Hi Kim,
Just another story to add to your information gathering.
My mother has stage IV tonsillar squamous cell that migrated to her soft palate. Also bilateral lymph node involvement. Because of the lymph node involvement, she was not able to have the IMRT.
She had twice daily radiation for 32 days - total dose 7680. Also had once weekly doses of cisplatin for 5 weeks, sixth week was carboplatin because of low blood counts.
My mother did not have a PEG tube and is still plugging along. Now, how long this will last is a mystery because I she is taking in very little calories and I feel this will be a detriment to her recovery - but this is something, as a daughter, that I have been unable to convey to her and have to let it ride it's course.
But she managed the above treatments quite well despite her 71 yrs. Still have a month to wait for follow-up CT to find out status. Although her lymph nodes have obviously shrunk, she most probably will have a neck dissection within 6 weeks.
I know it's difficult to feel 100% comfortable with the choices - I have always wondered why surgery on the tonsil was not even suggested for my mother, but there comes a point when you have to bite the bullet and hope for the best.
With you by his side, Dave surely will have a positive response to this. Have faith in yourselves as well as the doctors.
Best wishes,
Cynthia