Surgery for stage IV Lung Cancer

My hsuband (54) had a PET scan because he has a 2cm mass in his upper left lobe.  The PET scan showed "activity" in the upper left lobe and "activity" in the left adrenal gland.  He will be having a lymph node biopsied next week.  In what I've been researching, it appears that once cancer leaves the lung and infiltrates another organ it's automatically Stage IV and that once it's labeled Stage IV all surgery options are out -- there's only chemotherapy and/or radiation offered.   Is this true?  

[litbee]

My dear girl,
I'm so sorry. Unfortunately this is true.

[HeinrikMD]

Hi,

By definition, stage 4 cancer precludes surgery. However, if there is reason to believe that the adrenal mass is not malignant – then this removes the stage 4 designation and surgery may be considered. However, adrenal involvement is commonplace for lung cancer and some centers would not evaluate further. If the size of the lung involvement is amenable to surgery then this would raise some doubt that the disease may not yet be metastatic. An imaging study like an MRI could raise further doubts and a biopsy of the adrenal could be done to make sure it is not really stage 4.