[music playing] Kelly: When it comes to cancer, our feline companions are not immune.

In fact, at the University of Illinois, two veterinarians are examining a new treatment approach, for cats with mouth cancer.

On this episode of The Paw Report, we're joined by doctors Timothy Fan, and Alycen Lundberg to discuss their research, but also options for you if your cat is diagnosed.

Stay with us.

[music plays] >>Rameen Karbassioon:Okaw Vet Clinic in Tuscola and Dr. Sally Foote remind you to properly take care of your pets, and are happy to help support the Paw Report on WEIU.

Okaw Vet Clinic, located at 140 West Sale Street, in Downtown Tuscola.

More information available at okawvetclinic.com.

Dave's Decorating Center is a proud supporter of the Paw Report on WEIU.

Dave's Decorating Center features the Mohawk SmartStrand Silk Forever Clean carpet.

Dave's Decorating Center, authorized Mohawk Color Center,in Charleston.

Kelly: Thank you for joining us for this episode of The Paw Report.

I am your host Kelly Runyon, and we're joined today by two special guests, Dr. Alycen Lundberg, and Dr. Timothy Fan, from the University of Illinois Veterinary Teaching Hospital.

Interesting topic we've got today.

We're going to talk about really in depth cancer, but specifically, cats battling mouth cancer.

Thank you both for joining us today.

Timothy: Thank you.

Kelly: Very interesting study.

I've read a pet column that both of you were involved in, and the studies that you're undergoing at the U of I. Alycen, we'll start with you.

Tell us a little bit about you, yourself, what you do at the U of I, and specifically your interest in what you're doing with this study.

Alycen: Yeah, absolutely.

Currently I am a PhD candidate in Dr.

Fan's lab.

I finished my medical oncology residency last summer, it was a three year program, and was really interested in new cancer developments, and in research specifically.

So stayed on to do a little bit of clinical instructorship on clinics with resident training and student teaching, and then a much more heavy focus on doing research in cancer development, cancer/drug development.

Kelly: Mm-hmm (affirmative), Dr.

Fan?

Timothy: I'm a Professor at the University of Illinois, been there for about 20 years and really had a great opportunity over the two decades to really grow as a comparative scientist.

To look at cancer as a shared disease process between pet dogs and cats, as well as people.

And have had really great, and rich opportunities to work with basic scientists on the University of Illinois campus.

Kelly: We'll stay with you Dr.

Fan.

The U of I was one of four institutions to receive a prestigious grant to do some feline research specifically on cancer.

Talk about why that grant was important, and maybe some of the intricate ins and outs of what you have to do now that you've received that grant.

Timothy: Sure.

I think that there are limited opportunities for funding of companion animal research.

We actually receive funding from Morris Animal Foundation, which is the largest animal foundation that supports research in companion animals, large animals, and exotic animals.

We were very lucky to actually be successful in getting money from this organization.

I think that when we look at the funding landscape for different types of animal studies, there's probably more money available to help dogs, but cats are second in line to actually receive funding.

We were fortunate to look at cancer in cats as a major problem in the older population.

We do recognize that there are other diseases in cats that need a lot of attention, like heart disease, and kidney disease.

But, cancer is certainly an emerging disease that needs quite a bit of attention.

Kelly: Alycen and you're in the lab a lot, what is the most ... And we can talk about some varying types, but what is the most common type of cancer in cats?

Alycen: Yeah, so cats can get a variety of different tumors in their mouth, but most commonly we see something called, "Squamous Cell Carcinoma."

That makes up really 90% of the oral tumors that we see.

That's by far, the most prevalent of what we need to focus on.

Kelly: But others too, you said?

Alycen: Yep, there are other tumors.

They can get tumors called, "Fibro sarcoma," that would be the next most common.

Or, they can have tumors involving the bones in the jaws as well.

Kelly: Are they all deadly?

Alycen: Some tumors are benign and can potentially be treated with surgery, and they can have a good quality of life for some time.

Most of the time though, we just don't have a lot of room on a small little cat head to do any surgery that's going to remove a tumor in its entirety, that would give them a normal lifespan essentially.

Kelly: You know, there are lots of different breeds of cats.

Is there any ... What are the qualities of the cat that may be most susceptible to getting the disease?

Alycen: Getting this, yes.

Kelly: Yes.

Alycen: A lot of different cancers will have certain breed predispositions.

With this kind of cancer specifically, we don't really have a breed predisposition.

We do it see though in middle age, to older cats.

Those are the ones that are going to be developing this.

Kelly: is it gender specific?

Alycen: Not with this one, nope.

It can happen in males, or in females.

Kelly: And genetic, what if it was their mother- Alycen: Not that we know.

Kelly: ...

Right.

Alycen: We're still doing a lot of research, and trying to pinpoint the different genetic predispositions that might be there, or environmental causes as well.

Kelly: What about some of the early signs that owners might experience if they anticipate that something might be wrong with their pet?

Alycen: It can be very varied with cats, which is why it's a lot of times we don't see this, until it's very further along in the disease process.

It can be something as simple as, "My cat just isn't acting right," 'cause cats can be very stoic.

Maybe they're just hiding and not acting normal.

When something's not right, they tend to just resort to just being very withdrawn.

They can also be drooling excessively, there might be some swelling on the different parts of the face.

There can be bleeding from the mouth.

It might even be that the cat wants to go eat, so they go up to the food bowl, but then will attempt to eat but can't because it hurts.

You might see an interest in an appetite, but not able to actually prehend food.

They might just be very painful when you try to open up their mouth to look in it.

Kelly: Mm-hmm (affirmative), and cats, Dr.

Fan, are very ... Not all cats, but a lot of cats are keep to themselves, and they might hide something that might be wrong with them.

It's just their temperament.

Timothy: Yeah, and I think that, that's the challenge of the veterinary profession, right?

We are reliant upon pet owners to be observant, and we're also relying upon pets to be expressive.

Having those two qualities often forces us to ... Often results in us detecting cancer at a later stage.

We are challenged to actually provide strong cures for these animals, because we usually find the disease late in the stage, and usually if you catch cancer early, the better the chance you have at curing it.

Cats are, as Dr. Lundberg stated, can be very reclusive, and their symptoms can be very vague, even to the most preceptive pet owner.

If you have a pet owner that is not very preceptive or doesn't spend much time with that pet, then diseases can get really, really out of hand, and spin out of control before they're actually diagnosed.

Kelly: A preceptive pet owner may not think, "Oh, I need to open up my cats mouth and start looking around."

If they are preceptive and they do think of that, or maybe they've done some research, or they're knowledgeable, how would you even go about trying to hold your cat and try to do something like that, or feel around, or feel around on their face?

They don't like that.

Alycen: Nope, they don't like that.

Kelly: You probably deal with that, both of you probably deal with that.

Alycen: I think the best thing a pet owner can do if you think something is wrong and not quite right with your cat, is go and see your family veterinarian.

We know that people come in with very vague descriptions of what's going on, and we can do a very thorough physical exam, and we can better examine the oral cavity, 'cause we know what is normal, so it's easier for us to detect what is abnormal.

Kelly: Mm-hmm (affirmative), what about risk factors, or maybe that goes along with the cause too of what brings this on.

I mean, is there any ... And I'm sure in your research and your studies, that's something that has evolved.

Alycen: Yeah, absolutely.

There are multiple epidemiological studies that have looked at what are some environmental things that might be causing this.

They're not necessarily ... We don't know an exact cause of it, but we know that cats that wear flea collars do have an increased risk of developing this.

Or, cats that eat canned food, specifically canned tuna, might also have an increase risk.

There is a potential association with household smoke as well, being a potential association with cats developing this.

Those are things that have been studied, but we don't have a specific cause for this kind of cancer yet.

Kelly: Maybe if you could take us into the exam room.

I'm a pet owner, I have a cat.

I notice some irregularities with my animal.

I make an appointment, I come into your office.

Kind of take me through the evaluation process, and I can address that to either one of you 'cause you've both done it.

But the evaluation process before, in your mind you're thinking, "I think we need to take this a step further."

Dr.

Fan?

Timothy: I think that really as clinicians, we have to listen to the pet owners.

Every doctor has their own style.

My initial style is to actually spend a lot of time just speaking with the pet owner, trying to glean from them what they think is going on, what they perceive as different.

Then mentally, I begin to develop my own idea list of, "Well, what could be causing these symptoms?"

I spend a lot of time speaking with pet owners first.

That establishes a good idea of what they're seeing at home, but also develops a relationship with the pet owner, right?

The pet owner needs to have confidence that they're being beard, that their observations are being listened to.

I spend a lot of my time doing that first, and then I put my hands on the cat, and I actually do a physical exam.

Everyone has a different way of doing physical exams, but we want to hit all the major body systems.

Meaning that, we want to listen to their heart, listen to their lungs, feel for any lumps or bumps, take a look in their mouth.

Usually I try to couple my physical exam emphasis, with what I hear the pet owner telling me about, right?

The pet owner is complaining about drooling, or foul odor from the mouth, then I'm going to spend more time looking in the mouth.

That's kind of how I approach it, really to speak with the owners first to get an idea of what they see, they perceive is concerning, and then try to backfill with my physical exam.

Kelly: When a pet owner probably hears the possibility of cancer, I know as a pet owner, I think I would probably go into panic mode.

When you associate that, you associate that disease with potential death.

Their first question is treatment.

"What can you do to save my cat from this disease?"

My guess is, there are probably several treatment options that can be evaluated.

Timothy: Yeah, I think that for not only for this type of cancer in cats, but for any cancer, there's probably four pillars of therapy that we think about for every type of cancer.

Recognizing that certain pillars are going to be cornerstone treatments, while other pillars may be not that helpful.

The four pillars we usually think about is surgery, chemotherapy, radiation therapy, and probably more importantly as we develop a bigger veterinarian medical tool box, will be immunotherapies.

For this disease specifically, we usually get the best results when we do surgery.

However, as we said earlier, if you're not a preceptive pet owner, or if the cat doesn't show these clinical symptoms, the disease is very advanced before it's discovered.

Surgery is very difficult in an animal such as a cat, that has a small head, has a small jaw, that you can't really do big surgical removal.

Surgery is not often something that we could do regularly with this disease, so then we're really left with radiation therapy, and/or chemotherapy.

Neither of those two treatment options are highly effective in managing big, measurable disease.

We're really kind of stuck with not very good therapies for this disease right now, and that's what emphasizes the importance of the research that Dr. Lundberg is doing.

Kelly: Mm-hmm (affirmative).

If we could go back to the research just for a moment, and go back to the grant that the U of I received.

What type of work will this allow you to pursue?

It's my understanding, correct me if I'm wrong, it's in the pilot testing stages right now, and then it will move to the clinical phase, and we'll get to that.

In the pilot stage, what will it allow you to do?

Timothy: I think that this goes back to the whole concept of comparative oncology, right?

Cats with oral Squamous Cell Carcinoma, which we're studying in these pet cats, is very similar in biology, and clinical presentation, and very likely genetics as people that get it, head/neck carcinomas, not associated with human papillomavirus.

People that have tobacco exposure, or have alcohol exposure will develop head/neck carcinomas in the oral cavity.

The purpose of this research or this granting opportunity is two fold.

One is to provide potentially new therapies that are very much needed to help pet cats with oral Squamous Cell Carcinoma, because there's nothing effective for that disease right now.

But in parallel, in leering upon those important findings, we are hopeful that whatever we discover that is innovative, or hopeful, or promising in pet cats with oral Squamous Cell Carcinoma, that can be translated to actually improve treatment options for people with head/neck cancer.

Again, the diseases are very similar, and the outcomes for people with head/neck cancer is not exceptionally good either.

There's a substantial fraction of people that don't have good treatment options long term.

Kelly: Is there any sort of partnerships currently going on?

Maybe with the other institutions that receive the grant?

Is this a forever process, or is this, is there ...

I know you smile because it's like- Alycen: Yeah.

Kelly: ... "I wish we had a cure tomorrow."

But is this something that, months, years to come?

Timothy: Well I think that with regards to partners, I think at the University of Illinois campus, we have something called, "Anti Cancer Discovery From Pets to People Theme," which is a theme within the Carl Woese Institute for Genomic Biology.

This theme has a group of very dedicated scientists with diverse skillsets.

Chemistry, veterinary medicine, genetic type of studies.

All these are kind of coalescing towards identifying targets that are shared between pet animals and people, and trying to leverage and include pet cats, or pet dogs into drug discovery to help those patients from the veterinary perspective.

But at the same time, provide unique and necessary information to advance or accelerate drug development for the people side too.

Kelly: Right.

In your studies Dr. Lundberg, have you noticed that ...

I think too, and I always go back to me being a pet owner, that side effects have been reduced over time, and maybe that's something that you've discovered too?

Because probably years ago, side effects were a lot worse.

Alycen: Yeah, yeah.

So the traditional chemotherapies that we have are not specific to tumors necessarily.

They're just going to attack all rapidly dividing cells, which is why people that you've seen go through cancer treatment, and your pets potentially too, will have side effects.

Effecting the bone marrow, the GI tract, you lose your hair, and you can get really sick because we're not really just killing cancer cells necessarily.

The new compound that we're working with, is targeting a specific enzyme that we're seeing really just in tumors, and is either absent, or in very, very little amounts in normal tissue.

We are seeing less systemic side effects in the cats we've been treating.

I think any cancer treatment that you use, essentially is going to have some degree of side effects.

Whether it's radiation, surgery, chemo, there's always going to be something.

But we wanted to be as minimal as possible so that our pets and people can have a good quality of life on those treatments, but also be effective against the cancer that we're treating.

Kelly: Just to understand it, so in this particular treatment, if you have a mass, what you're doing is you're going in and getting the bad stuff, as opposed- Alycen: That's our goal.

Kelly: ... As opposed to just getting bad stuff, and then some of the good cells around it too.

That's really what you're trying to focus on.

Alycen: Yeah, yeah.

Kelly: As this moves into the clinical stage, I'm sure that you're looking for potential candidates to be part of this study, to move into like I said, to enhance your studies.

How are cats chosen?

Or if maybe somebody out there is watching, how can they be part of the clinical phase of this?

Alycen: Yeah, so we are underway with the trial right now, so we've already had a few cats that are in the official trial.

Prior to starting the Morris Animal Foundation trial that we got money for, we had a few cats that we had already been doing some pilot testing on with this, and really had promising results.

Now that we are underway with the trail, we've so far had four cats that have really found us through things like this, where we're advertising that we're doing this.

We have a cat from Montana came and stayed with us for five weeks for the trial.

We have a cat from Minnesota, we have two cats from Virginia.

Really, people are finding out that their cat has this cancer.

When they're talking to their family veterinarian, they're realizing that the prognosis is poor to grave, and we don't have good treatment options.

A lot of family veterinarians are trying to be very proactive, and seeing what's out there for their patients, and really pet owners are being very proactive for their pets.

They're getting online, they're seeing what's out there, they're seeing what options they have, and they're making huge efforts to do the best they can for their pets.

But really, a lot of people are very, very passionate about trying to better cancer research, and trying to help develop better treatment options for other pets that will develop this cancer.

Kelly: And potentially humans too.

Alycen: And humans, yeah.

Absolutely.

Kelly: You said that there were some promising results in some of the clients that you're seeing now.

Is that a shrinkage in the tumors that you've discovered, or level?

I mean obviously you would know better than I.

What are some of the promising things that you're noticing?

Alycen: Right now what we're measuring is tumor response, so how much is that tumor shrinking.

We take a measurement with a CT scan before we start the trial, and then we administer radiation therapy, and our IBD&Q compound that we're using.

Then at the very end of the trial, we repeat that CT scan, then we're measuring the size of the tumor.

We've had varying responses, anywhere from 40 to 60% reduction in tumor size.

Kelly: Oh wow.

Alycen: So, a significant reduction in size.

A lot of those cats are going home, and are much more comfortable, they're having a good quality of life with their families.

What we don't know yet is, is this going to be a very durable response?

Right now the treatments we have, cats survive on average, three months with surgery, radiation, chemo, or a combination of those.

We're seeing a very promising response in the short term, and now this clinical trial will allow us to determine is that going to be a durable response, and are those cats going to live longer?

And more importantly, will they live longer with a good quality of life?

Kelly: Right.

Dr.

Fan, I know that this research excites you.

Not just on the patients that you see on a regular basis, but long term.

You get very excited when you talk about the relationship on how what you're doing today, could help canines, and eventually humans.

Let's talk about the future, and where you hope this goes.

Timothy: I think that the future is promising.

We work very closely with a chemist on campus, Paul Hergenrother, who is actually the inventor of many of these anti cancer compounds.

Without his expertise in really leadership in it, we would be not very far in our efforts.

The goal of the study, these studies, is to really provide early information.

I think that the road to drug discovery, validation, and ultimately approval for the veterinary medical field, as well as the human field, that's a long road.

That's not an undesirable barrier, I think that we just need to be realistic.

The findings that we are having at this point, are very promising, they're early.

I think that what will very likely happen, is it will ...

The results from this Morris Animal Foundation study, will inform us how can we improve treatment regimen strategies, that will maximize the durability of response.

I think that we're very excited that these cats that get enrolled, they have substantive tumor reduction, like really, really outstanding tumor reduction.

Kelly: That's what you said.

I mean, 40 to 60% is phenomenal.

Timothy: It's really quite pleasant to see.

But where are we going to, I think have to have future and considerable effort and thought, is how do we make that response durable.

I think the findings from this initial study will say, "Yes, IBD&Q coupled with radiation therapy is effective in reducing the tumor burden in these cats."

But, the next step will be, how do we modify treatment regimens to maximize the durability of that response.

Kelly: I think essentially what you're saying is, you'd like to see that survival, that right now as you mentioned, three months, turn into years.

That's part of what you're doing right now.

Do you think that it's more prevalent today?

The cancers in animals is more prevalent today than in previous years, in the past?

Alycen: I think that's hard to say.

We have better studies now that are actually identifying the prevalence of all these different types of cancers that we see in dogs and cats.

But we're seeing more of it because people are more interested in actually treating their pets.

Pets are a part of the family, they're not ...

Most of them aren't just out in a backyard anymore.

They're sleeping in bed with their owners at night, they're really best friends.

People are very interested in pursuing these treatments when their pets are diagnosed with cancer.

We are seeing more of it, especially at the University of Illinois, for that reason.

We have an oncology service that is pretty busy, and people come in, and they're very passionate about doing the best by their pets.

Kelly: That's good to see.

Alycen: Yeah.

Kelly: People love their dogs and cats.

Alycen: They do.

Kelly: Well Dr.

Fan, Dr. Lundberg, thank you so much for joining us for this episode of The Paw Report.

The studies that you're doing, the research that you're doing is phenomenal.

I look for great things to come out of not only your office, but your university.

Thank you so much.

Alycen: Yeah, thank you.

Timothy: Thank you.

Kelly: If you're a veterinarian, trainer, groomer, specialist, rescue organization, or shelter that would like to partner with the Paw Report by providing expert guests for the show, please contact us by emailing weiu@weiu.net, or call 217-581-5956.

If you have a topic you'd like to see on the show or questions for our experts, contact us with those, too.

Dave's Decorating Center is a proud supporter of the Paw Report on WEIU.

Dave's Decorating Center features the Mohawk SmartStrand Silk Forever Clean carpet.

Dave's Decorating Center, authorized Mohawk Color Center,in Charleston.>>Rameen Karbassioon:Okaw Vet Clinic in Tuscola and Dr. Sally Foote remind you to properly take care of your pets, and are happy to help support the Paw Report on WEIU.

Okaw Vet Clinic, located at 140 West Sale Street, in Downtown Tuscola.

More information available at okawvetclinic.com.

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