Peter Attia· MD
and the other point I was just going to make is that it's feasible to surgically remove Regional lymph nodes along with the primary — site of disease in you know the vast majority of cases and so because of that you know sort of historical standard practice of you know surgical reection including Regional lymph noes — we think of surgeries that can Encompass all of that as you know basically being you know one one treatment and then those patients are you know we're going to come to this I think probably a little bit further along in the conversation but you know they are thought to have not have metastatic disease