Getting a diagnosis of feline lymphoma is never going to be good news. But there is some hope because you have a few different options for how you can treat your cat. Every individual kitten that receives a cancer diagnosis will be a one-of-a-kind case because they are a one-of-a-kind animal. Knowing the options that will be best for both your pet and your wallet will make a big difference when choosing the right treatment plan.
While lymphoma is not currently curable, getting the right treatment can bring your cat into a state of remission where the cancer cells are not active or affecting their quality of life. Cats who reach remission can live comfortably and happily for several months at a time, depending on the stage of their cancer and the treatment chosen for them.
Lymphoma is a systemic cancer, meaning that it affects many parts of the body at the same time. And because chemotherapy is able to treat the entire body at once without causing very much strain on your cat, it has become the most common and recommended treatment for lymphoma.
The most common protocol for chemotherapy treatments in cats will be CHOP, a multiagent chemotherapy plan that uses different drugs to combat the adaptive cancer cells that create lymphoma.
Lymphoma is a cancer of the immune system, it develops in cells called lymphocytes. Your cat’s immune system is made up of cells—including lymphocytes—whose job it is to help combat infections or other threats. When the lymphocytes change or mutate, they evolve as abnormal cells that grow out of control. These abnormal lymphocytes gather and develop into tumors. The cancer cells have multiple mechanisms of survival and will, eventually, learn how best to fight against the medication. By using multiple different drugs, it becomes more difficult for the cancer cells to adapt and develop into resistant forms, which then makes the treatment more effective in the long run.
Lymphoma in cats has many histological subtypes, including low-grade lymphoma and intermediate- or high-grade lymphoma, the latter having a more aggressive clinical course. CHOP-(cyclophosphamide, doxorubicin, vincristine, prednisolone) or COP-based protocols are commonly used as first-line therapy for intermediate- or high-grade lymphoma in cats; reported response rates average around 60%.1
Cats with the most common form of lymphoma—gastrointestinal and large cell—that receive CHOP as their treatment method are likely to respond well to treatment and achieve at least a partial remission. Over half (50%-70%) of the cats receiving this treatment achieve a partial remission that keeps them healthy for at least 6-9 months, with those that achieve a complete remission living longer and a small percentage of those cats living over 2 years after treatment.2
Though they are often more effective, chemotherapy doesn’t always have to be administered through a multiagent treatment plan. Single drug treatments can also be effective for certain types of lymphomas. In intermediate- and high-grade gastrointestinal lymphomas that have not yet been introduced to the chosen drug, single-agent lomustine had an overall response rate of 50%, with a median duration of response of 302 days. Drugs like CCNU (lomustine) and Prednisolone as a steroid treatment may be able to effectively treat your cat for at least some time.1
Radiation therapy is an option for some cats, though there are not as many benefits to the treatment as there are from chemotherapy treatments. For cats with gastrointestinal lymphoma and those with nasal lymphoma, radiation treatment in addition to chemotherapy has the potential to bring a longer remission time, or shorten the length of time during treatment before remission is achieved.
Radiation therapy, while less invasive than surgery, causes significantly more strain on your cat’s body than chemotherapy alone would. Radiation therapy or radiotherapy treatments require your cat to be put under anesthetic and treated with high doses of radiation (similar to the radiation used to perform X-rays, though at a significantly higher volume).3
Radiation is often only recommended to patients that have the lymphoma localized to one specific area, making cats with nasal lymphoma the most likely to receive this treatment.4
Cats are also more likely than other animals to receive long-lasting skin changes in the area where the treatment is administered, either getting skin lesions or having long-lasting hair loss in the treatment area. Many cats post radiotherapy will need to wear an E-collar to protect the affected area from becoming more irritated.5
Surgery as a treatment option for lymphoma by itself is incredibly uncommon, with most cases needing additional treatment support in the form of chemotherapy. While it is uncommon alone, that doesn’t mean that surgery in addition to a chemotherapy treatment is not incredibly helpful for progressing the efficacy of the chemotherapy.6
Examples of a type of case that would benefit from surgery would be gastrointestinal lymphoma where a large mass has developed in the intestinal tract. Removing the large mass will allow the chemotherapy to not have to work as hard to remove the cancer from the body. Rather than having to neutralize all of the cancer cells that were in that large mass, they now only have to neutralize cancer cells that were left behind, or in other parts of the body’s immune system.7
There are other instances when surgery can help to finalize the diagnosis, and allows for the clearest understanding of what kind of cells are affected by the cancer as well as other specifics that can help in making the right choice of treatment. For some patients, the lymphoma may develop in a place that cannot be accessed safely for a non-intrusive biopsy and in those cases getting a sample of the affected tissue needs to be done through surgical removal.
While chemotherapy will always be the most recommended treatment option for any pet with lymphoma, in the case of gastrointestinal lymphoma, there are some natural approaches available for assisting with your cat’s quality of life (note that this will not help them to achieve remission).
The reason that gastrointestinal lymphoma can be approached this way is because its symptoms have been found to be linked with feline inflammatory bowel disease, which has holistic treatments available to help negate the symptoms and bring your cat more comfort.
Of those options, the most common include adding supplements to your cat’s diet. Specifically, supplements that help with easing the process of digestion, like digestive enzymes, which help foods get broken down more efficiently and nutrients brought to where the body needs them. Or supplements that can help limit inflation in the intestinal tract, often in the form of hemp oil. There may also be some that are designed to help boost your cat's immune system, as it is compromised due to the cancer cells affecting it.8
Some holistic approaches would recommend that you feed your cat homemade food, though be sure to talk to a vet before creating a new diet for your cat; there are some foods that may be healthy for us but are dangerous to our pets.
ImpriMed has successfully developed a system that helps dogs with lymphoma, and is now working hard to build up that same system for cats, but needs help to collect enough data to offer effective help to cat parents out there.
Immunophenotyping is one of the initial steps your veterinarian will take to determine the best treatment option for your pet. It comes shortly after identifying that there are cancerous cells in the body.
ImpriMed is conducting a study on feline cancer cells and is happy to offer free immunophenotyping for your pet.
Not only will allowing us to provide your vet with some support help you and your pet, but it will also aid us in being able to help even more cats in the near future.
Find out more about our Free Immunoprofile for feline lymphoma and leukemia