I’ve been lucky. The dreaded ‘metal mouth’ that so often accompanies chemotherapy has waited until the last four weeks of my treatment to descend. Up until now I’ve been able to eat well and enjoy my food. Suddenly everything tastes like I’m licking a cast iron frypan.
A quick consultation with doctor google and I discover that the cause of this condition (known medically as dysgeusia) is unclear. I suspect it’s related to the peripheral neuropathy that kicked in around the same time. It makes sense to me that if the nerve endings in my mouth are being damaged in the same way as the nerve endings in my hands and feet then my sense of taste would be affected. Of course, it might just be coincidental.
What’s clear from my research is that we all react differently. There is no ‘ideal food list’ for metal mouth and everyone needs to find their own strategies for coping with it.
I think the biggest issue is poor nutrition. I’ve had stretches of feeling like I don’t want to eat anything and then, when I finally find something that tastes good, I over-eat. Some of the foods that taste really good are not healthy options. I can’t live on salted chips and dark chocolate! There has to be a better way.
Here’s the tips I’ve found on the internet:
- Maintain good oral hygiene – brush your teeth before and after each meal.
- Choose and prepare foods that look and smell good to you.
- Eat small, frequent meals.
- Do not eat 1-2 hours before chemotherapy and up to 3 hours after therapy.
- Use plastic utensils if food tastes like metal.
- Eat mints (or sugar-free mints), chew gum (or sugar-free gum) or chew ice to mask the bitter or metallic taste.
- Substitute poultry, eggs, fish, peanut butter, beans and dairy products for red meats.
- Marinate meats in sweet fruit juices, wines, salad dressing, barbeque sauce, or sweet and sour sauces.
- Flavor foods with herbs, spices, sugar, lemon, and tasty sauces.
- Chilled or frozen food may be more acceptable than warm or hot food.
- Try tart foods such as oranges or lemonade (this may be painful if mouth sores are present).
- Avoid cigarette smoking.
- Eliminate bad odors.
- Eat in pleasant surroundings to better manage taste changes.
- Save your favourite foods for when you finish treatment
- Increase your fluid intake.
The tip about maintaining good dental hygiene is sound, but I really think brushing six times a day is obsessive and impractical. It’s also likely to wear your gums down if you’re not very gentle. I have found that using my toothbrush to clean ALL of the inside of my mouth, including my cheeks and tongue, really seems to help. Perhaps it’s the action of stimulating the nerve endings. When ‘metal mouth’ is particularly bad, giving your mouth a good clean might help.
I haven’t found that eating during, before or after chemotherapy makes a lot of difference. I often crave sugar or salt within half an hour of treatment. We’re on the road home when this happens so I carry little tubs of fruit and a brand of snacks called ‘Mary’s Gone Crackers’ that I get from the organic shop. They’re made with linseed, so they’re high in omega 3, and they’re low in fat. Unlike a lot of similar products, they really are as satisfying as chips but they’re also as more-ish.
I haven’t found that switching to plastic utensils makes much difference. I’m still using my metal water bottle too. My brain knows that it’s not either of these things causing the metal taste and switching won’t solve the problem.
I can’t stand mints. The combination of mint and metal is awful but it might just be me. I do find that dark chocolate pushes back and so does anything salty. One of my best discoveries has been bananas as a snack food. A nice, tart apple works for me too.
Soda water has been so useful that I’ve bought one of those systems to make my own and I keep several bottles of it in the fridge. With or without a squeeze of lemon juice it’s great for hosing down the iron taste and a healthier option than chocolate.
When it comes to advice about marinating, spicing or switching proteins I’ve had mixed success. Some curries are a treat and others are inedible. Cinnamon seems to be something of a miracle and I’ve had one meal where just adding some cinnamon to the curry transformed it. Worth a try, particularly if the other option is to bin it. I’ve also found that fresh herbs can lift the inedible into the acceptable category, especially chopped parsley, chives, tarragon and thyme.
For categories of food, it’s Italian and Lebanese that are working best for me right now. Anything tomato based with lots of herbs (pizza, pasta with sauce, lasagna) is so delicious I feel as if I’m descending into a food-fuelled frenzy. When you haven’t been able to enjoy much of anything, finding something delicious is very exciting. Last night my husband collected Lebanese take away that was also a delight.
I love food. In my pre-cancerous days one of our favourite things was to dine out. Fine dining or just the local Indian, we love it all. We also love to cook beautiful food for ourselves or to share with our friends. Not being able to taste things has been a shock, but it has given me a new appreciation of how important good food is for me, and what a wonderful source of enjoyment it will be when my taste buds return.
In the mean time, I’m doing the opposite of what I’ve always done. I usually prefer to savour my food, to give it the attention it deserves, and to do nothing other than share good company while I do. What’s working best for me at the moment is distracting myself while I eat. I read or watch television. I find that cook books and cooking shows are a great way to remind me of the pleasures of food, to stimulate my appetite and to distract me from the mundane metallic taste that accompanies almost everything.
I’ve found it helpful to think ‘tomatoes’ instead of ‘metal’. The two tastes are so close, and somehow redefining it as tomato flavoured makes it much easier to cope.
I’m really conscious of paying attention to good nutrition. I know there’s a school of thought that says, “Hey, you have cancer and your appetite is chemotherapy’s handball so just eat whatever the hell you want!” but if I’m going to give my body the best chance of beating cancer then food is part of my arsenal. So much research on nutrition points towards the impact it has on all aspects of our health, including the ability to prevent cancer and to help the body fight it. While I have ‘metal mouth’ I’m eating by numbers; making sure I get enough macro and micro nutrients to nourish my body.
Like so much of this treatment, the key for me is in the head game. If a temporary loss of taste is the part of the price I pay for killing cancer then it’s a small price. My drugs are working. My body is fighting and my nerve endings are casualties.
Only a few more weeks to go.