[Felvtalk] Has anyone gone with radiation treatment for FeLV+ with cancer?

Lance linimon at fastmail.fm
Sun Mar 15 20:15:42 CDT 2015


I’m so sorry to read this, Marsha. You might join the Yahoo feline cancer group and post your question there.

Best hopes for Harley,

Lance

> On Mar 15, 2015, at 3:36 PM, Marsha <martia at lynxe.com> wrote:
> 
> Harley had a CT scan on Monday, and needle biopsy Friday.  Saturday (yesterday) the report came back that he has cancer.  It is in the area of his right middle ear and TMJ.  By the CT images, it does not appear to be something operable - it does not have distinct borders and there is no room to get margins.  I have many things to discuss with vets tomorrow:  comfort care for the time being for sure; how effective is radiation treatment vs. benefit to Harley; are there any chemo protocols for this that can help?  Also they push for a full biopsy requiring surgery because the diagnosis will be more "definitive" and they could stage the cancer then.  But I question the cost (both money and physical discomfort to Harley) vs. benefit to him.  How will the full biopsy change potential treatment?  It will cost money, has risk due to anesthesia, location of mass, and possible infection, and will cause him some pain afterwards.  Is it worth it for the extra bit of detail?  Below is the report if you're interested, and able to read the technical stuff.  One note on the final comment that radiographs are recommended to rule out bone involvement:  the CT scan showed already showed bone lysis (erosion), but the pathologist did not have access to the info from the CT scan.
> 
> In the meantime, Harley has gotten meloxicam or buprenorphine when he doesn't want to eat.  The anti-inflammatory effects of meloxicam give him relief for 4 days or so, allowing him to eat comfortably.  I just worry about potential kidney toxicity with that drug, so they have to be really careful about dosing, and the risk goes up long-term.  I wouldn't ordinarily say yes to that drug, but it helps him.  And if he's not going to make it long-term, the kidney concern takes back seat to his comfort.  The buprenorphine doesn't help nearly as much, but may make him feel good.  He has been eating all his food for the last 5 days, and plays and grooms himself.  A little more subdued than usual, but he has a big burst of energy after his breakfast or dinner.
> 
> Marsha
> 
> CLINICAL INFORMATION:
> Mass adjacent to/involving the right tympanic bulla; painful to open
> mouth; bulge palpated through skin medial to the right caudal mandible
> suspected to be the mass; blind aspirate; concern for carcinoma;
> patient is FeLV positive; regional node (and all peripheral nodes)
> palpate normal
> 
> SOURCE:
> Mass adjacent to roof of mouth right side: 12 slides
> 
> DESCRIPTION/MICROSCOPIC FINDINGS/COMMENTS:
> 
> Microscopic Description: The smears are low to moderately cellular on
> a clear background with moderate blood contamination, many scattered
> platelet clumps and a low to moderate number of ruptured cells. Few
> small, loosely cohesive clusters of polygonal to cuboidal epithelial
> cells are observed. This population exhibits mild to moderate
> anisocytosis and anisokaryosis. The cells have a small amount of
> variably staining purple cytoplasm and a round central nucleus. The
> nuclei have finely stippled to reticular chromatin and often 1-2,
> small prominent nucleoli. There are also rare mesenchymal cells noted
> displaying oval nuclei, one to three small nucleoli and moderate
> amounts of basophilic cytoplasm. This population exhibits mild to
> moderate anisocytosis and anisokaryosis and occasionally surrounds a
> small to moderate amount of pink extracellular matrix. No infectious
> agents or cytologic evidence of inflammation are observed.
> 
> Microscopic Findings: EPITHELIAL NEOPLASIA; MILD TO MODERATELY
> ATYPICAL MESENCHYMAL CELLS
> 
> Comment: The observed epithelial population exhibits only mild atypia
> but based on the number seen and the provided history raise concern
> for a well-differentiated, malignant neoplasm. Cell morphology of
> this population is most consistent with a basal cell, ceruminous gland
> or apocrine gland population. Significance of the rare mesenchymal
> cells is uncertain (they could be a fibrous component associated with
> the mass/granulation tissue, connective tissue, possibly rare cells
> associated with a well-differentiated mesenchymal tumor). Tissue
> biopsy with histopathology is recommended for a specific diagnosis.
> Radiographs of the area are also recommended to completely rule out
> underlying bone involvement.
> 
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