In California the county health care system is pretty decent. I had a friend go through lung cancer treatment and she had all of the state of the art chemo cocktails that the CCC's are currently recommending along with IMRT (she had a 15% chance of 5 year survival and has over 2 years in remission). Many of the county hospitals are also teaching hospitals and not as bad as you think. A person who is indigent or with no property actually has better options than you would imagine. You need to set up an appointment with the hospital social worker to see what all of your options are. Qualifying for Medicare can be a bit daunting - you have to stay with it. The radiation being picked up by the state is huge - my treatments were 5K a pop (it was a $300,000 program in total). Why aren't they picking up the surgery as well?

If she had IMRT they may be able to irradiate again if the new region of interest is not the same as the original site, otherwise "salvage surgery" would be the last resort.