I have been monitoring this site for quite some time, but have not done a "formal" introduction yet (but will soon), BUT, have you considered a feeding tube?
By "accident" (read "know it all" doctor who assumed I had "all this cancer in my stomach"- NOT!) while I was getting a metal bile duct stent put in, he also put a metal, non-removable stent in my duodenum, which created a blockage, where my stomach didn't empty. I went from having no problems eating, to losing 15lbs in a little over 2 months (I only weighed 105 to start). I simply could not eat enough, and my ONC said 5 Ensures a day (Oh good, sugar and corn syrup), would at least keep my weight up, but even liquids couldn't get through. I was on Cis/Gem chemo at the time and was spending 75% of my time in bed. When I hit 89 lbs, I knew I had to do something. I asked about a feeding tube. My brother is a Dr, and he said YES! My ONC, said NO! worse mistake ever (not sure why), anyway since getting it, I have gained back the weight, plus. It was the best thing I ever did, (even though it is kind of a pain), I get 1400 calories of GOOD nutrition everyday (Nestles "Compleat", which is REAL food).
The key is to get a "jejunal" tube that bypasses the stomach and puts the food directly into the small intestine. This way you CAN still eat by mouth (I eat anywhere from 300-600 calories a day depending on nausea, or lack of appetite. The "feeding" takes place starting about 6:00pm and runs overnight. Less food = less time, and if your "motility" (speed of processing food) is better than mine, you can probably do it faster.
I am doing very well with my stage 4, extrahap CCA. It's been a year, and my scans still don't show any progression (still too small to show up??), BUT part of me thinks good nutrition has to be helping. How can you fight a cold, much less cancer, if you don't eat well??
For me, its major surgery to remove that stent, basically a Whipple, so I don't know that I will ever be able to eat normal again. BUT for the rest of you, a feeding tube could be a good way to fight this disease while maintaining your strength and energy. My insurance does cover it.
I have learned a lot about "motility" the past seven months. A lot of things slow down your digestive process, which effects your appetite. Ironically, the anti-nausea pills they give you? Are the WORST. Better to get your anti-nausea drugs by IV with your chemo, as that doesn't effect motility. Contrast drugs given prior to CT scans will slow your motility. Mirolax or similar stimulants can help speed things up which will also increase your appetite.
I'm amazed that this is not something that is even mentioned by ONC's, I first heard about it from a gastro dr, who gave me a quick course.
Anyway, this post is way too long, Good Luck to you.