Food Stopped Tasting Like Food

A meal you have eaten your whole life can suddenly register as cardboard, metal, or something faintly chemical. This is one of the more disorienting side effects of cancer treatment. Part of what makes it hard is that it is invisible to everyone else at the table. It is also common. The American Cancer Society notes that many people with cancer develop changes in taste and smell during or after treatment.

Two separate senses are involved, and they are easy to confuse. MedlinePlus points out that much of what is perceived as "taste" is actually smell. Flavor is the two senses combined. So a treatment that dulls your sense of smell can make food seem tasteless, even though your tongue is working normally.

The National Cancer Institute describes distinct patterns depending on the treatment. Radiation therapy may cause a change in sweet, sour, bitter, and salty tastes. Chemotherapy drugs may cause an unpleasant chemical or metallic taste in your mouth. NCI also notes that food may have less taste overall. Certain foods — meat especially — may taste bitter or taste like metal.

Other treatment effects pile on. Dry mouth develops when you have less saliva than you used to. That makes chewing and swallowing harder, and it changes how food tastes. Chemotherapy and head and neck radiation can damage the salivary glands. NCI notes that immunotherapy and certain medications can do this as well. Mouth sores add pain to the picture, because cancer treatments can harm fast-growing cells in your mouth.

NCI groups its suggestions by the specific problem. That is more useful than a general list.

If food tastes metallic or bitter. Switch to plastic or wooden utensils. Try plant-based proteins like tofu, beans, or nuts. If red meat tastes off, substitute chicken or turkey. Sweet beverages may go down more easily — cherry, cranberry, or pineapple juice. So may fresh fruits like mango, peaches, or dates.

If food tastes like nothing. Choose fresh produce. Marinate meats overnight. Add vinegars and citrus juices. Add herbs such as basil, oregano, and thyme. Add spices such as garlic powder, turmeric, and ginger.

If everything tastes too salty. Use low-sodium seasonings, herbs, and naturally sweet foods. Skip restaurant meals that are high in sodium. Adding a little sugar or honey can offset saltiness.

If smells are the problem. Keep foods covered until you serve them. Use lidded cups with straws. Turn on kitchen ventilation. And lean on no-cook options: protein shakes, smoothies, Greek yogurt, sandwiches.

For dry mouth, NCI has several suggestions. Moisten food with sauces, salsa, gravy, or dressing. Sip water consistently, aiming for eight or more cups daily. Chew sugar-free gum, or suck sugar-free candies, popsicles, or ice. And ask your doctors about artificial saliva products. A dry mouth can increase the risk of tooth decay and mouth infections, so daily flossing matters more than usual.

NCI states that taste and smell changes often get better after treatment ends. Your mouth and gums will most likely feel better once cancer treatment ends. For radiation specifically, most side effects begin two to three weeks after radiation therapy begins. They go away a few weeks after it is finished. But some side effects can last for months or years after treatment ends.

The American Cancer Society is blunt about the variation. These changes most often go away after treatment ends. But for some people, these changes in taste and smell can last a long time. Neither organization publishes a reliable timeline. And it is honest to say that no one can tell you in advance which group you will be in.

NCI's mouth and throat guidance is the basis for these.

• Call your care team the same day if your mouth, lips, or throat hurt enough to get in the way of eating, drinking, or sleeping. Pain that stops you drinking is the one that turns into dehydration fastest.
• Ring your care team at once, day or night, if your thermometer reads 100.4°F (38°C) or higher, which is CDC's threshold. A fever during chemotherapy is a medical emergency, not something to hold until office hours. If you cannot reach them within minutes, go to an emergency department and say you are on chemotherapy. Other sources set the line at 100.4°F (38°C), so use the number your team gave you.
• Call your care team the same day if you have not been able to eat for more than two days, which NCI's patient guide flags on its own.
• Call your care team within a day or two if your daily mouth check turns up new sores or white patches, or if pain and sensitivity are shifting.
• Call your care team within a day or two if taste changes are costing you weight, or meals have shrunk to almost nothing.

Losing weight, or struggling to keep up with meals? Ask for a referral to a registered dietitian. The American Cancer Society specifically recommends this, along with a dental evaluation to rule out oral problems.

• National Cancer Institute — Nutrition During Cancer: https://www.cancer.gov/about-cancer/treatment/side-effects/nutrition
• National Cancer Institute — Mouth and Throat Problems and Cancer Treatment: https://www.cancer.gov/about-cancer/treatment/side-effects/mouth-throat
• MedlinePlus (NIH) — Taste, impaired: https://medlineplus.gov/ency/article/003050.htm
• American Cancer Society — Taste and Smell Changes: https://www.cancer.org/cancer/managing-cancer/side-effects/eating-problems/taste-smell-changes.html