There
are numerous types of therapies for oral neoplasia depending
on the tumor type, size and location. Prior to any definitive
therapy there are many steps that should be undertaken. The lesion
should be biopsied to determine the type of tumor involved. Dental
radiographs should be obtained to determine the extent of involvement
of the bony structures. Depending on the type of tumor (especially
Melanoma's) thoracic radiographs should be obtained to look for
metastasis (spread). The regional lymph nodes should be at least
palpated, if not biopsied to determine involvement. A complete
blood panel should be obtained to ensure that the patient does
not have any other underlying problems that may make anesthesia
a risk. Finally, a treatment plan should be thoroughly discussed
with the owners. The treatments may be very expensive, possibly
disfiguring, and in some cases not curative, therefore all expectations
and likely results should be discussed prior to commencement
of definitive therapy.
Surgery
for oral neoplasia is still the gold standard. The key to treatment
is to obtain 1 to 2 cm margin of normal tissue around the tumor.
As you can imagine this is very difficult in cats where 4 cm
is the whole jaw. Therefore early detection and early radical
surgery is in general the only chance for a cure. In general,
the more forward in the mouth a tumor is, the better the chance
for cure. Suffice to say that you can essentially remove 1/2
of the lower jaw (either half way back, or all of one side) and
almost all of the maxilla with good function and quality of life
for the patient. In addition, the esthetics is only slightly
compromised, and most owners find them acceptable.
Complete
discussion on oral cancer therapy is beyond the scope of this
page. If you have specific questions please feel free to e-mail
me. The major treatments for oral malignancies are surgery, radiation
treatment (plus or minus hyperthermia therapy), and chemotherapy.
Chemotherapy and radiation therapy is in general not great for
oral tumors, and will not be discussed here. The exception is
that there is some new chemotherapies being developed for melanoma
that rivals surgery in survival time (still not great), and that
some fibrosarcoma respond fairly well to radiation therapy.