What is the prognosis for oral cancer in a cat?

Q: “ My 10-year old cat has what looks like a pea-sized tumor under his tongue. If it is found to be cancerous, what is the prognosis for a complete recovery? Can you provide more information on this topic? Thank you.”

A: It depends on the type of cancer.

The presence of a mass or lump in any animal is potentially serious and should be evaluated by a veterinarian to determine if it is benign or cancerous.

In older cats, especially those over 10 years old, squamous cell carcinoma is the most common oral tumor, accounting for 60 to 70 percent of all oral tumors. Younger cats can also get this type of cancer. Most of these tumors occur at the base of the tongue, although they may also occur on the lip, gums, palate, and tonsils, as well as in the maxillary and mandibular (jaw) bones. These bones are frequently involved. When oral squamous cell carcinoma metastasizes (spreads), it does so via the regional lymph nodes near the jaw. However, regional and distant spread of this type of oral cancer is apparently rare unless the tumor arises in the tongue or tonsil. It is speculated that the extensive grooming habits of cats possibly expose them to carcinogens on the hair coat, thereby predisposing the tongue to the development of this type of cancer. Response to treatment and prognosis for recovery is poor.

Two other relatively common types of oral cancer in cats are fibrosarcoma and epulis (dental tumor). Although fibrosarcoma is the second most frequent oral cancer in cats, it constitutes less than one in five oral cancers. Fibrosarcoma usually appears on the gums and palate. This cancer may affect adult cats of any age, although older cats are more likely to develop it. Fibrosarcoma, like squamous cell carcinoma, rarely spreads to regional lymph nodes, but unlike the latter, it occasionally metastasizes to tissues distant from the oral cavity. Prognosis is generally fair.

Epulides are cancers of the gingiva, or gums, that arise from the periodontal ligament. Some types may invade bone, displaying malignant behavior. These dental tumors occur much less frequently than fibrosarcoma, and do not tend to spread. With treatment most dental tumors of cats carry an excellent prognosis. Other cancerous tumors of the oral cavity exist, but are seen even less frequently.

You need to have your veterinarian examine your cat and do a work-up on the tumor. Your cat's health status may be assessed with a thorough physical examination, bloodwork, and a urinalysis. Radiographs of the primary tumor are advised and x-rays of the chest recommended to look for visible evidence of cancer. Regional lymph nodes are sampled concurrently to look for metastatic (spreading) cancer cells. The veterinarian typically will take a fine-needle aspirate, scraping, or a biopsy of the mass and send the tissue to a pathologist to identify the tumor and to provide information about its prognosis. This will help your veterinarian determine what therapeutic steps are appropriate.

Depending on the pathology report, your veterinarian may refer you to a specialist in surgery, oncology, or radiation oncology.

Treatment of oral cancers varies according to the type of tumor, how extensive it is, and the health status of the patient. Treatment may include surgery, chemotherapy, and radiation therapy. Treatment is very successful in the epulides and considerably less so in fibrosarcoma and squamous cell carcinoma.

Please consult with your veterinarian promptly.

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