Stereotactic Radiosurgery Followed by Wedge Resection in Treating Patients With Early Stage Peripheral Non-small Cell Lung Cancer

Inclusion Criteria: * Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2 * Biopsy proven non-small cell lung cancer * Maximum tumor dimension =\< 5 cm * No clinical evidence of N1, N2 or N3 lymph nodes as assessed by CT and/or PET-CT * No evidence of distant metastatic disease * Tumor verified by a thoracic surgeon to be in a location that will permit a sublobar resection * Tumor located peripherally within the lung (peripheral defined as not touching any surface within 2 cm of the proximal bronchial tree in all directions) and not touching the mediastinal pleura * Pulmonary function tests (PFTs) with diffusing capacity of the lung for carbon monoxide (DLCO) within 90 days prior to registration * Patient at high-risk of complications from lobectomy meeting a minimum of one major criteria or two minor criteria as described below: * Major criteria * Predicted postoperative forced expiratory volume in one second (FEV1) =\< 40% * Predicted postoperative DLCO =\< 40% * Age \>= 72 * Minor criteria * Predicted postoperative FEV1 41-60% * Predicted postoperative DLCO 41-60% * Pulmonary hypertension (defined by a pulmonary artery systolic pressure greater than 40 mm Hg) as estimated by echocardiography or right heart catheterization * Poor left ventricular function (defined as an ejection fraction 40% or less) * Resting or exercising arterial partial pressure of oxygen (pO2) =\< 55 mmHg or oxygen saturation (SpO2) =\< 88% * Partial pressure of carbon monoxide (pCO2) \> 45 mm Hg * Modified Medical Research Council Dyspnea Scale \>= 3 * Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 90 days following completion of therapy; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately * A female of child-bearing potential is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria: * Has not undergone a hysterectomy or bilateral oophorectomy; or * Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months) * Ability to understand and the willingness to sign a written informed consent Exclusion Criteria: * Pregnant women * Patients with central tumors within the proximal tree or touching the mediastinal pleura * Patients with evidence of distant metastatic disease