Advice re my father

Hi,

I'm looking for some advice regarding my father's situation.  He is 87 years old, in relatively good health, but has some dimentia/short term memory loss.  He went in for an xray in 12/2012 and they saw something that sent him for further testing.  He had a pet scan and this is from the report - "Moderately intense FDG avid nodule in the upper left node anteriorly with an SUV of 5.4.  Finding is consistent with lung carcinoma. There is a mildly FDG avid subcarinal adenopathy with an SUV of 3.7 Finding is suspicious of metastic adenopathy."  Based on that, they did a biopsy of his lymph nodes and that came back negative.  But they still think the nodule is cancer and were ready to treat it as cancer but we requested a biopsy.  The needle biopsy came back inconclusive.  So now we are not sure what to do.  The cancer board of RI hospital apparently reviewed the findings and concluded that it was cancer even with the inconclusive biopsy.  The surgeon is pressing us to make a decision and thinks that surgery is the best course because it's most effective, if he can tolerate the surgery.  

We are a little nervous to put him through the surgery because of his age and the dimentia and when we present the info to him he gets confused and doesn't really understand why we need to do anything since he doesn't have pain.

We had an appointment with an oncologist today to help us decide. He is going to talk to the surgeon and review the pet scan but he seemed to be leaning towards surgery.  He thought our decision points were - do something or not.  If we do something, do surgery or repeat the needle biopsy before pursuing other possible options of radiation or ablation.  It seems weird to do the surgery when we don't even know for sure it's cancer, but they seem pretty sure based on the pet scan. Although they also thought it had spread to the lymph nodes based on the scan and it hadn't.

Does anyone have any thoughts, advice, further questions we should ask to help bring us more clarity on what to do?  Any advise is greatly appreciated.  

Thanks,

Lola