Hi Wendy,
we try to avoid mentioning specific doctors names here. If your Bill is being treated at a CCC they should be convening a tumor board to coordinate his treatment plan. The teeth extraction and PEG placement are 2 different surgical teams - you may not be able to acheive that at the same time. I have only been able to do that kind of multiple stuff at my Vet.

Are his teeth in really bad shape? - I wouldn't let them remove mine.

There are quite a few tests and other things that need to be performed prior to final Dx and Tx they are (they may be others dependant on his other medical conditions):

PET or PET/CT
MRI
CT
Chest x-ray
Creatinine clearance (kideny function for tolerance to chemo)
complete blood chemistry workup
biopsy
nasolaryngoscope
Dental evaluation
Audiology test
Thyroid TSH baseline test
radiation mask fitting w/C arm x-rays
simulation in the rad machin
PEG placement
there may be others like port installations, etc.

It took almost 2 months before my treatment started and I was on the fast track.

Being a social worker, you are probably aware that Stage IV, BOT, is a very serious cancer. It will require a very agressive treatment plan. Estate planning and advanced directives should be done immediatly.

Twice daily radiation is a fairly new RO concept and the results have been pretty decent. It is a little less convenient for the patient and the total fractional dose is the same either with daily or twice daily treatments.

My guess is that they will recommend Cisplatin if he can tolerate it (i.e. -good kidney function) as an adjunct to the radiation.

Attached is a link that will give you all the the information on the Standard of Care for diagnosis and treatment of H&N cancer. Check section "ORPH-1"
http://www.nccn.org/professionals/physician_gls/PDF/head-and-neck.pdf

My advice for the meeting with the MO is to send a good note taker or get the docs permission to tape it.