Coping With Taste Changes (Dysgeusia) During Chemotherapy

If you are among the 50% of patients that experience taste changes (dysgeusia) during chemotherapy, you know it can be annoying. It's described variably as “metal mouth,” a bitter taste, loss of taste, or decreased ability to taste sweet foods. Certainly, it can affect your ability to enjoy food, and sometimes, it also can interfere with getting the nutrition you need during cancer treatment.

Why Do Taste Changes Occur During Chemotherapy?

Since chemotherapy is designed to kill rapidly dividing cancer cells, it also affects normal cells that divide rapidly, such as those in the mouth. Chemotherapy may also damage taste receptors. In some cases, loss of taste may be due to an association of chemotherapy with nausea and vomiting. Taste changes often begin a week or so after starting chemotherapy, and last for 3 to 4 weeks. Medications used with lung cancer that are commonly associated with taste changes include:

• carboplatin (Paraplatin)
• cisplatin (Platinol)
• doxorubicin (Adriamycin)
• gemcitabine (Gemzar)
• paclitaxel (Taxol)
• vincristine (Oncovin)

Coping

There are no medications to help with taste changes during chemotherapy, although mouthwashes are sometimes prescribed to help prevent infection if you have mouth sores. Practicing good oral hygiene – ideally brushing after each meal – is important, both for taste changes, and for the mouth sores that can accompany chemotherapy. Practices some people have found helpful for coping with abnormal tastes include:

• Avoiding eating for a few hours before and after chemotherapy
• Using plastic utensils instead of metal
• Eating with friends or family to provide a distraction from tastes
• Sucking on mints or chewing gum
• Trying tart foods, such as oranges and lemonade (unless you have mouth sores)
• Adding taste by using strong flavors in foods
• Serving food cool or chilled. Cool food often feels better on the tongue than hot foods, and this can also minimize cooking odors
• Sampling a variety of foods, especially if everything begins to taste the same
• Foods such as beef and pork can be less appealing. Try marinating to increase the flavor, or substitute other sources of protein such as poultry, fish and dairy products
• Some people recommend avoiding foods you really enjoy during this time, so you don’t develop poor associations with your favorite foods

When Should I Call My Doctor?

Even though there is little that can be done to prevent or treat taste changes, let your doctor know what you are experiencing so he or she is aware of any symptoms you are having. If you find that taste changes are limiting your intake of foods or liquids, or resulting in significant weight loss, be sure to contact your health care team and seek their recommendations.

_Sources:

_{National Cancer Institute. Oral Complications of Chemotherapy and Head/Neck Radiation. 03/13/08. http://www.cancer.gov/cancertopics/pdq/supportivecare/oralcomplications/Patient/page5}

_{Stanford Cancer Institute. Chemotherapy Side Effect. Appetite/Taste Alterations and Chemotherapy. Accessed 03/15/12. http://cancer.stanford.edu/information/cancerTreatment/methods/managing_effects/appetite.html}