Taste Changes and Cancer Treatment

Cancer treatment can change the way food tastes and smells. Food may seem to have no taste at all, or it may not taste the way it used to. Doctors call a change in taste dysgeusia. It is one of several mouth and throat problems that cancer treatment can cause.

These changes can be discouraging — a favorite meal may suddenly taste wrong. The good news is that there are many small adjustments people try, and your health care team can help you find what works for you.

Cancer treatments can affect the mouth, throat, and the cells inside them:

• Radiation therapy to the head and neck may harm the salivary glands and tissues in the mouth. It may cause a change in how sweet, sour, bitter, and salty things taste.
• Some types of chemotherapy and immunotherapy can harm cells in the mouth, throat, and lips. Chemotherapy drugs may cause an unpleasant chemical or metallic taste in the mouth.

Taste changes often come along with other mouth and throat problems, such as dry mouth, mouth sores, or sensitivity to hot or cold foods.

According to the National Cancer Institute, food may seem to have little or no taste, or it may not taste the way it used to. Your sense of smell may change too. Red meat is a common example — for some people it starts to taste strange or metallic.

Your health care team may suggest steps like these to manage taste changes:

• Try different foods to find the ones that taste best to you right now. Cold foods may also help.
• Add flavor. If food tastes bland, marinating foods or adding spices can improve the flavor.
• Swap proteins. If red meat tastes strange, other high-protein foods — chicken, eggs, fish, peanut butter, turkey, beans, or dairy — may taste better.
• Balance strong tastes. If foods taste salty, bitter, or acidic, sweetening them can help.
• Skip the metal. If foods taste metallic, plastic utensils and non-metal cooking dishes may make a difference.
• Freshen your mouth. Sugar-free lemon drops, gum, or mints can help with a bad taste in the mouth.

A registered dietitian can also help you find good food choices while your sense of taste is changed. Checking and gently cleaning your mouth every day — and telling your team about any sores, white spots, pain, or sensitivity — is part of caring for your mouth during treatment.

Mouth problems become more serious when they interfere with eating and drinking, because that can lead to dehydration or malnutrition. Taste changes are not just an annoyance — they can affect how well you eat, and eating well helps you keep up your strength during treatment.

• Call your care team now, at whatever hour it is, if a thermometer reads 100.4–100.5 °F (38 °C) or higher while you are on chemotherapy — sources word this threshold slightly differently, so use the number your own team gave you. The CDC treats a fever during chemotherapy as an emergency, not a wait-and-see, because infection can move quickly when blood counts are low. If the team cannot be reached quickly, go to an emergency department and tell them you are on chemotherapy.
• Call your care team the same day if pain in the mouth, lips, or throat is stopping you from eating, drinking, or sleeping.
• Call your care team within a day or two if nothing tastes edible enough to keep fluids and meals going, or if you spot new mouth sores, white patches, or sudden sensitivity to hot and cold. The National Cancer Institute names dizziness, weakness, or confusion as signs of dehydration, and those are worth reporting the same day rather than waiting.

Many people want to know how long these changes last. The answer depends on your treatment, so it is a good question for your care team. People receiving radiation therapy to the head and neck sometimes ask whether supplements such as zinc could help their sense of taste return after treatment — NCI lists this as a question to raise with your doctor rather than something to try on your own.