34 year old with recent diagnosis. So many questions

[Maia]

Level, so sorry you're dealing with this, and at such a young age. I don't know where you are located but I just mention this, in case it helps you. At the National Institutes of Health --Maryland-- there is a trial that combines standard of care --chemo-- with two immuntherapies --a vaccine and a checkpoint inhbitor--, only for those recently diagnosed that had not systemic treatment yet --just surgery. This is the trial https://clinicaltrials.gov/ct2/show/study/NCT03050814 There is a post about that here: viewtopic.php?f=1&t=57245

And there is a similar trial starting at many locations in Heidelberg, Germany. Same concept, about starting combination with immunotherapy up-front in treatment for colorectal cancer : https://clinicaltrials.gov/ct2/show/NCT03174405

[Jacques]

In my opinion, what you would want to do at this point in time is to try to find a board-certified thoracic surgeon or a board-certified pulmonologist at a nearby major cancer center so that you can start discussions about what to do to remove your 4 lung nodules.

You can use the instructions in the link below to find board-certified doctors in various specialties. Select specialty "Thoracic surgery" to find board-certified thoracic surgeons, or select "Pulmonary Disease" to find board-certified pulmonologists

How to find a board-certified doctor:
http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=52349&p=410280#p410280

It is my understanding that the best way to deal with metastatic lung nodules is to remove them once and for all by one of the available surgery methods -- if that turns out to be possible (i.e., if the mets are indeed 'resectable'). So, one of the first steps that you would need to take is to get a 2nd opinion on whether these 4 nodules are in fact resectable and whether they could be removed by surgery at some point in time.

That's just my informal opinion. You would need to get more detailed information from folks here who have actually had such surgeries.