There is a woman thoracic surgeon at Memorial Sloan Kettering that does surgery on these. It is not something that many attempt, since the area is where all the major arteries from your heart are located, and the slightest misstep is a catastrophic event. I don't have her name, but it could be chased down. That combined with RFA for the lung issues, might buy time, or reduce things to a point where other measures MIGHT be effective.

Many here might remember Glenn, who had this same progression. He tried all of this. In the end it bought him enough time to see his daughter get into college. I know from many conversations with him on the phone over a year, how difficult all of this was physically and emotionally. It is not a path for everyone. Glenn was a particularly tough and stoic man, a NY cop that was probably one of the toughest men I have ever known. When he had mets to his kidney he had it removed and lived on one. Mets to his liver were caught early and he had surgery to resect them. He never once bitched to me about the physical discomfort, and he didn't know the meaning of the words - give in. Eventually his progression was beyond these stop gap efforts. These are tough choices. In the end they may not produce the results that you wish. I am only posting this here for your consideration as you view the big picture.

I might also add that there are CT guided biopsy techniques to confirm that those chest nodes are actually malignant, again a dangerous procedure, but I can't count the times that people have been told that they have chest mets, to find out that the nodes are hot in a PET scan from something other than cancer.