What specific dietary changes do you recommend for patients undergoing H&N, CNS, or GI RT?

I would leave Boost and Ensure as the absolute last recommendation possible. This goes for Carnation Instant breakfast as well, which is mostly made up of sugar and high fructose corn syrup. These supplements are poor sources of nutrition for anyone, let alone cancer patients. As cachexia is a state of inflammation, the inflammatory vegetable oils in these supplements further complicates things. I recommend making smoothies or shakes with a whey or hemp protein powder. I do not recommend soy protein isolate. I ask patients to mix in several ingredients like coconut or MCT oil, green vegetables, and some berries (in smaller amounts) with the protein powder. If patients are getting decent nutrition but just need more protein, I will recommend...

For patients undergoing rectal radiotherapy, I would recommend avoiding large amounts of high roughage: nuts, popcorn, crunchy raw fruits and vegetables. This may help with frequency and urgency of stools, both during RT and (sometimes) long-term afterwards.

Bob Myerson