| Lymphoma Cancer in Cats |
| What are lymphomas? Lymphoma is a diverse group of cancers that originate in lymphocytes - a type of white blood cell in the immune system. The commonly affected sites are lymph nodes, spleen and bone marrow, but lymphoma can occur in almost any tissue in the body where there is lymph tissue such as the gastrointestinal tract, eyes, central nervous system, bone, testes, bladder, heart, and nasal cavity. Lymphoma is one of the most common cancers in cats, with the median age at diagnosis 11 years old. Lymphoma can be classified into several categories:
Alimentary/intestinal lymphoma This type of lymphoma can be either specific to the intestine or involve other organs such as the liver. The most common site is the small intestine (50-80% of cases), followed by the stomach (25% of cases) and colon. It can be present as either a single tumor or can be diffused (spread) throughout the intestine and muscle layers that can interfere with food passage. Mediastinal lymphoma This type of lymphoma can involve the thymus and lymph nodes within the chest cavity, and is frequently accompanied with fluid accumulation. Most cats with mediastinal lymphoma are young and positive for feline leukemia virus. Nodal lymphoma Involvement of peripheral (external) lymph nodes alone represents only about 4-10% of cases in cats, however, over 25% of cats with other lymphoma present in other body locations will also have affected lymph nodes. Extranodal lymphoma The most common sites for this type of lymphoma are the kidneys, nasal cavity, eyes, central nervous system and the skin. Kidney lymphomas represent approximately 5% of all lymphomas and extend to the central nervous system in 40-50% of cats. Lymphoma in the nose is usually a localized disease but spread to other sites have been reported in some cases. What are the symptoms of lymphoma in cats? The symptoms will depend on the tumor's location and how advanced the disease is. Regardless of the lymphoma location, blood tests may show reduced number of red blood cells. The alimentary/intestinal lymphoma is usually associated with an abdominal mass, enlarged lymph nodes, weight loss, lack of appetite, diarrhea, and occasional vomiting. The mediastinal lymphoma is usually associated with shortness of breath, fast breathing, sounds in the lungs and fluid accumulation in the chest. Cats with nodal lymphoma will typically show signs of weakness and depression. Cats with lymphoma affecting the central nervous system will show sudden onset of weakness, bladder paralysis and lack of muscle coordination. Cats with lymphoma in their nose will frequently show nasal discharge, bleeding deformity, or shortness of breath. How is the diagnosis made? Pets with suspected lymphoma will have a variety of tests done to confirm the diagnosis, including physical exam, blood tests, urinalysis, imaging studies and biopsy. In many cases, fine-needle aspirates of the affected area is sufficient to confirm lymphoma but biopsy remains as the gold standard for any cancer diagnosis. After confirming the diagnosis, it is important to evaluate how advanced the disease by imaging techniques such as ultrasound, X-rays, CT scan or MRI in order to plan an appropriate treatment. Does cancer cause pain in cats and dogs? Pain is common in pets with cancer, with some tumors causing more pain than others. In addition to pain caused by the actual tumors, pets will also experience pain associated with cancer treatments such as surgery, radiation therapy or chemotherapy. Untreated pain decreases the pet's quality of life, and prolongs recovery from the illness, treatment or injury. It is, therefore, essential that veterinary teams that are taking care of pets with cancer should also play a vital role in educating pet owners about recognizing and managing pain in their pets. The best way to manage cancer pain in pets is to prevent it, a term referred to as preemptive pain management. This strategy anticipates pain ahead of time and administers pain medication before the pet actually experiences pain, thus ensuring the pet's maximum comfort. To learn more about which tumors are likely to cause a lot of pain, how to recognize pain in pets with cancer and what cancer pain management options are available for your pet, please visit the Cancer Pain Management section. How important is nutritional support for pets with cancer? Cancer cachexia (a term referring to progressive severe weight loss) is frequently observed in pets with cancer. Pets with cancer lose weight partly because of lack of appetite and partly because of cancer-induced altered metabolism. Some of the causes for decreased appetite are related to the cancer itself (for example, tumors may physically interfere with food chewing, swallowing, and digestion process) and some may be related to the side effects of cancer treatment (for example, some chemotherapy drugs cause nausea and vomiting, and radiation therapy can cause mouth inflammation). Proper nutrition while undergoing cancer treatment is essential to maintain your pet's strength, improve survival times, quality of life and maximize response to therapy. Adequate nutritional support was shown to decrease the duration of hospitalization, reduce post-surgery complications and enhance the healing process. Additionally, pets with cancer need to be fed diets specifically designed to provide maximum benefit and nutritional support for the patient. To learn more, please visit the Cancer Nutrition section. What are the treatment options for cats with lymphoma? Chemotherapy remains as the treatment of choice, and combining several different chemotherapeutic drugs has shown greater benefit compared to single drugs. The most effective chemotherapeutic drugs currently in use include the combination of doxorubicin, L-asparaginase, polyethylene glycol-L-asparaginase, vincristine, cyclophosphamide, and/or prednisone. If multi-drug therapy cannot be used, single drug doxorubicin or prednisone can be offered as an alternative. Are there any clinical trials for cats with lymphoma? Although there are no clinical trials evaluating new treatments specifically in lymphoma, there are several clinical trials available for cats with any tumor type for which your cat may qualify. To learn more these trials (which are partially or fully funded by the institutions), please visit the Cat Clinical Trials (any tumor type) section. Additionally, there is one clinical trial evaluating how often cats with lymphoma are deficient in cobalamin (vitamin B12). To learn more about this study, please visit the Cat Lymphoma Clinical Trials section. What is the prognosis for cats with lymphoma? The prognosis for cats with lymphoma is not as good as for dogs, and will depend on a variety of factors such as lymphoma type, location, and how advanced it is. Complete response rates range from 50-70% after multi-drug chemotherapy and overall survival is approximately 6 months. For those cats who responded to chemotherapy, 25-30% of them enjoy long-term survival (more than 1 year). Unfortunately, it cannot be determined beforehand which cats will respond. Alimentary/intestinal lymphoma The median survival of cats with this type of lymphoma is 7-10 months following doxorubicin-based chemotherapy treatment. One study of 28 cats who did not receive doxorubicin-based treatment showed that the median survival of these cats was 50 days. Mediastinal lymphoma Cats with mediastinal lymphoma positive for feline leukemia virus (FeLV) face a poor prognosis, with median survival times of 2-3 months after chemotherapy. Cats who are negative for FeLV have much better prognosis, with 90% experiencing high response to chemotherapy. Nasal lymphoma Cats with lymphoma in their nose face the best prognosis. Radiation therapy or chemotherapy are able to control the tumor and the cats enjoy a median survival time of 1.5 years. However, cats with both lymphoma and FeLV infection face shorter survival. Additional online resources about lymphoma in pets: Gastric lymphoma in cats (by Veterinary Society of Surgical Oncology) Large intestine lymphoma in cats (by Veterinary Society of Surgical Oncology) Small intestine lymphoma in cats (by Veterinary Society of Surgical Oncology) Gastric lymphoma in cats (by Veterinary Society of Surgical Oncology) Nasal cavity lymphoma in cats (by Veterinary Society of Surgical Oncology) Spinal cord lymphoma in cats (by Veterinary Society of Surgical Oncology) Kidney lymphoma in cats (by Veterinary Society of Surgical Oncology) Lymphoma in Cat by Doctors Foster and Smith Feline lymphoma (by Washington State University) Lymphoma in cats and dogs (by Michigan Veterinary Specialists) Sources:
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Last updated 2/19/2017
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