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

[Margo]

Marsha, 
 I'm so sorry. I know how tough this kind of diagnosis is, having been there several times. I'm no Vet, but what you posted doesn't actually diagnose. It posits possibilities. I think where you go from here depend on your interest in treating as apposed to palliative care. 
 If you would treat, then the biopsy is pretty important (IMO). It will tell you what you are dealing with, and whether there is an actual chemo protocol that might/will help. Some cancers are treatable than others. They might also be able to de-bulk the mass, and give Harley the ability to move his jaw without pain, at least for some time. My cat Pattern had what was finally diagnosed as SCC (Squamous Cell Carcinoma) in approximately the same area you identify, but the mass extended into her mouth, interfering with her ability to eat. At the time of the biopsy, the Vet removed all she could get and used silver nitrate to staunch the considerable bleeding (I was present). SCC is pretty much non-responsive to chemo, so we decided to hospice. She was with us for another 10 _good_ months. Sounds as if Harley is looking at something quite different, possibly treatable. Before you decide, you might want to run the results past some more knowledgeable people.
If you aren't already a member,consider joining https://groups.yahoo.com/neo/groups/feline_lymphoma/infoand https://groups.yahoo.com/neo/groups/feline-cancer/info. There are members and Vets there (the lymphoma list has an amazing Vet participating pretty much daily) who can help decipher the lab results.
Hoping for the best,
Margo
-Original Message- From: Marsha Sent: Mar 15, 2015 4:36 PM To: felvtalk@felineleukemia.org Subject: [Felvtalk] Has anyone gone with radiation treatment for FeLV+ with cancer? 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 

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

[Marsha]

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

[Lance]

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 mar...@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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Re: [Felvtalk] Has anyone gone with radiation treatment for FeLV+ with cancer?

[dlgegg]

I THINK THAT IF IT WAS MY HARLEY, I WOULD SAY NO.  IT WOULD NOT HELP THE 
QUALITY OF HIS LIFE AND THE TRAUMA OF SURGERY.  I AM ON A SALVE FOR TUMORS ON 
THE SKIN AND A TONIC FOR INTERNAL JUST TO WARD OFF A POP UP OF MY LYMPHOMA.  IF 
YOU WANTED TO TRY GETTING THE TONIC DOWN HIM, I CAN GIVE YOU THE INFORMATION.  
I WILL ADD BOTH OF YOU TO MY PRAYER LIST.

 Marsha mar...@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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