal of the mass is the treatment of choice. Radiation therapy may also be suggested.
Radiation therapy is the medical use of high dose radiation to destroy cancer cells by damaging the cells’ DNA to interfere with cell replication and kill them. It may be used on its own or in combination with other treatments, such as surgery or chemotherapy, or to reduce the size of very large tumors prior to surgery. There are several radiation protocols used in veterinary medicine. Your veterinary oncologist will choose the therapy most appropriate for your pet’s individual situation.
Squamous cell carcinoma (SCC) is a tumor of the cells that make up the contact or upper layer of the skin. UV light exposure has been described as a developmental factor in people and appears to be associated with the development in cats. Areas affected include the ear tips, skin, toes, or peri-ocular region. Fine needle aspiration or biopsy may be performed for diagnosis. The metastatic rate does not appear overly clear, though staging is always recommended. SCC of the toe can occur as a primary tumor or may have spread from the lung (lung-digit syndrome). Surgery is almost always recommended in any case of SCC; the role of chemotherapy is controversial. Radiation therapy has an excellent response rate in cats with the SCC affecting the nasal planum and may give long-term tumor control.