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Coping with Taste Changes

Cancer patients often experience changes in their sense of taste and smell while undergoing treatment. Why does this happen and what can you do to cope?

Chemotherapy and radiation affect any cells in the body that divide rapidly. These include the cells that are located throughout the lining of the oral cavity, including the mouth and esophagus, and gastrointestinal (GI) tract. As a result, cancer patients often experience changes in sense of taste and smell.

Certain chemotherapies, like platinum-based chemotherapy drugs (i.e. cisplatin, carboplatin) can cause a more distinct metallic taste.

Radiation treatments to the head and neck area can also diminish taste, leaving a dry “cardboard” taste in the mouth.

Foods that were previously enjoyable may become unappealing. Foods can also taste bland, bitter, or metallic. Food preferences may also change due to treatment side effects.


Managing General Taste Alterations

Rinse with 1-2 oz of baking soda rinse before and after meals (recipe for baking soda rinse: 1 quart water, ¾ teaspoon salt and 1 teaspoon baking soda). DO NOT SWALLOW

  • Use a non-alcohol based mouthwash or mouth rinses such as Biotene.
  • If red meats taste strange, try substituting other proteins such as chicken, turkey, fish, eggs, dairy, beans, or tofu.
  • Eat foods that smell and look good.
  • Avoid favorite foods on the day of or days around treatment.


Managing Specific Taste Aversions

Lack of taste, “cardboard”  

If you don’t have mouth soreness you can go ahead and season foods with tart flavors, such as lemon, citrus, vinegar, or add pickled foods.


Metallic taste

  • Avoid using metal utensils; use plastic utensils instead.
  • If you do not have any mouth soreness and foods taste metallic, add extra flavor to foods with spices such as onion, garlic, chili powder, basil, oregano, rosemary, tarragon, barbecue sauce, mustard, ketchup, or mint.
  • Avoid hot foods to reduce strong odors, serve food at room temperature.
  • Use sugar-free lemon drops, gum, or mints. 


Salty, Bitter or Sour taste

Try adding sweetening agents such as sugar, maple syrup, or honey to help enhance the taste.


Sweet taste

Add six drops of lemon or lime juice or until sweet taste is muted.


Final Words

Remember, sometimes you have to “think outside the box” when it comes to your taste – things that may have never been appealing to you before, may now be quite tolerable!  Don’t be afraid to experiment with new flavors until you find something that works for you.

If these tips do not work for you and you are still finding it more difficult to eat, be sure to speak to your health care team and Registered Dietitian for further management.

Always communicate with your doctor and nurse about what you are experiencing. Contact your MD if you are having trouble swallowing, difficulty with coughing while eating or drinking, you experience a choking sensation, have pain, or weight loss.

Jessica Iannotta, MS, RD, CSO, CDN

Jessica is a registered dietitian and certified specialist in oncology nutrition (CSO). She studied nutrition at Cornell University and completed her dietetic internship at New York Presbyterian Weill Cornell Medical Center. She obtained her Master's degree through the University of Medicine and Dentistry of New Jersey. Jessica has worked in inpatient and outpatient oncology settings since 2001 in the North Shore-LIJ Health System. Jessica is in charge of all operations including clinical and culinary operations ranging from menu development to evidence-based website content, relationships with registered dietitians and social workers and developing processes and protocols for intake, management and outcomes analysis of patients.

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