People often report that the flavour of food changes during cancer treatment. Common comments are that ‘all food tastes the same’, ‘food is like cardboard’, ‘food has a metallic taste’, and ‘I no longer like the taste of my favourite food’.
Usually this is a temporary issue experienced during the period of treatment and for a short time afterward, but unfortunately taste changes can be long lasting in some patients. It may also take some time to be able to resume enjoyment of foods you find off-putting during treatment.
Changes to the flavour of food are highly individual and can be unexpected and quite frustrating especially if food is a large part of your social life and a source of daily enjoyment.
If you have a sore mouth, sore throat or swallowing difficulties, talk to your doctor, speech pathologist, dentist or dietitian as some of the following suggestions won't be suitable. The following information may be useful in preparing you for what to expect and for minimising symptoms. The tips also include suggestions for exploring new flavours during treatment.
Some cancer treatments cause mouth ulcers or change the amount and thickness of saliva in your mouth. These changes can make your mouth feel hot, dry or uncomfortable, and chewing or swallowing may become difficult and painful. Tooth and gum problems can occur and your lips can become dry.
People that have cancer in or around the mouth and throat may experience chewing and swallowing problems. Sometimes radiotherapy and chemotherapy to this area can also cause temporary problems. If teeth are extracted, chewing may be more difficult.
If you have pain when chewing or swallowing, tell your doctor who will be able to give advice on suitable medications. If you have severe difficulty swallowing for a considerable period of time, a feeding tube may be considered to ensure you get adequate nutrition. Your dietitian, speech pathologist and doctor can guide you through this.
'Once I started chemotherapy, I went off my food. My mouth felt very dry, which made food taste unappetising. Adding extra sauce helped.' — Neil
When your mouth is dry you're at increased risk of getting infections such as oral thrush and tooth decay which will make eating harder.
Ensure good oral hygiene. Keep your mouth clean and prevent infections with regular mouthwashes and gargles. Make sure you use an alcohol–free mouthwash to avoid further irritation to the mouth. Speak with your dentist or health care team about mouth rinses or lubricants most suitable for you during treatment.
You may need to change the consistency of your foods by chopping, mincing or pureeing to make them easier to manage. Don't persist with a solid diet if it's taking you a lot longer to chew and swallow, or if you're experiencing coughing, choking or food sticking in your mouth or throat.
If you're having problems with your dentures, only wear them at meal times, or take them out and try softer foods that don't need to be chewed. If you're receiving radiation therapy to the head or neck area, you may need to discuss when to wear your dentures with your doctor or radiation therapist.
If you're experiencing problems swallowing normal foods and fluids, notify your doctor who may refer you to a speech pathologist for assessment.
A speech pathologist can continue to monitor your swallowing after treatment, and modify the texture of your food once the side effects that are affecting your ability to swallow and chew begin to diminish.
Sometimes people may need to remain on a texture modified diet after their treatment; however this is different for everyone and will depend on the type of cancer, treatment or surgery received.
|Soft diet||Soft foods can be chewed but not necessarily bitten. Foods should require minimal cutting and be easily broken up with a fork. Food should be moist or served with a sauce or gravy to increase moisture content. Food may be naturally soft or may be cooked or cut to alter its texture.|
|Minced and moist diet||Food should be soft and moist and easily form into a ball in the mouth. Small lumps can be broken up with the tongue rather than biting or chewing. Food should be easily mashed with a fork and may be presented as a thick puree with obvious lumps in it. Lumps are soft and rounded with no hard or sharp lumps.|
|Smooth pureed diet||Food is smooth, moist and lump free. It may have a grainy quality and is similar in consistency to commercial pudding. Food can be moulded, layered or piped. For more suggestions about what foods can be included in a soft, minced or pureed diet refer to the table below.|
If you've been told that you need to follow a texture modified diet it can be difficult to think of foods to eat. Your dietitian can help to identify certain foods and fluids that will be easy to eat and drink. The following table provides some suggestions for foods from each of the different texture modification categories.
|Food type||Soft||Minced and moist||Smooth pureed|
|Meat||Casseroles with small pieces of tender meat, stew, mince dishes, moist fish dishes.||Minced or well cooked meat, (lasagne, Shepherd’s pie) chicken or fish. Serve with extra gravy or sauce.||Pureed meat, chicken or fish blended with gravy or sauce until smooth. Serve with extra gravy or sauce.|
|Meat alternatives||Omelettes, quiche, scrambled or poached eggs, baked beans or other cooked legumes, soft tofu.||Poached, scrambled or boiled eggs, soft tofu, minced or mashed baked beans, cottage cheese, soufflé (small pieces).||Pureed scrambled or poached eggs, pureed baked beans or legumes. Soft silken tofu.|
|Drinks||Commercial nutritional supplements. If you're having ongoing difficulties swallowing, your speech pathologist may suggest thickened fluids.|
|Cereals||Soft bread without crusts, use mayonnaise, butter or wet topping to moisten bread. Breakfast cereals well moistened with milk (avoid dried fruit or nuts and crunchy breakfast cereals e.g. muesli). Soft pasta or noodles. Well cooked rice. Soft pastry. Other soft cooked grains.||Porridge. Well moistened dry breakfast cereals with little texture, e.g. Cornflakes, Weetbix, Rice Bubbles. Well cooked, moist pasta dishes e.g. macaroni cheese.||Strained or pureed porridge or semolina. Serve with extra milk and sugar. Pureed pasta, noodles or rice.|
|Fruit (avoid acidic fruits)||Fresh fruit that's naturally soft e.g. banana, pear, mango, pawpaw, watermelon. Canned and stewed fruits. Pureed fruit.||Soft, canned or cooked fruits without seeds or skins. Mashed soft fresh fruits e.g. banana. Pureed fruit.||Pureed fruit or mashed soft fruit pushed through a sieve (no pieces) or blender.|
|Vegetables, legumes||Well–cooked vegetables mashed or served in small pieces. Soft canned vegetables. Well cooked legumes.||Soft well–cooked vegetables that can be mashed easily with a fork. Well cooked legumes, partially mashed or blended.||Pureed vegetables (blended until smooth with no lumps), pureed legumes, vegetable soups strained or blended to remove lumps.|
|Soup||Meat, chicken and/or beans with vegetables homemade or canned.||Soups with easy to chew meats or vegetables. Piece size should be less than 0.5cm.||Blended homemade or canned soup. Smooth with no lumps. Add milk, cream or oil.|
|Dairy foods and desserts||All dairy and desserts except dry cakes or anything with nuts, seeds, dried fruits, coconut or pineapple or other hard fresh fruits such as apple.||Milk, milkshakes, custard, ice cream, creamed rice, blancmange, junket, baked egg custard, mousse, soft cheesecake (no crust), yoghurt.||Milk, milkshakes, thin custard, ice cream, blancmange, mousse, yoghurt (no pieces), fromage frais.|