Remember that Ultimately it is your brother's decision to make, NOT the doctors, nor anyone else. Like David, I refused a PEG tube over strenuous objections by the doctors in the CCC based on the fact that I had run marathons 25 years ago weighing 136 lbs so losing 40 pounds from 177 still left me a pound to the good. I never needed hydration nor any IVs (except of course the Erbitux IV)and just drank my 6 Ensure Pluses a day. It wasn't easy but neither is a PEG. To show just how confused even the doctors are on this, here is an excerpt from an interview with the director of the Swedish Cancer Institute on PEG:

"H. JACK WEST, MD: How often are you having patients get a percutaneous endoscopic gastrostomy (PEG) tube prophylactically at the beginning, or are you integrating IV fluids regularly, just to keep people going? Is that a common occurrence, or is that really just a reactive approach, as needed?
VIVEK MEHTA, MD: The idea of a feeding tube or a PEG tube is one where I've been at both ends of the spectrum. When I trained, the idea was that we would not put a PEG tube in any patient because there was a portion of patients that could get through the treatment without needing the PEG tube. So, if you put it in everybody, you were potentially overtreating these patients with PEG tubes. Then, the idea that treatment breaks should be avoided became so compelling that you really wanted to prophylactically put this PEG tube in everybody, so that you could avoid it. You want to keep them nutritionally sound and hydrated; so you put a PEG tube in everybody.
I have now moved onto