''You can be overweight and even obese and still be malnourished. It's a dilemma,'' says Carolyn Lammersfeld, the Cancer Treatment Centers' nutrition director who works with Shoop, the chef, to help patients find palatable options.

Typically, a cancer patient needs as much as twice the protein of a healthy person and about 10 percent more calories. Some tumors bring bigger nutritional threats than others: Gastrointestinal and lung cancers tend to cause more weight loss than breast cancer.

Anti-nausea medications developed in the past decade bring relief to many patients, although they're not always covered by insurance. Among options is a synthetic version of an ingredient from marijuana; cancer experts don't promote smoking marijuana although some advocates claim it helps. Doctors also can prescribe appetite stimulants and, for worst cases, feeding tubes.

But eating by mouth is best, and dietitians can offer tips to help: Snacking throughout the day instead of trying to force down large meals can help, and high-fat or high-fiber foods make nausea last longer.

In his Philadelphia hospital cafeteria, Shoop gives taste tests to introduce patients to healthful foods they may never have tried: Quinoa, a grain with the same amino acids of meat, or Arctic char, a salmon-like fish but less fatty.

Doing his own butchering allows Shoop to make stocks and sauces with the bones to add even more protein to meat dishes. Garnish with mushrooms, he advises, for a bit more.

And he teaches caregivers how to add 400 extra calories and 20 grams of protein to a simple smoothie, milkshake or oatmeal -- using whole milk or yogurt, some protein powder, and grinding up fruits, nuts and flax seed.

''If you're not getting answers, keep searching,'' Lammersfeld says. ``People need to know that weight loss and not being able to eat is not a good thing during cancer treatment.''

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