Taste Changes

Overview
Changes in how things taste commonly occur as a side effect of chemotherapy, as well as radiation therapy for head and neck cancers. For example, sour or bitter foods may taste very strong while sweet foods may not taste as sweet as they used to. There is no treatment for taste changes at this time, but there are steps you can take to reduce the impact of this side effect on your appetite and ability to maintain your weight.

What are taste changes?
Taste changes are an alteration in how you perceive flavors. The four main tastes that our taste buds perceive are sweet, sour, bitter and salty. Any or all of these may be altered.

Why do things taste different?
Changes in how things taste commonly occur as a side effect of chemotherapy, as well as radiation therapy for head and neck cancers. Taste changes may be caused by damage to cells in the mouth by chemotherapy or by the spread of chemotherapy drugs in the tissues of the mouth.

Taste changes may also be caused by radiation damage to the salivary glands, resulting in a dry mouth. Saliva contributes to our sense of taste by mixing with food, which helps to stimulate the taste buds on our tongue. When there is less saliva, the food does not come into contact with the taste buds as easily and there may be changes in how we perceive the four tastes.

How will things taste after chemotherapy treatment?
It is common to have an increased sensitivity to sour and bitter taste,1 or to have a “metallic” taste in your mouth. Also you may be less sensitive to sweet foods; meaning sweet foods will not taste as sweet as they used to. Food may simply taste bland. How long these changes last is different for everyone and depends on your treatment. However, taste changes usually resolve in 2-3 months after treatment.

Why is it important to address taste changes?
While changes in how things taste may seem like a minor side effect of cancer treatment, it is important to find ways to cope because these changes can affect your health and well-being. Changes in taste may cause you to lose your appetite, making it difficult to get adequate nutrition and resulting in weight loss. Weight loss is a common complication of cancer and cancer treatment and can compromise your health and well-being.

Which treatments are likely to cause taste changes?
Chemotherapy drugs most commonly associated with taste changes include:

  • carboplatin (Paraplatin®)
  • 5-FU
  • cisplatin (Platinol®)
  • levamisole
  • cyclophosphamide
  • mechlorethamine
  • dacarbazine
  • methotrexate
  • dactinomycin
  • paclitaxel (Taxol®)
  • doxorubicin
  • vincristine

Biological therapies, such as interleukin and interferon, have also been associated with taste changes.2

Is there a treatment for taste changes?
At this time, there is not a treatment for taste changes. Research has shown that taking zinc sulfate during treatment may be helpful in expediting the return of taste after head and neck irradiation.3 However, once you discover that you have taste changes, the best thing you can do is make changes in food choice and preparation to minimize the impact of this side effect on your ability to get enough nutritious foods.

What else can I do?
Try these tips to help reduce the impact of taste changes on your ability to get good nutrition and avoid weight loss.4

  • Do not eat 1-2 hours before chemotherapy and up to 3 hours after therapy. It is common to develop a taste aversion to foods eaten during this time, so it is particularly important to avoid your favorite foods.
  • Rinse mouth with water before eating.
  • Eat small, frequent meals and healthy snacks.
  • Eat meals when hungry rather than at set mealtimes.
  • Have others prepare the meal.
  • Substitute poultry, fish, eggs and cheese for red meat.
  • Eat meat with a marinade or sauce; try something sweet.
  • Use plastic utensils if food tastes like metal.
  • Use mints, lemon drops or chewing gum to mask the bitter or metallic taste.
  • Chilled or frozen food may be more acceptable than warm or hot food.
  • Try tart foods, such as citrus fruits or lemonade, unless you have mouth sores.
  • Avoid bad odors, as these may affect your appetite.

References


1 Epstein JB, Phillips N, Parry J, Epstein MS, et al. Quality of life, taste, olfactory and oral function following high-dose chemotherapy and allogeneic hematopoietic cell transplantation. Bone Marrow Transplant. 2002 Dec;30(11):785-92.

2 Plata-Salaman CR. Cytokines and anorexia: a brief overview. Semin Oncol. 1998 Feb;25(1 Suppl 1):64-72.

3 Ripamonti C, Zecca E, Brunelli C, et al.: A randomized, controlled clinical trial to evaluate the effects of zinc sulfate on cancer patients with taste alterations caused by head and neck irradiation. Cancer 82 (10): 1938-45, 1998.

4 Overview of nutrition in cancer care: Nutrition suggestions for symptoms relief. http://www.cancer.gov/cancerinfo/pdq/supportivecare/nutrition/patient/#Section_42 accessed 1/14/04.