I had a stage 1 tumor (1.2cm on right lateral tongue) and 1 node positive (4mm) and I am going through both radiation and chemo. Although many have done it other ways, I can't imagine why a stage IV patient would not be the most agressive with this doing everything and then some. I think your husband might be in denial not only about what his habits are doing to him, but also what this choice might mean for him in the future.