Aggressive Digital Papillary Adenocarcinoma with lung metastases

I was diagnosed with Aggressive Digital Papillary Adenocarcinoma at the age of 32, back in 2012.  I'm currently 36.  They found it in my fourth right toe and my right groin.  The toe was amputated and multiple inguinal lymph nodes removed from my groin.  I would say that every several months another small "pea sized" lump would appear throughout my right leg, typically in the ankle, lower leg, and behind my knee.  These were all surgically removed as well.  More infected lymph nodes were removed from my groin last year.  I still have an infected node deep behind my knee, near an artery, so they decided to try immuno therapy with a new drug Keytruda, aka Pembrolizumab.  I've been taking this through an IV for about 45 minutes, every three weeks, for a few months.  It took some time to get approved for this drug because there isn't enough evidence to show it's success with this rare cancer.  It's typically used to treat more common cancers.  My most recent scan hasn't shown improvement.  I've had multiple nodes on my lungs from previous scans that weren't cancerous, but they have increased in number and size since I started this drug a few months ago, so I'm eager to find out what's going on when I go back this week.  I'm trying to avoid additional surgeries, especially in a sensitive area behind my knee, but was wondering how radiation or chemo has worked for anyone on here with Aggressive Papillary Adenocarcinoma.  I'm concerned about the change in my lungs and know that's a common area for this type of cancer to metastasize to.  I feel like surgery has been the only thing to combat this.  Thanks in advance!  I will continue to post updates after this Thursday.

65 yr old male,diagnosed 8/22 with dpac after having a (callus) on right thumb removed that i had for around 40 yrs,had it looked at many times by different doctors over the yrs again told it was a callus.went to moffit and was advised amputation was the way to go as I aligned with all research I had done.that was done sept.2022.had pet scan that was all clear.jan 2023 ct of lumph nodes came back clear.pet scan in april 2023 showed more than 20 small cancer cells in both lungs followed by lung biopsy that confirmed dpac.there were no options for targeted therapies so I was started on chemo(CARBOPLATIN) every 3 weeks and after 2nd infusion keytruda was added.had pet scan august 2023 termed undistinguished cells in lung no other hot spots after 4 treatments.it was decided to continue for an additional 4 treatments that I just completed and a pet scan next week.depending on the outcome of pet scan I believe I will stop chemo but continue ketruda .side effects have been mild nausea,tired ,muscle /bone pain,neropathy mainly in my feet ,dizzy.