Choice number two hands down. More invasive? Yes. But immediate resection of the primary (Get that cell generating puppy otta there) and important definitive information about local spread that is the most dangerous component, the mediastial nodes, is immediately at your disposal. You well know lymphatic involvement means a highway to other locations, and vital organs. The sooner you know that is a possibility, the sooner you can derail it, or prophylactially prevent it with chemo. In either case chemo cocktail remains the constant.

Variation three, there is no down side (if the nodes are involved) to doing that lobectomy anyway while he is there. Why put you back together and leave it behind as something else the chemo has to deal with and is still spinning off daughter cells?

Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.