This topic will never die here. I have lost count of how many times it has been discussed since 2002, and the original board. The take away from all this has to be something very simple. You can't heal or get through things without proper nutrition. That is not an issue of debate. If you lose 10-15% of your body weight that is a black and white indicator that you are not getting enough calories and certainly not proper nutrition... at this point if your docs are on top of things, you will be getting a PEG. If they don't recommend it the smart patients will ask why not.

Even with a PEG you can take some things occasionally by mouth as the pain allows you to. That comment should satisfy those that continually post here that you somehow forget how to swallow, or that you develop dysphagia or strictures from not using your regular "by mouth and throat" eating process. Personally from the therapists that I have talked to and the doctors I deal with, they agree these are treatment damage related issues and whether you PEG or you don't PEG, it isn't going to change things. Radiation is a bitch and the scar tissue that it forms, the nerves that it destroys, and many more things, are components of why these issues occur. Getting a PEG midway means that you are ALREADY behind the nutrition curve (which you could have avoided) and you are already compromised nutritionally.

As to David's comment, I fail to see how someone can use a PEG to their ultimate disadvantage. He clearly thinks that people become dependent on them. Having had one of these things (which he clearly states that he has not) I have the advantage of knowing this from both sides. I didn't want a PEG. I fought it like crazy for reasons that were entirely emotional and not logical nor correct. I lost a ton of weight and my docs forced me into it. In retrospect, I don't know what I was so afraid of. In the beginning, except for water, it was all I used, my mouth was bloody with mucocitis, and every inch of it was raw and painful to the extreme. Eating, even on morphine, was not an option. Everything, including my pain meds went into the PEG.... 8 months later I was about 50/50 PEG and ultra soft foods. One day I was finally all on oral feeding, and 30 days after that when I was sure that it was for good, I took the PEG out myself. ( Another story) There is no reason to believe that a PEG is used to anyone's detriment. That means that you believe the problems arise from lack of use of the throat, and that is contrary to medical facts as to why the problems arise. Having said that I would certainly try to take things by mouth as long as it is practical. It adds a sense of normalcy to your life, if you have a taste left, it may even be pleasurable, and from a purely psychological perspective it reinforces the fact that you are still living somewhat a normal existence. If you do find yourself 100% on a PEG stretching exercises (tongue blades between the front teeth etc.) are always going to be mandatory... I take that back, those are mandatory for anyone getting radiation with or without a PEG.