Changes in your taste
Foods may seem to have no taste, hardly any taste or may not taste the way they used to. Radiation therapy may cause a change in sweet, sour, bitter, and salty tastes. Whereas chemotherapy drugs can cause an unpleasant chemical or metallic taste in your mouth.
- If food tastes bland, marinate foods to improve their flavor or add herbs & spices to foods.
- If red meat tastes strange, switch to other high-protein foods such as chicken, eggs, fish, peanut butter, turkey, beans, or dairy products
- If foods taste salty, bitter, or acidic, try adding something sweet
- If foods taste metallic, try switching to plastic utensils and non-metal cooking dishes
- If you have a bad taste in your mouth, try sugar-free lemon drops, gum, or mints
- If the problem persists, let your medical team know. It's important to take on the nutrients you need to maintain your strength throughout treatment, and if the taste of your food is affecting your ability to eat it’s important to get professional advice.
Sore mouth and throat (mucositis)
Mucositis means inflammation of the lining of the mouth. The inside of your mouth might become red and swollen with white patches and these areas can turn into ulcers. Sore mouth happens because the cancer drug not only kill rapidly dividing cancer cells but also the cells that make up the lining of your mouth. You’ll generally start to notice inflammation about 5 to 10 days after you start treatment and gradually clearing-up up 2 to 3 weeks after your treatment ends.
- It is important to keep your mouth clean while having chemotherapy. Your nurse might give you mouthwashes to help prevent infection
- Choose foods that are soft, wet, and easy to swallow
- Soften dry foods with gravy, sauce, or other liquids
- Use a blender to make milkshakes or blend your food to make it easier to swallow
- Avoid foods and drinks that can irritate your mouth such as foods that are crunchy, salty, spicy, or too sugary and alcoholic drinks
- Don’t smoke or use tobacco products
- Tell your doctor or nurse straight away if your mouth is sore. They will be able to give you advice on pain medicine, such as lozenges or sprays that numb your mouth and make eating less painful. Or if the problem is very bad, they may prescribe stronger painkillers such as morphine or morphine-based painkillers
The most common mouth infection is thrush. Thrush usually appears as white patches, or a white coating, over the lining of the mouth and tongue.
- Salt has antiseptic, cleansing, and soothing properties. This makes it a common home remedy for many oral problems. Rinsing your mouth with salt water can help relieve symptoms of oral thrush
- Probiotic yogurt contains live, “good” bacteria cultures that may help treat oral thrush. The cultures don’t kill Candida - instead, they stop its growth. They may also help restore the proper balance of good to bad bacteria in the mouth. Choose unsweetened varieties since Candida thrives on sugar
- People have used clove oil as a folk remedy for oral problems for centuries. It’s still used in dentistry today as an antiseptic and pain reliever
- Try Apple Cider Vinegar. It has enzymes that work against the candida infection, while also balancing the PH levels in your body. Add two teaspoons of vinegar to two teaspoons of water, and use the resulting solution to gargle with two times a day, for about 1 minute each time
- Baking soda is an effective thrush remedy, especially if combined with other antifungals. It can be used either as an ointment or mouthwash
- Speak with your doctor and ask if they can prescribe you an anti-fungal medication such as Fluconazole in tablet form or nystatin, a liquid you put on your tongue
- Please note, although uncommon, an infection in your mouth can enter your bloodstream and make you very unwell. If you begin to feel unwell or have a high temperature contact your medical team straight away.
Some cancer drugs can make your mouth dry. This can happen because the drugs affect the glands that produce spit (saliva). You may find your saliva becomes thick and affects swallowing and talking. It generally only lasts whilst you’re on treatment and will improve once you stop.
- Brush your teeth after each meal and at bedtime with a soft-bristle toothbrush and toothpaste
- Drink sips of water throughout the day
- Use artificial saliva to moisten your mouth
- Rinse your mouth 4 to 6 times a day, especially after meals, with salt and baking soda. Try a solution of half a teaspoon of salt and half a teaspoon of baking soda in 1 cup of warm water.
- Avoid mouthwashes and other dental products that contain alcohol. Products designed for people with dry mouth are available without a prescription.
- Suck on ice chips or sugar-free hard candy, have frozen desserts, or chew sugar-free gum
- Use a lip balm
- Acupuncture may also help with dry mouth
- Your medical team will be able to advise or prescribe medicines to help, such as saliva substitutes that can coat, protect, and moisten your mouth and throat and others that stimulate the salivary glands
Thick, sticky saliva (mucus)
Cancer treatments such as radiotherapy to your head or neck can make it thicker your saliva, stringy and sticky - this is called mucus. The mucus does not flow as well as normal saliva, so it may build up in the mouth and throat. Changes in your saliva may get better within about 8 weeks of radiotherapy ending, but sometimes it continues for several months or longer.
- It’s a good idea to keep tissues close by so you can spit to get rid of the mucus build-up
- Rinsing your mouth regularly can help. Using a sodium bicarbonate mouthwash every 3 to 4 hours may help clear thick saliva. To make the mouthwash, add 1 tablespoon of sodium bicarbonate to 900ml of cooled, boiled water
- If the mucus continues, tell your cancer specialist or nurse who can advise you on the type of mouth rinse that is best for you
- If your sleep is disturbed by coughing, ask your medical team about using a nebulizer before bed. This is a small machine that changes liquid medicine into a fine mist or spray, to help to loosen the mucus
Problems chewing or swallowing
Difficulty swallowing is called dysphagia and can affect your ability to eat and drink. Certain types of cancer or cancer treatments especially ones that affect the head and neck can make it hard to swallow. Some sufferers find that they gag, cough or choke when they try to swallow. Other people have pain or feel like food is stuck in their throat.
- Sit upright when eating meals
- Avoid hard and dry foods, such as potato chips or pretzels. Foods that are soft or have a smooth texture, like mashed potatoes, are often easier to swallow
- Add gravy or sauces to foods to make them easier to swallow. Dip dry, crisp foods, such as cookies, into milk, coffee or tea to make them softer
- Cut food into small, bite-sized pieces to make them easier to chew
- Use a blender or food processor to chop foods that are difficult to chew. A soft, pureed diet, such as soups or smoothies, is often a good way to continue to eat nutritious, tasty foods when swallowing is difficult or painful
- Take small bites. Completely swallow each bite before taking another
- Make sure to include plenty of fluids every day, especially water, to help prevent dehydration
- Eat foods that are cold (to help numb pain)
- Limit spices such as chilis or chili powder, pepper or curry, and spicy foods. These can irritate the lining of the mouth, throat and esophagus
- Avoid alcohol and tobacco
- Make every mouthful count by choosing foods that are high in protein and high in calories
- Check with your medical team for suggestions on how to deal with difficulty swallowing.
- Tell your healthcare team if swallowing becomes painful or you are struggling eating - it's important you get the nutrients you need during treatment to stay strong. They may suggest or prescribe special pain-relieving mouth rinses or other medicines.
General mouth hygiene
- Before undergoing any cancer treatment visit your dentist in advance to ensure your oral health is in tip-top condition
- Keeping your mouth as clean as possible during your treatment will help to prevent or reduce side effects in your mouth
- Avoid your normal strong mouthwash – instead, try using a simple homemade salt-water mouthwash which is just as effective at reducing soreness. Or your doctor can prescribe an anesthetic gel or mouthwash instead
- Use a children’s soft toothbrush and clean your teeth gently.
- Use a mild toothpaste to clean your teeth. If your usual brand irritates your mouth, or if your mouth is sore, choose a mild, non-foaming toothpaste. Some people find children’s toothpaste less irritating.
- If your tongue is ‘coated’, it may make your food taste unpleasant and might put you off eating. You can clean your tongue with a bicarbonate of soda solution. Use 1 teaspoon of bicarbonate of soda dissolved in a pint (900ml) of warm water. Clean your tongue with a soft toothbrush or gauze dipped in the solution
- Ask your medical team for mouth care guidelines for people having different types of treatment
Source of information include: Macmillan Cancer Support, Cancer.net, Cancer Research UK, Healthline, Chemocare, thrushtreatmentcenter.com.
If you have been affected by any of the issues within this blog please share your experiences, and advice, with the 7,000 members of the Facebook Chemotherapy Support Group.
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