Thank you so much for taking the time to respond to my post. My brother's job is in land clearing and prior to this diagnosis he was pretty used to having to periodically dig trenches using a shovel and doing other types of "hard labor" so he is pretty fit. In addition we live in Florida so it is pretty hot too. My other brother owns the company which is such good fortune so my brother is under strict orders to NOT do any manual work during this time. Also, my brother chose not to do surgery yet as the tumor is near areas (I don't know the particulars of that) that could possibly have him needing a bag so his oncologist, and his gastro doctor agreed to do chemo first to see if they could shrink the tissue. He does not have much of an appetite in general anymore but he does force himself to eat the diet his oncologist recommended and when he can't eat he does protein shakes. I printed out your recommendations and will give them to him to ask his oncologist. Again, thank you very much.