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Today, in Your Health: Cancer patients and lost appetite. Chemotherapy can cause extreme nausea. And because of this, cancer patients often lose their appetite. But there's something else that makes eating during this treatment unpleasant.

As NPR's Patti Neighmond reports that it has to do with how food tastes.

PATTI NEIGHMOND, BYLINE: Hollye Jacobs was diagnosed with breast cancer at the age of 39. As a nurse she was expecting to be nauseated by chemo therapy drugs. But as a patient she was surprised to discover how much the drugs also affected her ability to taste.

HOLLYE JACOBS: Nothing tasted good. Nothing was appealing. I just didn't have any desire whatsoever to eat.

NEIGHMOND: Foods tasted like cardboard. Textures were mealy. Then there was the nearly chronic taste of metal.

JACOBS: Oh, the metal mouth was horrible. Even just saying it again, I can taste it.

NEIGHMOND: Chemo patients call this chemo mouth. Beverly Cowart is a researcher who studies taste and smell at the Monell Chemical Senses Center in Philadelphia.

BEVERLY COWART: The medications that are injected into you obviously get into your blood. And they also get into your saliva.

NEIGHMOND: And everything you eat is mixed with saliva.

COWART: And most medicines are bitter so you can get, you know, this bitter taste that flavors your food as a result - at least as long as the medication is in your system.

NEIGHMOND: And when the taste of food does break through, Hollye Jacobs says it's often too salty, too sweet or too harsh. For example, she used to love pasta with marinara sauce.

JACOBS: One day I ate it and it literally was absolutely repulsive. I thought: I can't put this in my mouth. It was just almost like, literally like eating cardboard. And the tomato sauce actually had almost had a stinging sensation in my mouth.

NEIGHMOND: Researcher Beverly Cowart says one reason food doesn't taste the same is that taste cells are like cancer cells: they reproduce very quickly.

COWART: So these drugs tend to hit rapidly proliferating cells. And therefore they will hit the taste cells as well as cancer cells.

NEIGHMOND: Literally killing the cells that produce taste, which is why taste is often compromised or completely off kilter.

Rebecca Katz is a chef who works with cancer patients, helping them learn how to eat and even enjoy it during chemo. One method she uses is to trick people's taste buds with new flavors, so there's no expectation of what the food should taste like.

REBECCA KATZ: Maybe I'm going to take your taste buds to Thailand. Or maybe I'm going to take them to Spain or Morocco. And all of a sudden, I'm introducing things like cumin, which is an appetite stimulant but also has got a wonderful taste when it's married with cinnamon and coriander. And all of a sudden, your taste buds are like tickled instead of like, drab.

NEIGHMOND: Then there are some very practical changes. Water or food tastes like metal? Add a little acid, says Katz, the type found in lemons, limes and oranges. Your food might as well be cardboard? Add salt. Sea salt, she says, the more healthy unprocessed type. Food taste bitter or harsh? Add some sweet, says Katz. Maple Syrup is best. As for fats, she says eat them - the healthy ones like olive oil, coconut oil, nuts, seeds, even butter because fat, she says, is a flavor carrier.

KATZ: Fat is like a magic carpet transversing back and forth across your taste buds. So all of a sudden, you have that involuntary spasm of vocal delight, which is: hmm yum, I never thought it could taste so good.

NEIGHMOND: One caution: Many patients, including Hollye Jacobs, discovered the food they ate during chemo was impossible to eat later on. That's why many people decide not to eat their favorite foods during treatment. So when it's over, they can still enjoy the food they always loved.

Patti Neighmond NPR News

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