Removing the cap & rotor has nothing to do with the timing, so it is not necessary to adjust the timing. However, since you said it hasn't been tuned up in years I would check the timing and reset it if needed.
If you can't get that screw to come out you may need to remove the entire distributor (to get better access to it). This is easy to do, but make sure you mark the position of the rotor and ignition module. That will make reinstallation much easier (and won't screw with the timing). At that point you should also replace the distribuitor O ring too.