Managing taste changes during cancer treatment

Systemic Anti-Cancer Therapy (SACT) and radiotherapy to the head and neck area can change how food tastes. Foods may taste metallic, overly sweet, salty, bitter, or have no flavour at all. Taste changes can make eating less enjoyable and affect your appetite. Good oral care is a vital part of managing these changes, keeping your mouth comfortable and helping to clear altered tastes.

Taste changes after SACT should return to normal three to four weeks after treatment has finished. Taste changes after radiotherapy may take longer, and you should see improvements two to three months after your last radiotherapy session. It can take a long time to return to normal, and some people may find it does not return entirely back to normal.

Self-management tips

Eating and drinking strategies

Sip water regularly throughout the day.

Rinse your mouth before and after eating.

Avoid foods that do not taste normal to you and try some of the alternatives listed below. Remember to monitor your taste changes as they will change overtime. Re-introduce foods you have avoided after a small period of time by trial and error. Some people find it helpful to keep a record of taste changes and different methods trialled.

If food tastes bitter or metallic

If red meat (such as beef) tastes bitter or metallic, you can try alternative protein sources e.g. chicken, eggs, fish, beans, pulses or diary.

If tea and coffee tastes bitter, you can try hot chocolate, malted hot drinks, herbal or fruit teas.

Use plastic, wooden or bamboo cutlery instead of metal if foods are tasting metallic.

Marinate meats in a fruity or tamarind based marinades.

Try dipping sauces such as sweet chilli, curry, chutneys or horseradish (as long as your mouth is not feeling sore).

Suck on sweets, such as mints or lemon drops, or sugar free gum between eating meals to try and remove any remaining bitter tastes.

Try eating only cold foods.

If food tastes bland

Try foods with different or stronger flavours e.g. umami paste, soy sauce, Worcester sauce.

Try adding seasonings to your food e.g. fresh or dry herbs, spices, salt or pepper.

Try pickled foods e.g. gherkins, beetroot or cabbage.

Try adding sauces and dressings such as sweet chilli, balsamic vinegar, teriyaki, chutneys or horseradish.

Allow hot foods to cool down to allow your taste buds identify flavour.

If food tastes too sweet

Try adding seasonings to your food e.g. fresh or dry herbs, spices, salt or pepper.

Use nut butters without added sugars.

Try adding sauces and dressings such as sweet chilli, balsamic vinegar, teriyaki, chutneys or horseradish.

Try adding lemon juice when cooking.

Try snacks like salted pretzels, popcorn.

If food tastes too salty

Do not add salt when cooking.

Use a small amount of sugar, honey or maple syrup.

Swap cured or salted meats in sandwiches for roasted meats, prawn cocktail or egg.

Swap higher salt cheeses to mozzarella, ricotta or cottage cheese.

Keep your mouth clean

Brush your teeth or dentures gently with a soft toothbrush at least twice daily with a fluoride toothpaste.

Change your toothbrush every 3 months.

Use a mild toothpaste if regular toothpaste stings.

Check with your cancer team if it is safe to use dental floss. Low platelet levels can make it difficult to stop any bleeding caused by flossing.

Leave your dentures steeping overnight as this can help keep your mouth clean.

Avoid alcohol-based mouthwashes. Instead, try a salt-water mouthwash by mixing one teaspoon of salt in one glass of tepid water (remembering not to swallow it).

Smoking and alcohol can irritate your mouth and make side effects worse. Speak to your team, GP, or pharmacy if you would like support to stop smoking.

Seek immediate advice from your healthcare team if:

You are unable to eat or drink enough.

You are losing weight.

Mouth pain is severe or worsening.

You develop a fever or signs of infection.