Nutrition Before During and After Cancer

Information on nutritional needs for cancer patients

Cancer and Altered taste

Taste is a stimulus for appetite.  The most common taste disorder is the distortion of the sense of taste or dysgeusia.  Taste acuity declines with age but people more often  report dysgeusia (distortion of taste) when they experience an abrupt alteration resulting in an overly strong/weak taste. Among the seriously ill, dysgeusia can adversely influence nutrition and quality of life as well as lead to food aversions, distorted smells, and loss of eating pleasure.


 In cancer, dysguesia is most associated with chemotherapy and radiation; yet there is considerable intra-individual variability regarding the intensity of impact.  Patients with head and neck cancer and those exposed to tyrosine kinase inhibitors or taxane based regimens are most at risk.  Common non-malignancy causes of dysgeusia in the seriously ill include, infections, zinc deficiency, hypothyroidism, Cushing ’s syndrome, liver disease, sequelae from ENT operations, and medications such as psychotropics, opioids, and antihypertensives.

Patients often fail to volunteer symptoms of dysguesia. Hence, patients with cancer or other described risk factors should be routinely asked about distorted smell and taste.

Chemotherapy induced dysgeusia most often resolves within months. However, in that time, it can have a devastating effect. Because eating habits are shaped by life experiences and life experiences are shaped by eating habits, dysgeusia can alter customs within the family unit and lead to a reduction in socialization around meals.

Many with taste alterations try home remedies such as lemon juice, candy before meals, sweet drinks, plastic utensils, drinking from a straw, brushing teeth and tongue before meals, and using salt, soda or antibacterial mouthwashes. There is weak evidence for flavor enhancers (e.g. salt, sugar, monosodium glutamate, monopotassium glutamate) during chemotherapy.

There are a multitude of ineffective drugs: corticosteroids, vitamin A, gabapentin, gingko biloba, glutamine, and amifostine have all been shown to be non-beneficial, other medications may help, however the data are not fully convincing.  A randomized trial demonstrated taste improvement with alpha lipoic acid (available over the counter); however, other studies did not reproduce this finding. Dronabinol at low doses such as 2.5 mg twice daily may improve dysguesia in advanced cancer without improving appetite. Multiple randomized trials of zinc supplementation at doses between 30 to 50 mg three times a day demonstrated a modest improvement in taste acuity and taste quality among individuals undergoing chemotherapy and/or radiation. This benefit was not observed in a non-cancer population.

Patients with taste distortion must try a variety of foods to pick the one that works for them, this time could be used to try various other cuisines that have multiple flavor’s, experimentation is the best option.


Alterations to Taste and Smell Due to Chemotherapy and Radiation

Chemo Diet

Changes in taste and smell may happen due to chemotherapy, infection or xerostomia (lack of saliva)

Chemo therapy induced changes to taste are reversible but, may take several weeks. However, Radiation therapy induced changes can be permanent. Some of the symptoms are intolerance to meats, increased bitter or sweet sensations, as well strange tastes like metallic or “gamey” tastes between meals.

There may be heightened sense of smell that may cause sensitivity to food preparation, aversion to perfumes or soaps may also happen.

Tips for management:

  1. Serving foods cold instead of hot may help.
  2. Regular rinsing with a baking soda solution (1 tablespoon baking soda in 1 quart water) will help with taste changes.
  3. Avoid mouth washes containing alcohol.
  4. Use plastic utensils instead of stainless steel to help with the metallic taste.
  5. Try adding mint to milkshakes or oral supplements that may taste too sweet.
  6. Fresh or frozen foods may taste better than canned foods.
  7. Sip on liquids or suck on ice chips throughout the day. Aim at 8-10 cups fluid/day.
  8. Marinades and spices can be used to mask the strange tastes.
  9. Add lemon, lime, or vinegar to foods that taste too sweet.
  10. If unable to have meat try another protein source, like dairy, soy products, eggs or poultry.

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Nutrition during Cancer Treatment

Eating well during cancer treatment can help:
  • Feel Better
  • Keep up your energy and strength
  • Keep up your weight
  • Tolerate side effects of the treatment
  • Decrease risk of infection
  • Heal and recover quickly
  • Eating well means eating a variety of foods that provide you with good nutrition
 Dietary Supplements:


Some people with cancer take large amounts of dietary supplements in an effort to fight their cancer.Dietary supplements include vitamins, minerals, antioxidants, herbs and botanicals, amino acids, metabolites and extracts.

Some supplements can be harmful in high amounts. In fact, large amounts of some supplements may interfere with cancer treatments or medications. If you are planning on taking any supplements please consult with your Oncologist and or your dietitian.

Radiation Therapy:

Radiation therapy uses high energy rays to keep cancer cells from growing and dividing. Most cells exposed to radiation are affected by it, but healthy cells can usually recover.Side effects usually start 2-3 week after the treatment. Most side effects last 2-3 week after the treatment is over, some can last longer.

People receiving radiation to mouth, neck, stomach or intestines often have side effects that affect their ability to eat. Side effects can include sore mouth or, throat, nausea and changes to bowel function.

Nutrition tips while receiving Radiation therapy:
  • Try to eat a light meal or snack at least one hour before the treatment.
  • Eat regular meals and snacks throughout the day to maintain your weight, strength and energy.
  • Include good source of protein in very meal.
  • Juicing, fruits and vegetables might make it easier to consume them.
  • Feeling tired is a common side effect of radiation; ask family and friends for help with shopping, cleaning and preparing meals.

Chemotherapy is the use of strong drugs to treat cancer. Chemotherapy affects the whole body. It can damage and kill cancer cells as well as healthy cells. Side effects depend on kind of chemotherapy and how it is taken.Common side effects of chemotherapy are fatigue, bowel function changes, changes in sense of smell and taste, loss of appetite, sore mouth and throat, nausea and vomiting.

Nutrition tips while receiving Chemotherapy:
  • On the day that you receive chemo, eat a light snack/meal before the treatment, and pack a small snack and bring to treatment with you.
  • Eat regular meals to maintain weight, strength and energy.
  • Include good source of protein in each snack and meal.
  • Feeling tired is a common side effect of chemotherapy; ask family and friends for help.
  • Eating small frequent snacks is a good idea than eating 3 large meals.

As care givers, preparing and providing meals can be a very important part of patient care. It is natural to pay attention to how a person with cancer eats, however it is important not to make that the focus. Mealtime should be an enjoyable experience, having a positive and relaxed attitude can help to encourage a person’s appetite.