You have to consider all options. Radiation and chemo are the primary tools, but if all else has not resolved the issue more tools have to be added. At this point I would want to know what the doctors feel his options are. Clearly in all these locations, surgery alone will not resolve things. It is possible that a change in chemo might help the lungs, but what works there does not always work in other areas. If their prognosis is dire, and I hope it is not, it may be time to look at clinical trial drugs and options.