Is this the beginning of the end?

Doctors notes from May 30 are as follows: A known biopsy-proven 5 to 6 cm left upper pole solid enhancing renal cell carcinoma. Looking at his renal mass imaging his mass looks relatively stable although I am a bit concerned that he has a small amount of tumor protruding into an upper pole segmental vein soft tissue of which appears just slightly larger than it did about a year ago. I think he would be best served with a left radical nephrectomy rather than partial nephrectomy as I think this is highly likely to be a T3a lesion. I do not see any regional lymphadenopathy his contralateral kidney appears normal his adrenal glands appear normal.

He did recently undergo a CT scan of the chest which shows some subcentimeter indeterminate lesions which will warrant follow-up and a CT chest will be obtained per radiology rec's.

Follow up chest CT scan June 12 as follows: Right lung: Scattered stable small subpleural nodules most notable in the right middle lobe (201/113). These are nonspecific and do not have suspicious features. Several scattered calcified granulomas. Small nodular thickening in the lateral superior aspect of the major fissure which is stable (2 1/107). No suspicious pulmonary nodules in the right lung. No focal consolidation. Airways are widely patent.
Left: Stable small subpleural densities largest in the anterior lateral left upper lobe (201/68). Several smaller calcified nodules in the left lower lobe. New curvilinear irregular density demonstrated in the superior segment of the left lower lobe (202/368, 2 1/88, and 202/99) measures approximately 8.7 mm and surrounds the subsegmental bronchus. This is specific and may represent inflammatory change however developing pulmonary nodule not excluded. Findings are not entirely typical of a urogenital metastasis. No other suspicious nodules or focal consolidation. Airways are widely patent.