Should I Repeat Surgery For Breast Cancer?

[Pouncecat1]

My cat has breast cancer. It started as a small lump which was misdiagnosed because i took her to Affordable vet- they are cheap and overbooked. I waited 3 hours - they wanted to repeat x rays because the vet thought she felt a huge mass next to her kidneys - it was normal. To say i was furious at their incompetence was an understatement. Any competent vet should not mistake kidneys for a mass. The tiny lump she had, they didn't recognize as cancer... ($200 for x rays)

The cancer spread quickly (within months)- mostly fluid buildup in the breasts with two lumps. I took her to a different vet who did bloodwork, repeat x rays, and surgery($800).

6 months later, and the cancer is back. Just one lump this time, but i can feel some fluid buildup.

I was told chemotherapy would be $4,000 so we aren't going that route. Plus she would need a complete mastectomy.

The lump right now would be relatively easy to remove -3 to 4 stitches and ten days in an E collar. But her prognosis is 6 months to one year to live- If we are lucky. Eventually the cancer will spread to her lungs. But if we leave the lump, it will get bigger and eventually break open and become infected.

Right now, she is as happy as ever - good appetite, happy, playful...she has absolutely no clue anything is wrong. The last surgery she came through with flying colors. The e collar was the hardest part.

I'm having a hard time saying no to the repeat surgery. But in 5 months, she could have lung cancer - it grows so rapidly. I'm torn. The vet thought we should repeat the surgery. I'm waiting for them to give me a quote before deciding. Should be under $800..

Still- i have other animals to think about. Pounce needs to see a specialist for allergy testing ($1000). I've been putting it off, which is hardly fair for him. We tried allergy shots based on bloodwork but that didn't help. He seems to do best on antibiotics as his skin gets infected easily...

 

[Mamanyt1953]

This is a hard and heartbreaking question, mostly because there are other animals whose needs have to be met. I will tell you this, many, many years ago, when animals were just begining to be treated for cancers with surgery, my dog was diagnosed with mammary cancer. Over a period of two years, she had 4 surgeries (no chemo for animal back then). She lived another 5 years after that, eventually having to be PTS, not because of cancer, but because her arthritis could no longer be controlled with medication. SO...if it fits the budget, one more surgery is not out of the question, and could give her several more good years...but there are no guarantees. There never are when it comes to cancer.

Should you decide that further surgery is NOT an option, discuss pallitive care with your vet. She can be kept comfy for a while, even without medical intervention. And, if that is the route you decide you must take, this link is to a chart to help you assess her quality of life at all stages, so that the Hard Decision can be made. I believe that Decision should be sooner, rather than later, but not TOO soon, hence the chart. It takes our hearts out of the equation, and lets us rely on our minds. As a very wise man often says, "Better a day too soon than a day too late. Never wait until their WORST day."

The Feline Quality of Life Scale Helps You Determine If It's Time to Say Goodbye to Your Cat | Catster

You and your girl are in my prayers, and a candle is lit for you both.

 

[FelisCatus]

As someone who recently lost a kitty cat to mammary (breast) cancer I have some experience in this field.

What was the first surgery that occurred? A lumpectomy? Those are generally not recommended, as the cancer comes back (as can be seen in this case).

One of the only options to get rid of the cancer before it metastasizes (spreads) is a radical chain mastectomy, preferably on both chains, left and right. The quote I had received for this was $2,500, however when my cat had cancer it had already spread so the vet said there is no point.

At that point I was sent to an oncologist to do chemo which was our final option. I don't see why your quote of $4,000 for the surgery and chemo is so high. Chemo itself is not that expensive.

For 1.5 months of treatment we paid $1,500 which included 4 appointments, the chemo, antibiotics, xrays.

If you do go chemo, the only option currently available is Palladia and from what I was told only has a 40% chance of working on mammary cancer in cats... my cat was unfortunately not lucky and it did not help at all.

If you want to go the palliative/end of life route, I would highly recommend Metacam (anti-inflammatory) if her kidneys are good.

Let me know if you have any questions and I will try my best to answer.

 

[Mamanyt1953]

Thanks, FelisCatus ! I knew one of our members had gone through this, but couldn't for the life of me pull your name to the top of my brain!

 

[Pouncecat1]

Update. I had a consult with a different vet. He wants a full mastectomy. He said it looks like they removed most of one side last time. He thinks he can remove what is left in one surgery. $1k is reasonable for the surgery...

i have not decided if it is worth doing. My concern is that there is remaining microscopic levels of cancer elsewhere.

My concern is, is it worth doing a mastectomy surgery if it doesn't work? There is no guarantee there isn't microscopic levels of cancer in her lungs already. I could put her through surgery only to make her suffer more.

Ugh. If i had caught this early, i would not be so hesitant, but it is an invasive surgery. We could just do another lump removal and let things go...

i read all the studies online which suggest treatment is futile if the lump is greater than 3 cm, and this is the second lump of that size.

I'm also not certain the vet is unbiased - he said all his personal cats developed breast cancer and had full mastectomies. His cats are doing well at this time.

it's difficult for me to make a decision on this. I want to do what is best for her. If the surgery were curative, it would be worth it.

As for just doing a lump removal, that would keep her comfortable for now, but what happens when it returns in another 6 months? When do I draw the line and say no more?

Right now she is happy and not suffering. Playing and eating well. My head says to just remove the lump and draw the line at further treatment. My heart says to try to save her no matter what...

 

[epona]

Hi, I am very sorry to hear about your cat's health issues.

One question that I cannot see the answer to (if it is there, my apologies), is how old is she? There is a difference between the way you might want to approach things if a cat is 3 years old, or 18 years old (simply in terms of having lived a full life already, and/or ability to physically bounce back from surgery and chemo)

 

[cat princesses]

I’m sorry to hear this. I always say it’s quality of life and if your kitty seems happy right now I would just leave things as they are. That’s a very difficult and invasive surgery and I’m sure the recovery isn’t fun. My last cat had mammary cancer and we removed the only lump she had and when another cake we chose to just let her live out her life and spoiled her rotten.

 

[fionasmom]

I also think that age is a factor. It is heartbreaking that it was misdiagnosed in the beginning as well and while it is absolutely not your fault, that will probably never quite go away. My 13 year old GSD who has had Cushings for 5 years is a melanoma amputee and received 6 immunotherapy injections of Oncept at $1000 each, not counting surgery. More health issues have come up and I have made the decision to stop the Oncept and keep him comfortable as much as I can. Treating Cushings is not an option; it has to continue. Having to consider finances is important and absolutely okay. Everyone here would do anything we could for our pets if we were able.

The lump opening and becoming infected does concern me and I am not sure what they are saying from there if you don't remove the lump now.

My dog was given a year to a year and a half with all the treatments that could be thrown at him, which I did. If he is alive in July he will have made it two years from the melanoma dx; however, recent blood work showed suspicious red blood cell activity which could signal melanoma on the move. There are no guarantees with cancer and that is part of what you have to deal with.....nothing is fair about how hard you tried and how you deserved credit for doing so. I learned that as a breast cancer survivor myself.

I think you are incredibly logical and clear headed about this, even if you feel confused inside and that you will make the right decision for your girl.

 

[NadiaRey]

Hey. If you see this, Pouncecat1, would you tell us what happened with your cat? I found this thread by chance; I came to this forum on a similar situation to yours and I was looking for some advise as well.

(...) this link is to a chart to help you assess her quality of life at all stages, so that the Hard Decision can be made. I believe that Decision should be sooner, rather than later, but not TOO soon, hence the chart. It takes our hearts out of the equation, and lets us rely on our minds. As a very wise man often says, "Better a day too soon than a day too late. Never wait until their WORST day."

The Feline Quality of Life Scale Helps You Determine If It's Time to Say Goodbye to Your Cat | Catster View attachment 276275

I just wanted to thank you, because this is actually one of the things I have been banging my head against the wall about... So, even if it wasn't for me, thank you.

Mine has melanoma, in the most aggresive state. She was given 3 months to live... which are about to be up. We subjected her to three surgeries. Radiation theraphy and quimio are useless.

Just to compare notes, about prices, in my country's currency the surgeries were: $4.000 the cryosurgery, and $8.500 per traditional surgery (she had two). And this was with half the usual prices. Plus antibiotics almost daily for all three months (doble the first month) because the tumor was in her mouth and it kept getting infected out of control - btw, $100 per shot daily for three months being $9.000+. Add to that the shots to control the antibiotics effect on her tummy, and serum for dehydratation that one time... I must have used up about $30.000+ argentinian pesos. (Btw, my salary is about half that ammount...)

And now I'm wondering if I should do immunotherapy, because if I can't control the growth, she can't eat. That's no way to go... She had to recover from a very difficult surgery recently. The last surgery had complications and she lost part of her jaw. She lost a lot. I want to believe with those surgeries at least we gave her a couple more... days (? I don't know if 'months' even...). But she's very willful and she acts like little is wrong... is all very confusing really. I'm just trying to find a balance - as you said, Mamany, I don't wanna be "too late", so I have to contemplate that while respecting her wishes to keep living -comfortably as I can provide- for whatever time she's got left.

Honestly, you ask me "Is the potential benefit worth the cost to your pet?", my answer will always be 'yes' and that I just need to sort of the 'how'. The comfortable part is the problem. If the medication is going to make her sick, for example, I need to weight that into the math too...

.... sorry, I just realized I rambled a lot there. What I wanted to ask is if anyone had any experience with immunotherapy that you can advise me about. I'm afraid she will stop eating if I try to mix medication with food, or have a bad reaction--- I just bought the first batch and I'm already second guessing myself.

 

[Pouncecat1]

Sorry to hear about your cat. I went ahead and did the second surgery but it was too late. The cancer returned at the incision site, then started growing internally. She developed 2 new lumps at the incision site, and a golf ball sized tumor growing against her intestines. She was happy and feeling good until the last week of life. I had her put down July 2nd. She wanted to eat but couldn't keep food down. I do not believe she suffered much. She was okay until she wasn't. I had a few days to say goodbye where her stomach was sore but she was still eating some.

if the tumor is in your cats mouth, i would watch food intake carefully. Use that as a guideline. I knew my girl was ready to go because she growled at me, just wanted to sleep and be left alone, didn't want to eat. Her tumors were starting to ooze fluid, and while not super painful to touch, they weren't comfortable either. Before this, they were not painful despite their size.

If your cat is still acting normally, i would continue treatment. I think the surgery was really the worst part of any of this. My cat was always disoriented coming out of surgery and scared of being someplace strange.

Maybe consider donating some DNA. I saw this too late to donate my cats dna.
Feline DNA Needed for 99 Lives Cat Genome Sequencing Initiative

The research team at the University of Missouri is seeking DNA samples from 16 cat breeds and from cats with particular feline diseases. Breeds in which DNA is needed are: American Bobtail, Balinese, Bombay, Burmilla, Cornish Rex, Chausie, Exotic Shorthair, Khamomanee, Kurilian Bobtail, Manx, Norwegian Forest Cat, Russian Blue, Singapura, Somali, Thai, and Turkish Van.

They are looking for DNA from cats diagnosed with inherited cancers: lymphoma, fibrosarcoma, squamous cell carcinoma, melanoma, and mammary cancer. They also are seeking DNA from these cats with unusual coat phenotypes: Peterbald, Don Sphynx and American Wirehair.

For information contact Dr. Leslie Lyons at the University of Missouri at [email protected]. For information about the cancer studies, contact Dr. Wesley Warren at [email protected].

 

[fionasmom]

NadiaRey I just read this and now have a bigger picture of what Sueno is facing. I did reply to the PM. All I will add here is that I would find out what the side effect could be to the immunotherapy that you will be using as it may be that dog and cat immunotherapy are following different pathways.

 

[NadiaRey]

Sorry to hear about your cat. I went ahead and did the second surgery but it was too late. The cancer returned at the incision site, then started growing internally. She developed 2 new lumps at the incision site, and a golf ball sized tumor growing against her intestines. She was happy and feeling good until the last week of life. I had her put down July 2nd. She wanted to eat but couldn't keep food down. I do not believe she suffered much. She was okay until she wasn't. I had a few days to say goodbye where her stomach was sore but she was still eating some.

if the tumor is in your cats mouth, i would watch food intake carefully. Use that as a guideline. I knew my girl was ready to go because she growled at me, just wanted to sleep and be left alone, didn't want to eat. Her tumors were starting to ooze fluid, and while not super painful to touch, they weren't comfortable either. Before this, they were not painful despite their size.

If your cat is still acting normally, i would continue treatment. I think the surgery was really the worst part of any of this. My cat was always disoriented coming out of surgery and scared of being someplace strange.

Maybe consider donating some DNA. I saw this too late to donate my cats dna.
Feline DNA Needed for 99 Lives Cat Genome Sequencing Initiative

The research team at the University of Missouri is seeking DNA samples from 16 cat breeds and from cats with particular feline diseases. Breeds in which DNA is needed are: American Bobtail, Balinese, Bombay, Burmilla, Cornish Rex, Chausie, Exotic Shorthair, Khamomanee, Kurilian Bobtail, Manx, Norwegian Forest Cat, Russian Blue, Singapura, Somali, Thai, and Turkish Van.

They are looking for DNA from cats diagnosed with inherited cancers: lymphoma, fibrosarcoma, squamous cell carcinoma, melanoma, and mammary cancer. They also are seeking DNA from these cats with unusual coat phenotypes: Peterbald, Don Sphynx and American Wirehair.

For information contact Dr. Leslie Lyons at the University of Missouri at [email protected]. For information about the cancer studies, contact Dr. Wesley Warren at [email protected].

I'm so sorry, Pouncecat. This horrible disease... I know I don't have anything to say to make it better... I'm so sorry for your loss.
Thanks for telling me your experience anyways. Yeah... not too different from what I expected... and it doesn't make it any less painful. I know too well about your struggle: just a week may be already too late, and every time a surgery got posponed for whatever reason, I felt like I messed everything up. Like you said, you can never know because the damn thing doesn't hurt them - the not being able to eat (or breath) is the problem. I had been scared all this time it got to her lungs, but it seems the mouth already is going to be the problem, if she cannot eat. But, like you said, at least she's still eating... I need to check for that for reference, rather than pain.... I swear, it makes me so mad. why the heck isn't there a cure for this yet?? everything is too messed up!

Thanks for the link too. I'm not in america so I don't know how I can send them what but maybe I can contact them and ask. Also, I think mine is just a common american cat... I'll attach a photo here, maybe you can tell me. I always had troubles identifying breeds. (It's an old one, jaw still whole.)

NadiaRey I just read this and now have a bigger picture of what Sueno is facing. I did reply to the PM. All I will add here is that I would find out what the side effect could be to the immunotherapy that you will be using as it may be that dog and cat immunotherapy are following different pathways.

Thank you too, fionasmom. I'm visiting my vet today (Sueño is due antibiotics anyways) so I'm asking him in a couple of hours. Thanks for replying to my PM too. I'll chek that out