Metallic Meals

Imagine for a moment sitting in a restaurant while relaxing with your friends and family. The server delivers an appealing hot entree. You attempt to sprinkle a little salt on to your dish, but the cap falls off. You accidentally pour a tablespoon of salt on your meal. Do you think there's any chance you would still eat it?

Now envision walking into the restroom and inhaling the smell of spoiled fish or even sewage. Would you be able to return to your table and finish your meal?

These examples illustrate the two nutritional impact symptoms of altered smell and taste: dysosmia and dysgeusia.

I remember experiencing an altered sense of smell during pregnancy. The whiff of vinegar resulted in moderate nausea and poor appetite. I imagine some patients are dealing with this during cancer treatment. When discussing treatment side effects, the healthcare team should inquire about changes in taste or smell. Otherwise, the oncologist may prescribe Zofran or Megace ES without resolving the real problem.

Dysgeusia is estimated to affect 46-77 percent of patients receiving chemotherapy.¹ ² This side effect can interfere with food intake, weight maintenance, and quality of life. Well-intentioned caregivers try to persuade the patient to eat, but encouragement won't improve oral intake when the food smells bad and tastes terrible.

If you encounter patients with dysosmia and dysgeusia, there is still hope for adequate nutritional intake. Here are some tips for dealing with these particular side effects.

1. Limit the patient's exposure to food aromas.
2. Ask family and friends to help prepare foods.
3. Advise caregivers to open the windows to ventilate the kitchen.
4. Encourage the patient to go outside and get some fresh air while food is being prepared.
5. Recommend cold or room temperature foods to reduce odors; serve cottage cheese and fruit instead of salmon and broccoli.
6. Mask unpleasant tastes with marinades, condiments, sauces, or dressing.
7. Try sugar-free hard candy or gum in between meals.
8. Clean the palate throughout the day with a baking soda and salt solution (1tsp salt and 1tsp baking soda in a liter of water).
9. If red meat is unappealing, offer chicken, turkey, eggs, or dairy as protein sources.

Do you have a great tip that you would like to share? If you have an effective strategy for dysosmia or dysgeusia, please share it with TheONC community in the comment section

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