Squamous Cell Carcinoma - any opinions on radiation treatment?

So, my darling boy cat of 15 years has what the vet thinks is a tumor on his nose. At first we thought it was a scratch but it has not responded to antibiotics and in fact it has grown, slowly but surely over five weeks and his skin has puckered a little around it. He is unaware of it at present - a little snuffly but eating like a horse as usual and happy in himself.

My vet was reluctant to biopsy the growth as it would mean giving him a general anaesthetic and at 15 years old, and having recently had a big general anaesthetic when he had his tail amputated in November due to a gangrenous lump, he thought it would be hard on him. We weren't sure he would even make it through that operation back in November but he is a little trouper,

So my vet shocked me a bit last night when he started suggesting radiation treatment on the growth he has now. He is under the impression it wouldn't involve another general anaesthetic for the treatment but general or not, it still sounds like a harsh course of treatment on an increasingly frail and elderly cat.

I'm not convinced its the right thing to do. As much as my urge is to try and preserve life, I really want to do right by my cat and I don't know if putting him through radiation treatment is right for him or if making the most of the time we do have together (if indeed it is a tumor. No firm diagnosis without a biopsy but my feeling is that it probably is) would be the kinder and ultimately more fulfilling option for him.

Does anyone have experience of radiation treatment on a facial tumor and what it might entail or what the outcome could be?

I'm based in the UK so treatments might be different here but broadly speaking, top line thoughts would be so welcome at a difficult and confusing time. Thanking you in advance.

I'm so sorry you haven't gotten a response before now.  My Milo passed away at 14 years from  squamous cell carcinoma - his tumor was on his upper gum.  I don't have the experience with radiation treatment you're asking for but do have some experience with the disease.   I opted not to go through the radiation treatment and my vet did not advise it but in his case, we did not discover the tumor until quite late.   He didn't develop symptoms until 11 days before he passed and then it was a rapid decline.  In your case, since your boy seems to still be doing relatively well, it might be worth considering. You might have caught it early when radiation might be more useful.   However, I don't understand the vet's advice to put him through such a harsh treatment without having a definite positive from a biopsy.   Often when cats (and people) get a serious diagnosis, it is worth getting a second opinion anyway, so perhaps you should consider that.

I'm really very sad to hear that you and your cat are going through this.  It is a heartbreaking thing.  I really hope your cat has something else (minor) wrong with his nose.

@Margd  Thank you so much for your reply, so much appreciated. And I'm very sorry to hear about your chap. Is that him in the picture? He is *very* handsome.

Its so useful to get extra feedback. As you say, a second opinion is a really good idea. I love my vet and appreciate everything he has done for us but he is old school and much as I listen to what he says, at this very important stage of Eddie's life, when I have a chance to make a big impact on what may be his Autumn months, extra voices are useful.

You also make a very good point about diagnosis. Without a biopsy, we don't actually know what we are dealing with.

I do suspect that its possibly nasty as it has not responded to antibiotics at all. It is growing, slowly but little by little.

The good part is that at the moment, Eddie is totally unbothered about it and being his usual diva self.

I just wanted to say that I am sorry to hear about Eddie's condition. Admittedly I do not have experience with that type of cancer nor a cat that old. I'm guessing that you are out weighing quality of life verses quantity of life.

Aside from the cancer how happy / healthy is Eddie? Do yo think he's got a good 5+ years if he beats the cancer? Financially is the treatment going to set you back? Are you able to devote the time for the vet appointments, feedings (possibly forced), logging medications and side effects?

These decisions are never easily and weigh heavily on the heart. In the end, I'm sure you will do right by Eddie.

It is good news that Eddie is his old self, despite the growth.  Did your vet ever take a culture of the spot?  Perhaps it does not respond to the antibiotics used because they are either the wrong ones?  I am just reaching for straws here, I know how very worried you are.  My heart really goes out to you as you try to make these decisions - there are so many things to take into consideration, it can be overwhelming.  Even so, I am sure you will make the right decision for Eddie.  You know and love him best.

My avatar is Chula, a delightful torbie who is my current roommate.  Here is one of the few pictures of my old Milo that I have.  Do you have any pictures of Eddie you could share?  We'd all love to see them!

Thank you all for your input and insights, very much appreciated.

The vet hasn't taken a culture - do you mean a biopsy? As this would entail a general anaesthetic and he doesn't want to give him another general if he can avoid it. He didn't think he'd make it through the general he had back in November when he had his tail amputated but Eddie, ever the trooper, surprised us.

I am however, planning on taking him to another local vet for a second opinion. Not because I don't trust the vet I have. I do. But I need another pair of eyes on this and as you mentioned @Margd, we might be reaching for straws but another opinion never hurt.

I should probably say at this point that I lost my mum in Sept after a cancer that involved a lot of invasive treatment that ultimately made her last months much harder so this does play into my current situation. I feel like Eddie has very elegantly endured a lot in his life (alongside all the loveliness too of course) and here I have an opportunity to *not* make him endure any more, but instead, enjoy the time he does have.

Here he is last year at his best cheeky self


And more recently with his nasal addition:

Eddie is such a beauty.   I adore black cats - they are such gorgeous creatures.  When I said culture, I meant like a scraping - something that wouldn't involve putting Eddie under.    Maybe that isn't possible with this kind of spot.  Anyway, I'm glad you're getting a second opinion.  Please keep us updated on everything.

I totally understand about not wanting to put Eddie through the rigors of treatment.   Like your Mum, my mother passed away from cancer.  I've always believed that the treatments actually hastened her death.  She was almost symptom free before the surgery and chemotherapy and was extremely sick thereafter until she left us six months later.  So, yes, I would agree that just enjoying Eddie in the time he has left is a very reasonable approach.  And who knows?  Maybe it is not as bad as you fear.  Fingers crossed for both of you.  

Oh, I'm so sorry about your mum. I'm sure this must have a profound effect on you.

I'm sort of on the opposite foot as you, so to speak. I have a young 4/5 year old (also black) cat. She has spinal lymphoma. We were given no options other than palliative care. Sent home with steroids and pain medication, I am heart broken.

I want her to have chemo and radiation. She's young and otherwise healthy. 5 years isn't very long for my precious angel. If the vet even offered an experimental treatment - I'd probably say yes if I thought my girl has a chance. Financially I am not wealthy, but I'm willing to do whatever it takes to get the funds to pay for her medical expenses.

In the end... I can not save her and it breaks my heart into pieces. All I can do is enjoy the short time we have left together. For that, I am grateful.

I know in the end you will do right by Eddie and through whatever decision you make will be one of love. We are here for you.

@Margd  & @Inanna

Thank you both for your kind words and in return, In sorry to hear of your own losses and current heart breaks. There is something about pet illness that I feel can be (and no judgement on myself, anyone else or this scenario generally) a vacumn or space in which to mourn a lot of things really. It all comes up and its neither good nor bad, I guess its just part of being human.

@Inanna  I agree, five years old is a very different story to 15. I came close to losing Eddie at 8 years old and it was awful. As it was, it was solvable and I felt he was young enough to deal with it but it wasn't easy. I'm really sorry to hear of your situation, sending good cat vibes and I wish you peaceful times together - and hopefully with some laughs thrown in, I encourage Eddies playful side as much as possible and it helps both me and him.

He has an appointment late next week with an oncologist vet as my local vet can't really answer all my questions. I need a diagnosis or at least a 'what to expect' scenario.

For the moment though, it feels like business as usual for Eddie which is a blessing. A little snuffly but otherwise ok.

I've been wondering how you and the handsome-cheeky-loving-regal-kitty Edward are doing.  SCC is so aggressive and I'm still learning something new about it everyday.

I was curious about his breathing, I've noticed with my Simon, sometimes he breathes heavy and sometime it's normal, I'm thinking it's the reaction to the med's.  Is Edward on any pain med's at this point or clindamycin for infection?  

Please let us know how the 2nd opinion goes.  I wish you and your furry mate well.

@2Cats4everLoved  Hey there, good to hear you and I often wonder how you and Simon are coming along - thank you for keeping us posted on the other page.

No huge changes for Eddie but instead, small incremental ones. You may relate to this but sometimes when you see a pet every single day, its hard to discern change (which is another reason why your diary keeping exercise is a great idea). His nose is starting to run quite a lot and I feel that he is a little quieter but again, I may imagine this. His appetite for food is un-diminished. Eating like a horse as usual.

.

We have to remember he has no official diagnosis yet (he is seeing the oncologist vet next Thursday) so we can't say for sure that its SCC but my gut feeling is it a tumor and benign or not, it is growing and starting to bother him.

My concern right now is that he is already concealing pain - he is a master of this. So many times in the past he has had the most horrendous fight related abcesses and I've not realised until they are virtually bursting out of him because his behaviour has not changed at all.

So, I am keeping a very watchful eye.

My concern right now is that he is already concealing pain - he is a master of this. So many times in the past he has had the most horrendous fight related abcesses and I've not realised until they are virtually bursting out of him because his behaviour has not changed at all.

Edward's a true warrior in every sense of the word.  Please keep us informed.  Thoughts & Prayers to you both.

@Edwardthefirst

When is the next appointment? Will you be asking for any kind of pain medication for him?

Thinking of you & your handsome warrior. Glad that he's still able to chow down like the best of them.

@Inanna  Hi there, Thursday is his next appointment at the Royal Veterinary College - and yes, I'll be asking all the questions and how best to proceed. He's sprawled across the bed as I write this. I think its safe to say he's having a lovely Sunday morning so far, bless him.

How did the vet appointment go?  Hoping that Eddie is feeling okay. 

Yes, please let us know.

Simon and I are wishing the best for you both.  Thank you so much again for your kind words.

I'll be thinking about you and Edward...

@Margd  SO, big day on Thursday, we drove out to the RVC just outside of London (Royal Veterinary College - so royal they actually had a royal visit that morning. Camilla - no biggie) to try get some answers.

Long story short, it quickly became apparent that without a biopsy, there was little they could tell me so I relented, (I was worried about putting him under a general) and hey presto, he came through it just fine.

No test results until next week but they did say a couple of things that made me feel a lot better....

If it is cancer, its most likely not an aggressive one otherwise he wouldn't have survived this long - its been 3 months since he first went to the vet for it and I noticed subtle changes around his nose for a while before that (so subtle I didn't even consider acting on it)

They also said what a happy cat he seemed to be. This was the best thing for me to hear. They said he seems very upbeat in himself so whatever the outcome, thats the most important thing for me right now.

Thank you for enquiring, much appreciated!

Edwardthefirst said:

 
@Margd  SO, big day on Thursday, we drove out to the RVC just outside of London (Royal Veterinary College - so royal they actually had a royal visit that morning. Camilla - no biggie) to try get some answers.

Long story short, it quickly became apparent that without a biopsy, there was little they could tell me so I relented, (I was worried about putting him under a general) and hey presto, he came through it just fine.

No test results until next week but they did say a couple of things that made me feel a lot better....

If it is cancer, its most likely not an aggressive one otherwise he wouldn't have survived this long - its been 3 months since he first went to the vet for it and I noticed subtle changes around his nose for a while before that (so subtle I didn't even consider acting on it)

They also said what a happy cat he seemed to be. This was the best thing for me to hear. They said he seems very upbeat in himself so whatever the outcome, thats the most important thing for me right now.

Thank you for enquiring, much appreciated!

Click to expand...

Wow, Royal Treatment...  Only the best for Edward!  LOL  Fantastic, this is great news...  Happy Cat...

Simon and I are keeping you guys in our thoughts and prayers. 

Edwardthefirst said:

 
@Margd  SO, big day on Thursday, we drove out to the RVC just outside of London (Royal Veterinary College - so royal they actually had a royal visit that morning. Camilla - no biggie) to try get some answers.

Long story short, it quickly became apparent that without a biopsy, there was little they could tell me so I relented, (I was worried about putting him under a general) and hey presto, he came through it just fine.

No test results until next week but they did say a couple of things that made me feel a lot better....

If it is cancer, its most likely not an aggressive one otherwise he wouldn't have survived this long - its been 3 months since he first went to the vet for it and I noticed subtle changes around his nose for a while before that (so subtle I didn't even consider acting on it)

They also said what a happy cat he seemed to be. This was the best thing for me to hear. They said he seems very upbeat in himself so whatever the outcome, thats the most important thing for me right now.

Thank you for enquiring, much appreciated!

Click to expand...

This is such wonderful news on so many levels.  Having a top notch vet is great and I'm so glad Edward sailed through the biopsy procedure.  Most of all, I am delighted to hear that if it is cancer, it is a slow growing one.  Those are the ones that respond to treatment. 

Please let us know what the biopsy shows!

Hello from me and Simon, Just wondering how you and Edward are doing...  I hope all is well with your handsome boy.  Best to you.