Feline squamous cell carcinoma: Difference between revisions
imported>Howard C. Berkowitz No edit summary |
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Early diagnosis is key. A biopsy is likely to be needed, possibly aspirational but preferably incisional. If in the oral cavity, a high index of suspicion for infection should be kept and appropriate antibiotic therapy used aggressively. | Early diagnosis is key. A biopsy is likely to be needed, possibly aspirational but preferably incisional. If in the oral cavity, a high index of suspicion for infection should be kept and appropriate antibiotic therapy used aggressively. | ||
==Treatment== | ==Treatment== | ||
Detected very early, the tumor may be removable by surgery, but, in most cases, it is inoperable yet the surgery allows a definitive [[histopathology|histopathological]] diagnosis. | |||
===Specific tumor reduction=== | ===Specific tumor reduction=== | ||
Assuming the owner authorizes active treatment, the first steps are radiation or radiation coupled with chemotherapy, followed by additional cycles of chemotherapy and possibly additional radiation. One series using these methods, with bleomycin or carboplatin after fractionated electron beam radiotherapy, had survivals from 11 to over 400 days, with a median of 90. Other protocols have substantially extended life. <ref>{{citation | Assuming the owner authorizes active treatment, the first steps are radiation or radiation coupled with chemotherapy, followed by additional cycles of chemotherapy and possibly additional radiation. One series using these methods, with bleomycin or carboplatin after fractionated electron beam radiotherapy, had survivals from 11 to over 400 days, with a median of 90. Other protocols have substantially extended life. <ref>{{citation | ||
| A retrospective study of <sub>90<sub>Strontium plesiotherapy for feline squamous cell carcinoma of the nasal planum | | title = A retrospective study of <sub>90</sub>Strontium plesiotherapy for feline squamous cell carcinoma of the nasal planum | ||
| author= Mark Goodfellow ''et al.'' | | author= Mark Goodfellow ''et al.'' | ||
| journal = Journal of Feline Medicine & Surgery | | journal = Journal of Feline Medicine & Surgery | ||
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Some of the tumors express [[cyclooxygenase-2]], so a selective [[NSAID]] offers both pain relief and the potential to reduce the inflammation of a tumor. Unfortunately, these agents also can cause life-threatening gastrointestinal bleeding. It is not yet standard practice to administer them with a prophylactic [[proton pump inhibitor]] or [[histamine H2 antagonist]]. | Some of the tumors express [[cyclooxygenase-2]], so a selective [[NSAID]] offers both pain relief and the potential to reduce the inflammation of a tumor. Unfortunately, these agents also can cause life-threatening gastrointestinal bleeding. It is not yet standard practice to administer them with a prophylactic [[proton pump inhibitor]] or [[histamine H2 antagonist]]. | ||
===Quality of life== | ===Experimental treatments=== | ||
Pain management is a challenge in cats, due to their intolerance of many [[opioid analgesic]]s. [[Gabapentin]], orally or by a skin-absorptive gel, can provide baseline pain relief. Buprenorphine, orally, in the buccal cavity, or subcutaneously is useful for breakthrough pain. | Various studies have used electric stimulation, hyperthermia and hyperbaric oxygen as a supplement to chemotherapy or radiotherapy.<ref>{{citation | ||
| journal = The Veterinary Journal | |||
| volume=179| issue = 1 | date January 2009| pages = 117-120 | |||
| doi = 10.1016/j.tvjl.2007.08.011 | |||
| title = (Abstract) Electrochemotherapy for the treatment of squamous cell carcinoma in cats: A preliminary report | |||
| author = Enrico P. Spugnini ''et al.'' | |||
| url = http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WXN-4PSJT73-2&_user=10&_coverDate=01%2F31%2F2009&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1379954601&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=9c1e7cce9ee984ff20f0a7023462c325}}</ref> Photosensitization and photodynamic therapy is being explored. | |||
==Quality of life== | |||
The tumor itself may not be painful; the concern, especially in oral cancers, is that it interferes with eating or breathing. | |||
The cat may suffer pain after manipulation of the tumor for examinations or oral medication, or perhaps by trauma (e.g., while eating). Pain management is a challenge in cats, due to their intolerance of many [[opioid analgesic]]s. [[Gabapentin]], orally or by a skin-absorptive gel, can provide baseline pain relief. [[Buprenorphine]], orally, in the buccal cavity, or subcutaneously is useful for breakthrough pain. | |||
==Complications== | |||
Especially in the oral cavity, the owner and clinician must be alert to secondary infection. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 00:19, 24 June 2010
Among the most common malignant cancers of cats, feline squamous cell carcinoma has a wide range of survival expectations and treatments. The neoplasm tends not to produce distant metastases, but is highly invasive, and, especially in the mouth cavity, can interfere with quality of life.
Early diagnosis is key. A biopsy is likely to be needed, possibly aspirational but preferably incisional. If in the oral cavity, a high index of suspicion for infection should be kept and appropriate antibiotic therapy used aggressively.
Treatment
Detected very early, the tumor may be removable by surgery, but, in most cases, it is inoperable yet the surgery allows a definitive histopathological diagnosis.
Specific tumor reduction
Assuming the owner authorizes active treatment, the first steps are radiation or radiation coupled with chemotherapy, followed by additional cycles of chemotherapy and possibly additional radiation. One series using these methods, with bleomycin or carboplatin after fractionated electron beam radiotherapy, had survivals from 11 to over 400 days, with a median of 90. Other protocols have substantially extended life. [1]
Some of the tumors express cyclooxygenase-2, so a selective NSAID offers both pain relief and the potential to reduce the inflammation of a tumor. Unfortunately, these agents also can cause life-threatening gastrointestinal bleeding. It is not yet standard practice to administer them with a prophylactic proton pump inhibitor or histamine H2 antagonist.
Experimental treatments
Various studies have used electric stimulation, hyperthermia and hyperbaric oxygen as a supplement to chemotherapy or radiotherapy.[2] Photosensitization and photodynamic therapy is being explored.
Quality of life
The tumor itself may not be painful; the concern, especially in oral cancers, is that it interferes with eating or breathing.
The cat may suffer pain after manipulation of the tumor for examinations or oral medication, or perhaps by trauma (e.g., while eating). Pain management is a challenge in cats, due to their intolerance of many opioid analgesics. Gabapentin, orally or by a skin-absorptive gel, can provide baseline pain relief. Buprenorphine, orally, in the buccal cavity, or subcutaneously is useful for breakthrough pain.
Complications
Especially in the oral cavity, the owner and clinician must be alert to secondary infection.
References
- ↑ Mark Goodfellow et al. (June 2006), "A retrospective study of 90Strontium plesiotherapy for feline squamous cell carcinoma of the nasal planum", Journal of Feline Medicine & Surgery 8 (3): 169-176, DOI:10.1016/j.jfms.2005.12.003
- ↑ Enrico P. Spugnini et al., "(Abstract) Electrochemotherapy for the treatment of squamous cell carcinoma in cats: A preliminary report", The Veterinary Journal 179 (1): 117-120, DOI:10.1016/j.tvjl.2007.08.011