Quick update on Peekaboo

I took our cat, Peekaboo, to the vet two days ago, around lunchtime. When her new CAT scan results came in, my vet told me that, even though the melanoma had spread a bit in the past two weeks, the cancer hadn’t gone into the jawbone yet. She recommended that we do the surgery.

After asking a few obvious but almost-impossible-to-answer questions (will the surgery PROLONG HER LIFE without impacting her QUALITY OF LIFE, blablabla), I called Stefano, and we both agreed it was our only choice at this point, even though there really aren’t any guarantees: this sort of cancer is very aggressive, so it may come back at some point…

But if we’d waited until, say, September, it would have been too late to do anything. And by then she would been suffering a lot…bleeding from her mouth, etc. I’ve seen the photos online…It’s nasty.

We had to try removing the blasted thing…

In a nutshell: the surgery went well. No complications. Now we just have to wait until she’s well enough to come home. That will happen once she begins eating on her own, which is going to take a few more days…

Yesterday Stefano and I went to see her twice, at lunchtime and just before dinner. I braced myself, expecting her to look like a little Frankenstein, but no, she actually looks the same (see photo). Not that we care what she looks like, of course! As long as she’s okay…

She’s not a happy camper, as perhaps you can tell from the photo. She’s NOT in any pain, of course, but I think the Elizabethan collar is driving her bonkers. Plus, the painkiller/sedative is making her live in a world of her own. I don’t know how much she even knew that we were there…

My job is to get her to eat on her own again. So at one point I put some mushy food on my finger and offered it to her. She turned her head, growling (growling? My Peekaboo???), got up and moved away. Who can blame her? Poor sweetie. I didn’t insist. I’ll try again today. As soon as she begins eating on her own, we can bring her home, where she will be happier and recover more quickly, for sure.

I just hope the vet surgeon was able to get all of that blasted thing, that no cells escaped, and that there will be no recurrences…

One day at a time.

It’s not just malignant. It’s very aggressive.

All of Peekaboo’s test results are in (see my July 4 post; Peekaboo is one of our cats…11 years old…I took the above photo of her in 2015).

The biopsy confirmed the diagnosis of an aggressive malignant oral melanoma.

I won’t go on and on about all the discussions Stefano and I (and friends and family) have had in the past couple of weeks, especially this past weekend…all the going back and forth (surgery…or no surgery???), all the online research we’ve done, reading horrible stories on various cat forums, the heartbreak, the anxiety…”what should we DO???”…

You can imagine all that…

We haven’t been sitting around…doing nothing but talk, I mean. In addition to speaking with the oncologist and the vet surgeon at our own vet hospital, last week we sent her test results to a well-known oncology specialist vet( outside of Florence) who called us on Saturday, recommending we go ahead with the surgery.

Even with that second opinion, I still didn’t want to put her through all that misery…the pain…the risks of doing this surgery…etc. During the weekend, talking things over with Stefano’s aunt (also a cat lover) and his cousins, I decided to let Nature take its course: palliative care…curcumin…pain killers…But no surgery. Definitely absolutely NO SURGERY. How do you explain to a kitty that she’ll have to undergo such a painful procedure blablabla? You can’t. It’s not fair, I decided. She might never recover…never be able to eat properly again…and then she will die anyway, eventually…So WHY do it? Those were all the things rushing through my mind this past weekend.

But what happened today changed my mind. This morning I took Peekaboo to see another vet surgeon, highly recommended, at a clinic here in Florence. He went through her tests very carefully and calmly and told me that, if this were HIS cat, he’d go ahead with the surgery. I still wasn’t completely on board, though…

Until we looked into her mouth…

I’d seen the melanoma almost two weeks ago, when it was just a tiny oval on the side of her gum. Well, it’s not an oval now, and it’s not tiny, either. In just two weeks it has spread quite a bit. Now you can see the blasted thing clearly. It’s growing.

It freaked me out, I have to admit.

I took Peekaboo home and decided I needed to discuss this new bit of information with our vet and the main vet surgeon over at the vet hospital. I was there within a half hour. I told them both what I’d seen this morning in her mouth, and here’s what we agreed to do (we = all of us, Stefano included, of course…Oh my poor sweetheart, getting all this awful news while at work!):

I’ll take Peekaboo to the hospital day after tomorrow (which happens to be my birthday…I hope it brings her luck!). The vets will do another CAT scan to see how much the tumor has spread. Then we will decide what should be done.

  1. If the blasted thing has spread TOO much, meaning that a manibulectomy would impair her QOL, then I’ll just take her home, and we’ll go with the palliative care option. Right now the tumor isn’t bothering her: she’s eating (even dry food), playing, purring, etc.
  2. If, as we hope, something can be done to give her a good QOL for quite some time, we’ll go ahead with the surgery.

Whatever the choice, it’s going to be hard on all of us…first and foremost, on Peekaboo, of course, but also on Stefano and me. And I can’t help but still ask myself: are we doing the right thing? Or rather, are we doing the right thing FOR HER?

To be honest, right now I don’t have an answer…

Incidentally, I’d really appreciate hearing from anyone who might have had this sort of experience with their cat. Thank youuuuuuu!

A case report: the antibiotic roxithromycin induces PR in a patient with smoldering myeloma

Well…Well…WELL!!! I’ve got a very interesting item for you today…

Many many many thanks to my blog reader Charlotte for this gem: goo.gl/hMsWov

The link will lead you to a case report about a 86-year-old patient (with IgA lambda smoldering myeloma) who went into partial remission after taking roxithromycin, an antibiotic, for just ONE MONTH. This happened last year in New Zealand.

The patient’s paraprotein, which had been increasing since he was diagnosed in 2008, dropped from 46 g/L to 20 g/L.

That’s a 57% decrease! Wowsie.

And another thing: in addition to his other markers remaining stable (calcium and creatinine, e.g.) in the four months after taking roxithromycin, his hemoglobin increased to 132…from 97. Another wowsie.

I also discovered something else: the antibiotic clarithromycin has been found to have anti-myeloma activity BUT only in association with other drugs (dexamethasone, etc.). That’s the difference between the two antibiotics, since roxithromycin appears to have “significant single-agent anti-myeloma activity.” That is, it goes after myeloma all by itself…

I’m not a big fan of antibiotics, that’s for sure (although when you need ’em, you need ’em!!!), but this case report has certainly given me food for thought…

A lot of food for thought…

 

“Crystal structure reveals how curcumin impairs cancer”

Wow, VERY EXCITING BIT OF NEWS that popped up in my Google Alerts yesterday.

My post title is the title of a new study revealing a previously unreported biochemical activity of curcumin. This very important study, carried out by three research teams (University of California San Diego School of Medicine, Peking University, and Zhejiang University), shows how curcumin attaches to, and INHIBITS, a gene called DYRK2, which is associated with cellular growth and/or development. This inhibition diminishes the proliferation of cancer cells. It reduces the tumor burden. 

How about THAT?

Here’s the link to the University of California San Diego School of Medicine press release: goo.gl/XPUz6G

Quote: “DYRK2 depletion impairs proteasome activity and exhibits slower cancer proliferation rates and significantly reduced tumor burden in mouse models. In combination with the FDA-approved multiple myeloma drug, carfilzomib, curcumin induced a much higher cancer cell death while normal non-cancerous cells were less affected. This suggest that targeting proteasome regulators (such as DYRK2) in combination with proteasome inhibitors may be a promising approach of anticancer therapy with less side-effects but further work is needed, said Banerjee.

Curcumin plus carfilzomib = HIGHER MM CELL DEATH. Food for thought.

One of the researchers involved in the study states the following: “In general, curcumin is expelled from the body quite fast. […] For curcumin to be an effective drug, it needs to be modified to enter the blood stream and stay in the body long enough to target the cancer. Owing to various chemical drawbacks, curcumin on its own may not be sufficient to completely reverse cancer in human patients.

I agree, of course. I never thought curcumin would (reverse cancer, that is, etc.). But I was also told by an expert that curcumin gets absorbed by our tissues, slurp slurp slurp!!!, within ten minutes or so after we swallow it. Well, whatever the case, curcumin has done me (and many of you, too!!!) a world of good in the past 12 and a half years…

And that is why, while waiting for researchers to come up with a truly effective, modified form of curcumin, I’m going to keep taking my daily eight grams of C3 Complex.  

Well, well. Curcumin never ceases to “wow” me, that’s for sure…

Possible case of feline oral (malignant) melanoma

Because our 11-year-old cat, Peekaboo, has been very aggressive toward the new kittens…stalking them, pushing them into corners and then hitting them until, screeching like hyenas, thus giving us heart attacks, they manage to escape (mind you, she doesn’t hurt them, no blood is shed, e.g., but she really scares them, and that isn’t nice at all!), I finally took her to the vet clinic yesterday morning for a checkup.

When, back in May, I took Pandora and Pixie to the clinic to be spayed, I spoke about this aggressive behavior with the vets who agreed with me that Peekaboo might have some sort of painful physical condition. Pain can make a cat aggressive. Well, come to think of it, pain can make ANYTHING aggressive!!! Made sense to us, since she has never been like this before…

Soon afterwards, though, I came down with bronchitis, so the appointment got postponed. Until yesterday, when my schedule finally coincided with the good vet’s schedule.

As soon as the vet began the checkup, however, Peekaboo started growling ferociously and acting like a wild animal. I’ve never seen her like that…and she has certainly NEVER behaved like that at the vet’s. She’s usually super friendly with human beings, even vets. Not this time. It was so bad that we decided it would be best to have her sedated to have all her tests done. This turned out to be a good thing, as we will see.

To make a very long story short, her blood and urine tests were fine, her abdominal ultrasound was also fine, and her spinal column is in good shape. All very good news.

BUT, and unfortunately there may be a big BUT (!), the vet found a small black spot on her gum (lower, left side) that worried her so much that she used a fine needle to suck up some cells, which she then examined. If Peekaboo hadn’t been sedated, the vet wouldn’t have seen the spot.

Apparently, there were some malignant cells in the sample. The vet thinks it might be oral (malignant) melanoma, which is quite rare in cats, but this diagnosis needs to be confirmed by the oncologist and by a biopsy, which Peekaboo is having done today (I had to leave her at the clinic last night), together with a CAT (hah!) scan. We won’t know the results of the biopsy until next week…

Stefano and I are incredibly worried, of course. If this turns out to be oral melanoma, the prognosis really sucks…

For now, all we can do is wait and hope…

P.S. Does anyone have any experience with feline oral melanoma (just in case that’s what this “thing” turns out to be)? Thanks!

P.P.S.S. Incidentally, the first three photos show Peekaboo as a kitten in 2007; the first two were taken in July, just before and just after we adopted her; the third, in November 2007. The fourth, not-very-great photo, taken with my cellphone, is more recent: June 25 2018. Our beautiful girl!!!