Like I said before, some have been able to tough it out through the physical problems associated with radiation in particular, and also surgical wounds and chemo. As most of the regular readers here know, I am diametrically opposed to getting any drug or treatment that is not completely necessary. Due to the benign nature of PEG tubes, it is one of the few things that I would consider getting prophylacticly. Because of the individual nature of patients, the treatments types they receive, the amount of those treatments, the location of those treatments, the duration of those treatments, they will have varying degrees of associated problems such as mucocitis, sloughing tissue which leave raw open wounds behind, xerostomia, etc. They will all have different responses the exact same treatment in the same location, though to a lesser degree. They will have different abilities to tolerate pain, and different psychological perspectives on what having a PEG tube placed means to them. So suffice it to say that the standard of "need" is obviously malnutrition or weight loss. If this is happening, the PEG is no longer an arbitrary issue. You need the nutrition. So the next logical answer would seem to be that getting one is predicated on a patients degree of physical discomfort and ability to get proper nutrition without a PEG system, with measurable weight loss of 10% of the pre-treatment weight being the maximum allowable, and this being the visual and finite definition of weather or not proper nutrition is being obtained, rather than a patients tolerance to pain and willingness to tough it out till the end. You don