How can I deal with changes to taste and smell during treatment?
Erin Lucas, clinical dietitian at Memorial Sloan Kettering Cancer Center in New York City
Changes to your sense of taste or smell can happen during cancer treatment for many reasons. Chemotherapy can damage the cells in your mouth and nose that allow you to taste and smell. Surgery to excise an oral cancer may remove part of your mouth. Radiation for head and neck cancers also can damage taste buds, salivary glands and cells in the nose.
You may find you’ve lost your sense of taste or it has dulled significantly. You may bite into a strawberry and find it doesn’t have much taste at all. On the other extreme, some people find their sense of taste heightened. That same strawberry may taste too sweet, bitter or metallic. Others find food tastes salty even when the food doesn’t have a lot of salt.
To deal with taste changes, practice good oral hygiene to ensure bacteria or problems in your mouth do not exaggerate any bad or “off” tastes. Throughout the day, rinse your mouth with a commercial mouthwash or a homemade rinse of baking soda, salt and water. Stay hydrated too, as dry mouth can diminish your sense of taste.
Your specific side effects will dictate other strategies. If foods taste extra bitter or metallic, try having fruit with your meal or splashing juice in your water to add sweetness. Switch to plastic utensils in place of metal ones, which can exacerbate metallic flavors. Have chicken, eggs or beans instead of red meat, as beef can taste more metallic. If food tastes salty, reduce or skip the salt in recipes, and look for low-sodium or no-salt broths when making soup.
If your food seems bland or flavorless, take the opposite approach: Be more heavy-handed with seasonings and flavorings. Add extra parsley or basil to your dish. Marinate meats for several hours in a sauce, such as sweet and sour or barbeque, or a salad dressing to enhance the flavor. Ingredients with a little bite like balsamic or red wine vinegar and lemon or lime juice can help wake up your taste buds.
If you struggle to eat because of aversions to certain smells, eat cold or room-temperature foods instead of hot meals to reduce cooking aromas and strong scents. If you have people in your life who can help with cooking or food preparation, step away from the kitchen and ask them to use all the vents to dissipate smells.
If your sensory changes and related aversions make it hard for you to eat enough, simple changes can help you get the needed energy and nutrients. Add two tablespoons of peanut butter or a few slices of avocado to a meal, or use whole milk in place of non-fat milk. Ready-made nutrition drinks are another good option when eating food is not appealing. For meal ideas and other advice, connect with a dietitian or nutritionist who specializes in oncology.
SENSORY SIDE EFFECTS // The American Cancer Society offers tips to manage taste and smell changes. // Mayo Clinic has advice on making food more appetizing during cancer treatment.
The expert’s response was edited for clarity and based on an interview with Kendall K. Morgan.
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