Oncology Flashcards
what are the 2 keys to successful mgmt of dogs and cats with cancer?
- clearly define tx goals
- biologic behaviour dictates optimal therapy
what are the two main tx goals of cancer mgmt? briefly describe them
- curative intent therapy: extend good quality life as long as possible, need thorough clinical eval (lots of tests)
- palliative therapy: maintain good quality of life (not extend it), testing not necessarily needed
what 5 essential pieces of information does clinical evaluation of neoplasia give you?
- definitive histopath diagnosis with tumour grade
- clinical stage of disease
- presence/absence of paraneoplastic syndromes
- clinical significant concurrent medical conditions
- detailed pt baseline
what is the only way to address all known and unknown sites of disease for a systemic cancer disease?
systemic chemotherapy
you want _____ therapy for local disease and ____ therapy for systemic disease.
local, systemic
duh
are there breed dispositions for canine lymphoma?
boxers, goldens, bull mastifffs
canine lymphoma has a relatively _____ presentation. tell me more about this.
homogenous
- disease of middle-aged dogs (6-9yo)
- multi centric involvement most times
- Lymphadenopathy most common presenting complaint
- frequently no systemic signs of illness
- other organs may be involved
true or false: you need a detailed diagnostic evaluation for canine lymphoma
true
explain the stages of canine lymphoma.
Stage 1: single node involvement
Stage 2: multiple node involvement at one side of diaphragm
stage 3: generalized LN involvement
Stage 4: stages I-III with liver and/or splenic involvement
stage 5: stages 1-IV with BM involvement; atypical dz
substage a: no signs of systemic illness
substage b: signs of systemic illness
what is the most practical and effective treatment for canine lymphoma? what type of protocol is preferred and why?
chemotherapy
combination protocol - maximize efficacy, minimize toxicity
what is the median survival time for canine lymphoma?
6-14 mo
what are the potential toxicities assoc with chemotherapy?
- GI (most common) - anorexia, nausea, vomiting, diarrhea, colitis
- alopecia + whisker loss
- perivascular necrosis
- sterile hemorrhagic cystitis
- life threatening toxicity (not common) [myelosuppression and infection or sepsis; doxorubicin-induced cardiotox]
what is the standard of care for canine lymphoma? like what medication
doxorubicin
list some factors affecting prognosis of canine lymphoma
- clinical stage of disease (worse with 4-5)
- clinical substage of disease (worse for b)
- prior tx with corticosteroids
- immunophenotype (B vs T cell)
- chemotherapy protocol chosen
- response to therapy
true or false: canine lymphoma is more common than feline lymphoma
false! incidence of lymphoreticular neoplasia in the cat is the highest of ANY species
feline lymphoma can be caused by what disease?
FeLV
true or false: with feline lymphoma, presentation and C/S vary widely
true
true or false: with feline lymphoma, peripheral lymphadenopathy is common
false. it is uncommon
what are the most common presenting complaints for feline lymphoma for…
1) nonspecific
2) specific
1) anorexia, lethargy, weight loss, dehydration, pallor
2) dyspnea, v+, d+, PU/PD, abdominal masses, decreased compression of cranial thorax
presenting complaints for feline lymphoma are mainly _____.
nonspecific
true or false: detailed diagnostic evaluation is essential for feline lymphoma
true
describe the stages of feline lymphoma
stage 1: single tumor (extra nodal) or single anatomic area (nodal)
stage 2: single tumor (extra nodal) with regional LNs; 2 tumours (extra nodal) or nodal area on 1 side of diaphragm; resectable GI tumour with or wo regional LNs
stage 3: 2 tumours (extra nodal) or nodal areas on opposite sides of diaphragm; all paraspinal or spiral tumour; all primary nonresectable intra-abdominal tumours
stage 4: stages 1-3 with liver and/or splenic involvement
stage 5: stages 1-4 with initial involvement of CNS, BM, or both
substage a: no signs of systemic illness
substage b: signs of systemic illness
what is the most practical and effective treatment for feline lymphoma? what is the recommended protocol and why?
chemotherapy
combo protocol - maximize efficacy, minimize toxicity
doxorubicin containing products
what is the median survival time for feline lymphoma?
7mo
for anatomically confined forms of feline lymphoma, what treatment should you do?
chemotherapy + adjuvant local therapy (surgery, radiation)
what are the factors affecting prognosis of feline lymphoma?
- FeLV status
- clinical stage of disease
- clinical substage of disease
- response to therapy
true or false: these factors affect the prognosis of feline lymphoma: age, sex, breed, FIV status, pretreatment with prednisone
false! they do not affect prognosis!
what is the most common canine skin tumor?
mast cell tumor
what breeds are predisposed to canine mast cell tumors?
boxer, Boston terrier, Goldens, labs, schnauzer
canine mast cell tumors: a disease of ____ dogs.
older
avg age 9yo
true or false: primary visceral involvement of canine mast cell tumors is rare
true
what is the common clinical presentation of canine mast cell tumors? what happens if the tumor is malignant?
single skin mass most common, sometimes multiple skin masses
rapid growth if malignant (ulceration, swelling, ecchymoses –> going to local LN, viscera, marrow)
true or false: systemic illness is uncommon with canine mast cell tumours but it may occur
true
with canine mast cell tumors, what predicts prognosis?
histopath grade
describe the Patnaik grading system for canine mast cell tumors
grade 1: benign
grade 2 (most): intermediate malignancy (aggressive local invasion, low-mod rate of mets)
grade 3: highly malignant (aggressive local invasion and distant mets)
with canine mast cell tumors, most dogs have ____ disease.
local
what is the primary therapy for canine mast cell tumors?
surgery
with a dog with MCT patnaik grade 2, what therapy should you do?
surgery and radiotherapy
50% of dogs with “resected” Patnaik grade 2 MCT have regrowth within 1 year - help with radiotherapy
true or false: chemotherapy is a reasonable primary therapy for canine mast cell tumors
false
what are the two forms of feline mast cell tumors?
cutaneous (mastocytic vs histiocytic) and visceral (splenic vs intestinal)
true or false: feline MCT has a breed and sex predilection.
false… although, histiocytic cutaneous MCT appears more commonly in Siamese cats
what is the most common cutaneous form of feline MCT?
cutaneous: mastocytic
tell me the typical presentation of mastocytic cutaneous feline MCT?
- older cats (~10yo)
- raised, white to pink, hairless dermal nodules, often on head & neck
- usually benign behaviour
tell me the typical presentation of histiocytic cutaneous feline MCT?
- young cats (~2.5yo)
- firm, pink, hairless subq masses often on head & neck
- benign
what do mastocytic and histiocytic feline MCT look like on cytology/histo?
M: typical mast cells
H: histiocyte-like cells with equivocal granules
what is the typical presentation of visceral feline MCT?
- older cats (>10yo)
- more malignant than cutaneous
- pleural/peritoneal effusion w/ mast cells and eosinophils
- cats often systemically ill (weeks-months) (anorexia, weight loss, v+, d+)
- splenomegaly, abd mass, abd effusion, lymphadenopathy, pallor
what is the treatment and prognosis for cutaneous feline MCT?
surgery, excellent
submit all specimens for histopath
what is the treatment and prognosis for visceral feline MCT?
splenectomy, less than cutaneous
what is the bone common bone tumor of dogs?
osteosarcoma
who does canine osteosarcoma affect?
middle aged-older dogs
large/giant breeds
true or false: canine osteosarcomas are not highly malignant
false. they are highly malignant
what is the typical clinical presentation of canine osteosarcomas
- lameness + swelling at primary site
- poor response to analgesics
- mild trauma often precedes lameness
- pathologic fx possible
- occurs most commonly at growth plates “away from elbow, towards the knee”, more common in forelimbs
- consistent rapid mets to lungs
tell me about therapy for canine osteosarcomas
initial therapy: surgical resection of primary tumor
then chemotherapy + radiotherapy
true or false: bone cancer is common in cats
false. it is rare
what is the most common form of bone cancer in cats?
osteosarcoma
keep in mind that bone cancer in cats is rare
true or false: feline osteosarcomas have a high met rate
false. it has a low met rate
who does feline osteosarcoma effect?
older cats
what is the clinical presentation of feline osteosarcoma?
- deformity + lameness
- hindlegs more common
- mets rare
describe the treatment for feline osteosarcoma
aggressive resection recommended
adjuvant therapy not clearly indicated
excellent prognosis