As long as there are new posters and patients coming to our boards, the PEG question will be asked here.

I will offer a personal opinion here, and that is that PEG's make it easier to keep weight on and nutrition and hydration at optimal levels for the vast majority of patients. Those things are directly correlated with not only improved healing rates and avoidance of other associated complications, but quality of life issues as well. Even on a PEG, there is no reason that SOME of your needs might not be met with oral consumption of soft foods and the drinking of liquids when possible. I agree with Gary that there are no studies that show that toughing it out without a PEG has any advantage to people in the long run. People that have dysphagia and other eating issues as well as strictures in their esophagus, do not get them from "forgetting" how to swallow. They get they as a by-product and morbidity of treatments. I have no feeling in the back of my throat and swallowing is a conscious and practiced (now second nature) experience. This is a result of surgical and radiation induced anatomical changes to my oral environment and the upper parts of my esophagus caused directly by radiation and has NOTHING to do with the fact that for about 13 months I was on a PEG.

Those that think it is some kind of "badge of honor" that they endured additional pain and discomfort for some perceived final result, are kidding themselves in my opinion. More than that, for some people PEG's are a life long end result, as the radiation damage to the nerves that control swallowing movements and peristalsis waves that move food down the esophagus, are permanently damaged, and the risk of associated aspiration is a serious threat. While I believe all would agree that not enjoying one of life's great pleasures (eating and tasting food) is a less than desirable end result, I hope it is not lost on all of you that in order to have this significant treatment induced end result, YOU HAVE TO BE ALIVE. And that in the overall scheme of things life can still be good.

Everyone, me included, is afraid of the PEG initially, but for the few complications that MIGHT come along with it, it is a valuable tool. If someone had this very minor surgical procedure to place one as a preparation for a period when they began to lose too much weight, (meaning they are defiantly not getting proper nutrition) they would not be unduly hurt by the procedure, especially in comparison to the other things that we go through to make it past this disease. And getting it once nutritional deficits are already happening, is being BEHIND the curve of taking care of your body's needs. It is time for the tough guys that are so proud of their getting through all this without one, to tone down the unsubstantiated rhetoric that this benefits patients in some measurable manner. Each patient is a unique biological entity, some will develop strictures and other issues with or without the PEG. These are morbidities of treatment and not a result of an unused autonomic function.

There are no absolutes in cancer treatment or the collateral issues associated with it. Our first job here is to not harm anyone with our advice. Please keep that in mind when posting your opinions based on personal experience. What works for one person may not work for another.

Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.