By Ann Ogden Gaffney

Nearly everyone I meet who has been through or is going through cancer treatment, myself included, has had to deal with the rather sneaky side effect of taste changes during chemo. I call it sneaky because, unlike nausea and hair loss, it’s often glossed over during the side effects discussion because it affects each individual so very differently.

The most common complaint of taste change is the heavily metallic taste that hangs around in your mouth. It turns water from a refreshing clean drink to something that tastes about as appetizing as mineral oil. Tea, coffee, and sodas fare no better. Favorite foods can suddenly taste unfamiliar, and it’s hard to know what to do.

There are many reasons why taste changes could be happening while in treatment, so be sure to talk with your health team to manage these side effects.

The good news? Once chemo is over your taste buds usually go back to normal. The hard news? While you’re going through treatment, you’re going to have to make a few changes to manage this annoying symptom.

Foods with natural umami are also helpful. Umami is considered to be the fifth category of taste and is responsible for giving food “rich” and “savory” characteristics. Umami taste comes from glutamate, a naturally occurring amino acid that acts as a building block for making proteins in the body. When people experience taste changes during chemo, consuming foods with more umami tends to be better tolerated.

Here’s a list of some common umami foods:

• Fruits – apples, coconut
• Vegetables – mushrooms, onions, seaweed, tomatoes, potatoes, sweet potatoes
• Meats – cod, chicken, eggs
• Cheese – parmesan, cheddar cheese
• Fermented foods – soy sauce, miso, kimchi, natto
• Herbs and spices – vegemite, marmite

Here are some suggestions for things to try if you are experiencing taste changes during chemo:

• Metallic taste: try adding a sweetener like maple syrup, and acids like lemon or lime, or your favorite vinegar. Adding lemon or lime to water can be a game-changer to increase fluid intake during chemo.
• Overly sweet: try adding an acid like lemon or lime juice or even balsamic vinegar or other vinegars until the sweet taste goes away.
• Too salty: try adding an acid like lemon or lime juice to help reduce the salty flavor.
• Very bitter: try adding a sweetener like maple syrup or honey or a little sugar.
• Bland and tasteless: try adding salt once it’s plated and add until the flavors start to appear.

If you use seasoned cast-iron cookware, it may be a good idea to shelve it as it can add to the metallic taste. If things get really bad, avoid canned foods and use plastic or wooden utensils instead of stainless steel. My best piece of advice is that if something you normally enjoy eating starts to taste weird, leave it alone and try something new. It is never going to taste how it should until chemo is over, no matter what you cook it in or eat it with, and by chasing the taste you may set yourself up for a lifelong aversion.

This is a great time to experiment with food and flavors to find out what works best for you.  Like many on chemo, I found strong tastes to be a boon. I loved eating Indian, Korean, and Mexican — typically more spicy cuisines — during my treatment. If you’re new to a certain cuisine, start with small amounts of spices and opt for a mild curry powder or sweet spices like cumin and turmeric and take it from there. Take care to go slowly as some strong tastes, particularly certain cooking smells can become really unpleasant. To this day salmon is a food that I still can’t fully enjoy because of my aversion to the smell during chemo. Once you know certain foods and aromas are a trigger, avoid them.

Quirky things can happen. A friend of mine found that sugar became bitter and he still can’t eat sweet things to this day. I normally lived for lemons, but during treatment, I couldn’t stomach lemon juice in my food or lemon wedges in my drinks, but the zest was fine. To make water more drinkable, I found chilling it helped, especially with big sprigs of mint, or I’d stir in tart flavors like pomegranate molasses. I got into granitas (shaved ices) too at this time. They tasted good and their iciness soothed my mouth. Between the spicy food and the fruity ices, I gradually got into a rhythm of eating what worked for me and managed to keep myself well-fed, happy, and hydrated.

It’s not impossible. You will find your own tricks to get through it too. If your eating less or eating smaller amounts at mealtimes, reach out to your team and your registered dietitian for more help and support.