Thanks again for everyone's kindness. Biopsy results are back. The lab says it's squamous cell carcinoma. The vet said it's a very aggressive one, especially comparing x-rays of foot just a few weeks apart. From what I understand it's a common cancer in cats. I just spoke with the oncologist. I guess if it's on the face, surgery works better. On the foot, it's highly likely it metastasized from lungs. He said only direction (besides euthanasia) we can take from here is amputation of the leg. But, he said that's not really what he would recommend because he believes it will come back in a few months in a different spot. I told him I didn't know what to say or do at the moment. Most likely I will just let him go, I don't want him to suffer like this.    

OK Scout said
I'm so very sorry to hear you are dealing with an aggressive cancer.  Did he say it's highly likely it metastasized from the lungs (leg was not original site) or that he believes it's highly likely it has metastasized to the lungs (leg being the original site).  Have they done chest x-rays to confirm cancer in the lungs (lung mets)?  If the cancer originated in the leg, where does he believe it will come back (if the leg is gone). My personal inclination would to proceed with the amputation IF the cancer originated in the leg and the lungs are clear-- statistics tell you nothing about your particular cat.  If the cancer has already set up shop in the lungs, then things are a great deal more serious, and your vet would almost certainly advise against amputation. However, it is a very tough decision, and one only you can make.  We are all here for you whichever route you chose to go, as it is clear you love Alex very much and will do whatever is in his best interest. Thinking of you.

See, that's the thing, I'm not sure. I only slept a few hours, then I had an appointment with the oncologist at 7am this morning. I took Alex down there. He said the biopsy results weren't back. He took the bandage off his leg and we went home. He called me awhile after to say he did get the results, and talked to me over the phone . I'm running on lack of sleep, but I feel pretty sure he was saying it had metastasized from the lungs. I was confused by that because we've done a lung x-ray and it appeared clear. I was about to interrupt him, but then he started saying even if we amputate the leg, his opinion is it will just appear somewhere else within a few months. I tried to find info on this cancer. Here it says:

  In the period 1993-1998, digital carcinomas in 64 cats were examined. In all animals primary complaints were painful digit(s). Eight cats had a primary squamous cell carcinoma which involved one digit or two adjacent digits of one leg. Fifty-six cats had metastases of a pulmonary carcinoma in the digits, and in general multiple digits of different legs were involved. In many of these cats metastases also occurred in other organs, including the skin and muscles. No primary sweat gland carcinomas of the digits were seen. Primary squamous cell carcinomas of the digits were characterized by cornification and the absence of PAS-positive cells, PAS-positive secretory material. Immunohistochemically, these neoplasms stained negative with the monoclonal antibody CAM 5.2 directed against Keratin 8 (K 8). The metastases of pulmonary carcinomas to the digits showed one or more of the following histological features: goblet cells, ciliated epithelial cells, PAS-positive cells or lakes, and/or a PAS-positive lining of luminal membranes and no cornification. Immunohistochemically, they showed positive staining for CAM 5.2 (K8). Thoracic radiographs from three cats with a primary squamous cell carcinoma showed no abnormalities, whereas all cases of metastases from a pulmonary carcinoma to the digits available for follow-up showed evidence of a primary pulmonary carcinoma on radiography and/or postmortem examination (25 out of 56). The conclusion of this study was that most carcinomas in the digits of cats were metastases of a primary pulmonary carcinoma (87.5%). Primary squamous cell carcinomas occurred infrequently. The prognosis of metastases of a pulmonary carcinoma in the digits is poor with an average survival time of 4.9 weeks, in contrast to 29.5 weeks in cats with a squamous cell carcinoma. These data stress the importance of taking thoracic radiographs of cats with digital tumours before surgical intervention.  Source: http://www.ncbi.....d/10952443

 

I guess in most cases of squamous cell sarcoma in the digits (toes) it does metastasize from the lungs? Maybe he's just assuming something missed on x-ray? Or, maybe he just feels it's going to spread anyway, so he's just giving an extremely poor prognosis. I didn't know what to say. I didn't say much really. He said he will communicate all this to my regular vet. My regular vet won't be back until Thursday, so I plan on thinking more, and talking to him then.