We call this discussion the PEG Wars and it has been going on ever since this site was started. Some swear by the PEG and others swear against it. Some RO's actually "make" you get one before they will treat you and some, like mine at Moffitt, a Comprehensive Cancer Center, left that decision up to me. The problem of this Tx is the radiation makes it very painful for most to swallow. You also will quickly lose your taste so that doesn't help. If you add chemo it can make things worse. For most, we don't really start to feel the pain until appx the 4th to 5th week of rad and it usually doesn't subside until a few weeks POST Tx so you potentially have a 7 week window of swallowing problems. If you get the PEG they usually want to surgically install it before your Tx begins whether or not you ever end up needing it. Even if you do get the PEG you are well advised to NOT use it until absolutely necessary since your swallowing muscles can quickly forget their function when not used. Many end up lifetime dependent on the PEG even though they are cancer free and pain free. A huge drawback IMO but without a bypass feeding method many getting this Tx would not survive. There is another alternative to the PEG and that is the Nasal Tube. I didn't get the PEG and I didn't need help until my 2nd week POST Tx and my docs inserted a tube up thru my nose into my stomach in about 1 minute. I had it for 2 weeks and pulled out at home myself. It really really made a huge difference in my recovery but I'm glad I didn't opt for the PEG.