Hi Trudy - there is a thread for multifocal lung cancer, perhaps one of Connect mentors can move our discussion there as I don't know how.
My first VAT surgery I was a stage 1b (because over 3cm) or based on the TNM staging system it was a pT2a. My second VAT had a pT1b (smaller), however pathology said STAS present - that means "spread through air spaces". There is now a new means of spread - the tumor is "shedding" but they don't know a whole lot about it. Tumor Board chose not to give me adjuvant therapy but only put me under close observation. Where do those cells go?
They need to find a blood supply, and how long can they survive? Not much known.
Anyway all my lymph nodes have been clean and my PET scans have indicated no spread and the other notable nodules are stable so I guess one can call this type of cancer "well behaved".
I have not needed chemo because they got it all and I have no metastasis.
I have been told I am not a candidate for immunotherapy because of my episode of pneumonitis. They can't be sure that the drugs will not trigger another inflammation causing more lung scarring. My numbers are already moderate obstruction, and the last test showed a severe drop in diffusion. They need to preserve lung function to preserve quality of life. My best option going forward will be ablation.