Combating 'chemo mouth': Experts offer tips on countering metallic taste

Experts offer tips on countering metallic taste after treatment that can taint the taste of food
Rebecca Katz
Rebecca Katz, author of "The Cancer-Fighting Kitchen," has been experimenting for years to find ways to fight chemotherapy's impact on food flavors. Jeffrey G. Katz

Sandra Evans lost nearly 25 pounds while getting treatments for breast cancer. It wasn’t so much the nausea that can come with chemotherapy that triggered her weight loss, but rather the way food tasted after her treatments.

“It was like tasting metal,” said the 64-year-old breast cancer survivor from Kent, Washington. “If I ate bananas, rice, or potatoes it didn’t affect them as much. But other things, like citrus, ketchup, mayonnaise, would have a funny taste. I couldn’t eat meat because it didn’t have a good flavor. It was hard to get enough food to sustain myself. “

The side effect some call “chemo mouth” and others “metal mouth,” can make favorite foods taste so bad that cancer patients are loath to eat at a time when they need nourishment to help with their recovery.

“It’s a very common side effect,” said Dr. Julie Gralow, director of breast medical oncology at the Seattle Cancer Care Alliance and an associate member in the Clinical Research Division at Fred Hutchinson Cancer Research Center. “Food tastes different. Sometimes I hear metallic. Foods people used to like, they don’t like anymore because they don’t taste the same.”

Even water can be a problem.

“I’ve had some people tell me that plain old water tastes different because of the chemotherapy,” Gralow said. “It’s probably irritating the taste receptors on the tongue and signals are getting mixed.”

Evans can attest to that. “The metal taste was worse in water than it was even in food,” she said. “You’re supposed to drink at least a gallon of water a day and I was taking one pill that required a lot of water. I just couldn’t do it. It tasted so nasty. Like metal in my mouth.”

What breakthroughs are coming next?

With food flavor so corrupted, it can be hard to get patients to eat and drink enough. “Good nutrition is so important for healing while you’re on chemo,” Gralow said.

But there are ways to combat the chemo-mouth effect, said Rebecca Katz, a chef, author of “The Cancer-Fighting Kitchen” and director of the Healing Kitchens Institute at Commonweal.

Katz’s first piece of advice: avoid your favorite foods.

“If you’re eating your favorite food and it doesn’t taste the way you want you’re going to be disappointed and walk away from the table,” she explained.

Katz has been experimenting for years to find ways to battle chemotherapy’s impact on food flavor.

It was when her own father developed cancer that Katz learned how challenging it can be to keep a patient eating.

“At that time there wasn’t any kind of guide to help you cook for someone going through cancer treatment,” Katz said. “And no one was talking about taste changes. I had to learn through trial and error. I felt really helpless. Here I was a trained chef and I didn’t know how to get him to enjoy food and eat it. I knew if he couldn’t eat he wouldn’t be able to make it through his treatments.”

In some cases, simple tweaks may be all it takes to bring flavor back to food, said Katz, who recently spoke at Seattle Cancer Care Alliance, offering tips to patients.

If there’s a metallic taste, sometimes a little sweetener, like maple syrup, can help,” Katz said. “If foods taste too sweet, you can add drops of lemon or lime until that’s muted. If it tastes too salty, then ¼ teaspoon of lemon juice can erase that. If it’s too bitter, you have to add a little bit of sweet. If everything tastes like cardboard, you can use sea salt.”

Another fix for flavorless food: add healthy fats.

Ultimately, Katz said, there are always “ways you can work with people to get them from yuck to yum.”

Solid tumors, such as those of the breast, are the focus of Solid Tumor Translational Research, a network comprised of Fred Hutchinson Cancer Research Center, UW Medicine and Seattle Cancer Care Alliance. STTR is bridging laboratory sciences and patient care to provide the most precise treatment options for patients with solid tumor cancers.

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