Oncology Flashcards
true or false: most cancers are treatable
true!
the primary intent of treating cancer is
extend good quality of life as long as possible
what is “curative intent therapy”
we intend to cure, but curative intent does not guarantee a cure
clinical eval provides 5 essential pieces of information regarding cancer which are:
- definitive histopath diagnosis with tumor grade
- clinical stage of disease
- prescence of abscnece of paraneoplastic syndromes
- clinically sig concurrent medical conditions
- detailed patient baseline
the primary goal of palliative therapy is
maintaining good quality of life, not extending life and detailed knowledge of the tumor is not always needed
cancer therapy should be tailored to match expected biologic behavior in 2 major categories which are
local disease, systemic disease (aka is the cancer local or systemic)
what kinds of treatments are best for local cancer disease?
surgery, radiotherapy, or both
what kind of treatments are best for systemic cancer disease?
chemo mostly, can consider surgery.radiotherapy if theres a confined tumor
examples of common local cancers and systemic cancers in small animals
local: soft tissue sarcomas, low greade mast cell tumor
systemic: lymphoma, canine osteosarcoma, feline mammary carcinoma (multiple foci OR a high likelihood of early metastasis(
the most commonly diagnosed malignancy in dogs is _____. which breeds are predisposed?
lymphoma
boxers, golden retrievers, bull mastiffs
how does canine lymphoma usually present?
usually middle aged dogs, usually multicentric with enlarged LNs, and quite often no systemic signs of illness. other organs like spleen, liver, thymus, bone marrow can be involved.
a 6yo golden retriever comes to see you for annual vaccinations and you notice enlarged LNs. You suspect lymphoma. What are your next steps ideally?
must establish a patient baseline, check for concurrent disease, check for paraneoplastic syndromes (such as hypercalcemia), and get a clinical stage and definitive diagnosis
describe stages 1-5 for canine lymphoma
stage I: single node
stage II: multiple node on one side of diaphragm
stage III: generalized LN involvement
stage IV: stages I thru III with liver and/or spleen involved
stage V: stages I to IV with bone marrow involvement
the most effective and practical treatment for canine lymphoma is_____, with a median survival time of
chemotherapy (doxorubicin containing protocols, CHOP most common)
6 to 14 months
what are some side effects of treating canine lymphoma with chemotherapy?
GI toxicity (anorexia, nasuea, vomiting)
alopecia, perivascular necrosis
life threatening toxicity is uncommon (myelosuppression, cardiotoxicity)
what factors affect prognosis for canine lymphoma?
clinical stage of disease, whether the dog is clinically ill or not, prior treatment with steroids, whether it is B or T cell, the chemo drugs chosen, and response to therapy
the incidence of lymphoma is the highest in
cats
in cats, lymphoma can be caused by
FeLV (young cats have thymic lymphoma usually, older cats will have GI lymphoma)
enlarged peripheral LNs are uncommon for which kind of lymphoma?
feline
which organs does feline lymphoma tend to affect?
thymus/mediastinum, GI, renal, nasal, multicentric
what is the most common presenting complaint for feline lymphoma
anorexia, lethargy, weight loss, dehydration, could be pale
if GI: vomiting and diarrhea
if renal affected: PUPD
if lung involvement: dyspnea
explain stages 1-5 for feline lymphoma
stage I: single tumor or a single anatomic area
stage II: single tumor with regional LNs OR 2 tumors on one side of diaphragm
stage III: 2 tumors on opposite sides of diaphragm
stage IV: liver and spleen involvement
stage V:CNS or bone marrow involvement
the best treatment for feline lymphoma is _____ with a median survival time of
chemotherapy
7 months
who handles chemotherapy for lymphoma better, dogs or cats?
cats
true or false: adjuvant local therapy can be beneficial in some cats with lymphoma
true! can do surgery or radiation and combine with chemo. localized disease is more common than in dogs
which factors DO affect feline lymphoma prognosis and which factors DO NOT?
DO: FeLV status, clinical stage, whether the cat is clinically sick or not, response to therapy
DOES NOT:age, sex, breed, FIV status, pretreatment with prednisone
what dog breeds are predisposed to mast cell tumors?
boxers, boston terriers, golden retreiver, lab, schnauzer
true or false: mast cell tumors usually affect older dogs and primary visceral involvement is rare
true
how do mast cell tumors usually present?
usually a single skin mass, can grow slowly over months or years but if malignant they grow very fast and are often ulcerated, swollen, bleeding, etc.
where do mast cell tumors metastasize to?
local LNs, viscera, bone marrow
true or false: systemic illness is common with mast cell tumors
false, but can occur with release of granules
for canine mast cell tumors, ______ predicts prognosis
histopathologic grade
briefly describe the grades for a canine mast cell tumor
grade I: bengin
grade II: intermediate malignancy (aggressive local invasion but low risk of metastasis)
grade III: aggressive local invasion and distant metastasis
the primary treatment for canine mast cell tumor is
surgery!
complete resection curative for a grade I and lower grade II
wide and deep excision is needed for grade II and III, 3cm margins
_______% of dogs with resected grade II mast cell tumors have regrowth within a year
50
_______ has proven to significantly improve local control of grade II mast cell tumors in dogs
radiotherapy
true or false: chemotherapy is inapprorpaite for most dogs with mast cell tumors
true! BUT you could consider chemo for high risk grade II or III
what are the 2 forms of feline mast cell tumors?
cutaneous and visceral
cutaneous feline mast cell tumors can be what 2 things
mastocytic or histiocytic
visceral feline mast cell tumors affect what 2 organs?
spleen and intestine
the most common dermal form of feline mast cell tumors is
mastocytic cutaneous, usually older cats with pink or white hairless dermal nodules, often on the head ad neck
are cutaneous feline mast cell tumors usually bengin of malignant?
benign
mastocytic cutaneous happens in ____ cats and histiocytic happens in _____ cats
old, young
true or false: histiocytic cutaneous mast cell tumors can spontaneously regress
true
____% of feline mast cell tumors are visceral
50
which is more malignant: cutenous or visceral mast cell tumor in cats
visceral: spread to liver, LNs, bone marrow
true or false: cats with visceral mast cell tumors are often systemically healthy
false, they are usually systemically ill
clinical findings in cats with visceral mast cell tumors?
massive splenomegaly, abdominal mass, abdominal effusion, enlarged LNs, pallor
prognosis for feline mast cell tumors?
excellent for cutaneous–>surgery
which dog breeds are predisposed to oestosarcoma?
giant breeds: great dane, irish setter, saint bernard
a great dane presents with lameness and swelling of the left hind leg. You tried giving the dog rest and NSAIDs but the dog did not improve. what are you thinking?
likely osteosarcoma :( take rads to check
what is the saying to remember where osteosarc likes to go?
away from the elbow, towards the knee
it likes growth plates
osteosarcoma in dogs likes to metastasize to
the lungs
how do you treat osteosarcoma?
surgical resection of primary tumor (leg amputation), MST 3-4 months
chemo: prolongs survival, MST 1 year
radiotherapy is also an option
true or false, bone cancers are common in cats
false! they are rare in cats, and they do not metastaszie nearly as often
dog oestosarcoma likes the _____ and cat osteosarcoma likes the _____
front legs
hind legs
how do you treat a cat with oestosarcoma
resection (amputation)
chemo doesnt do anything
excellent prognosis with surgery done, MST 2 years
