There is understaging and overstaging all the time...the PET/CT or CT with dye does not detect the microscopic cancers which might be lurking in a distant node...ie.,why they take so many nodes out........yes some may be very obvious...others not so. Additonal testing with chest x-ray, bone scan do their best to aid diagnosis. Its certainly not an exact science but you increase your odds with a top notch institution and top notch specialist that deals almost exclusively with blc..and that believe it or not is hard to find if you're a newbie. I actually remembered a advertisement that almost always appears in the NY Times magazine supplement.
"Cancer. Where you're treated first can make all the difference." I first hit the NCI sites and then the NCCN.org sites and weeded out from there.
As for the 47 million uninsured people in America and the countless others with insurance that doesn't cover a disease as devastating as cancer try
www.cancer.org
to see if they can help or 1 800 ACS 2345.