There clearly are people that got through treatments without a PEG. Some think is was because of something they personally did. I don't agree with that assessment having watched hundreds of patients go through the process. The truth of the matter is that each individual is affected differently by the treatments. The swallowing issues that develop in some people and not in others are more a function of the type of radiation, the pathways it takes, the structures it hits, the levels of it, and the number of treatments, not to mention the person's own physiology.

Given the benign nature of getting a PEG when you consider the downside of not getting one until the weight loss (and the accompanying nutritional deficiencies have already begun to compromise healing and well being), it is just are not worth the compromises. Your doctors are going to be the best judges of if you need it or not. But if more than 10-15% body weight is lost, and they haven't intervened, you need to step up for a serious discussion of it all with them. This usually isn't an issue a a big multidisciplinary institution. When you start loosing weight you are also loosing nutritional health. There is a point in which the decision to get one or not is often taken out of your hands. Just because you have one does not mean that you cannot continue to eat by mouth as possible. In many people it is the combined methods that allow the appropriate caloric intake.

I for one cannot believe that it has been posted here - after you have said that he is getting thin (this is not a good sign) and that he is only drinking carbonated beverages right now, that anyone would think that he is getting enough food/nutrition, and that he should avoid a PEG. That borders on illogical bad advice to me. If he gets weak from an immune perspective from poor nutrition, he is going to have longer healing, more complications like infections and other opportunistic problems, that with a stronger immune system from proper eating he wouldn't have to deal with.

It goes without saying that most of us have a psychological barrier to getting one, and you can put me at the front of that list. But in the end it likely made the difference to me in the duration of my recovery, and the amount of lean body mass that I lost.... which even with it, was startling.