Using all your senses to eat

Changes in your senses caused by cancer treatment can significantly impact what and how much you eat. Dietitian, Sindi-marie de Beer, offers guidance on how to combat these changes.

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Imagine eating a warm, golden-brown toasted cheese sandwich. First, you see the golden-brown bread. Then, you smell the comforting aroma of melted cheese. As you break it, you hear the crunchy bread crack and you feel the soft cheese run over your fingers. Finally, you taste it; the salty, soft cheese combined with the almost sweet toasted bread.

We eat with so much more than our sense of taste. Unfortunately, cancer and cancer treatments can affect these senses, making eating less pleasurable and sometimes difficult.

Cancer treatment side effects affecting senses 

Sight: Vision problems, blind spots, or double vision can make it difficult to find food on the plate. Double vision can also lead to nausea. Sight is vital in making food appealing, helping to distinguish between fresh and rotten vegetables, different coloured spices, and the right texture while baking.

Hearing: Hearing loss, tinnitus (ringing), or ear pain can make identifying the texture of food a challenge. While changes in hearing may not significantly affect your ability to eat, it can make the experience less pleasurable.

Taste: Food can have a bitter or metallic taste, taste too sweet or salty, or have no flavour at all. A dry mouth is also common. Taste is one of the senses most commonly altered by cancer treatments. Changes in taste can lead to malnutrition if not managed properly, as it can cause you to eat very little or not at all.

Smell: Alterations in smell can make food smell different than usual, with smells being too strong or not present at all. These changes can lead to nausea, causing avoidance of eating and potentially leading to malnutrition.

Other changes include balance or co-ordination issues, which are more likely with brain tumours. Being off balance can make cooking or preparing food difficult and even dangerous. Changes in touch, such as tingling, pins and needles, or numbness, can also complicate cooking and food preparation.

Taste

Side effect: Metallic or bitter taste

Possible solution

• Use plastic or bamboo cutlery. 
• Avoid cooking is cast-iron pots (black potjie pot) and using metal utensils. 
• Rinse or brush your teeth before eating. 
• Suck on lemon drops, chew gum, or eat mints during the day (to keep your mouth feeling fresh). 
• Use fresh vegetables instead of canned or frozen. 
• Eat chicken, fish, legumes, eggs, or soya if red meat is a problem.

Side effect: Food too sweet 

Possible solution

• Flavour foods with tart or sour flavours – citrus, vinegar, pickled foods, or tomatoes (avoid if you have mouth sores). 
• Add new flavours – garlic and onion, spicy flavours, strong herbs, salad dressings, or commercial sauces. 

Side effect: Food too salty 

Possible solution

• Add sweeteners or sour flavours. 
• Use naturally sweet foods – fruit and vegetables. 
• Cut back on the salt or spices when cooking. 

Side effect: Nausea 

Possible solution

• Serve food cold or at room temperature. 
• Make sure to have a well-ventilated room (not too hot or cold). 
• Ginger-flavoured foods might help – ginger sweets, biscuits, or drinks. 
• Eat small meals – snack throughout the day, eat the most when you feel the best. Being overly hungry can make you more nauseous; eat at least six times a day.
• Choose food you like; eat what is most appealing to you.
• Have liquids before or after meals; too much during meals will prevent you from eating enough. 
• Avoid strong flavours and smells (fish, cabbage, meat, or fried foods). 

Smell

Side effect: Too strong 

Possible solution

• Cover beverages and drink with a straw. 
• Eat foods that don’t need to be cooked like dry or cold foods (sandwich with cheese, tomato and ham). 
• Avoid using strong soaps, lotions, and perfumes. These might mix with food smells and make you nauseous.

Side effect: No smell 

Possible solution

• Use strong flavours while cooking (garlic, onion, curry, chilly, or mixed herbs). 
• Add more flavouring (limit salt), double the amount of herb and spices used in the recipe. 
• Heat food up to increase the smell. 

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*Did you know humans can’t smell cancer, but some dogs are able to identify specific biomarkers from cancer. So, technically cancer does have a smell.

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Touch (mouth feel)

Side effect: Mouth sores 

Possible solution

• Eat bland food (very little salt and subtle flavours). 
• Use cold foods (these can be soothing). 
• Have gravies and sauces with foods (avoid hot, spicy, sour, and tart sauces). 
• Avoid any fizzy drinks. 
• Have foods that are soothing, such as plain yoghurt, banana smoothies, mash potatoes, veggie soups (cold), plain pasta with cheesy sauce, and milky drinks.  
• Talk to your dietitian or doctor for oral supplements (normally L-glutamine).
• A feeding tube might be needed if you’re not eating at all due to the pain. 

Side effect: Dry mouth 

Possible solution

• Eat foods with lots of sauce or gravies. 
• Blend foods into soups or smoothies. 
• Freeze fruits for a refreshing cold snack. 
• Have water on hand and sip throughout the day. 
• Eating sour sweets can help in saliva production. 

Side effect: Tooth decay 

Possible solution

Go for regular dentist visits to help with oral hygiene and prevent infections. Foul smelling breath can affect the taste of food and cause nausea.

Difficulty preparing food 

Possible solution

• Ask friends and family to assist with cooking. 
• Use convenient and ready-made foods.  
• Cook a big batch of food on days when you feel good or you have support, then freeze meals in portions for the week. Soups and stews work well.  
• Choose easy-to-prepare meals. 
• Prepare foods when you feel the strongest. Schedule your cooking time before treatment. 

Find what works best for you and your senses

It’s important to remember that everyone’s cancer journey is unique. Some may experience a few side effects, while others may not encounter any. Finding what works best for you is crucial, as some solutions will be effective, and others may not.

Changes in your senses can significantly impact what and how much you eat, potentially leading to malnutrition. If you experience any side effects, please talk to your dietitian and doctor to prevent malnutrition. A dietitian can assist you with additional supplementation and a personalised diet plan.

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