Understanding Chemo Mouth

Understanding and Combating Chemo Mouth


If you’ve just been diagnosed with cancer and told chemotherapy will be part of your treatment regimen, it’s normal to have trepidation about what to expect. Chemotherapy is by no means a standardized treatment. There are a variety of drug therapies on the market, used for different reasons or in combination with other drugs. Two women with the same type and stage of breast cancer may not receive the same treatment cycle. Many people are under the impression chemo will significantly reduce their quality of life for an extended period of time. Most of the side effects are transient, frequently disappearing shortly after treatment. It’s certainly true, the diagnosis of cancer and treatment can both take an emotional, mental, and physical toll, but knowing what to expect can help alleviate some of these fears.


What is Chemo Mouth?


One of the most ubiquitous side effects of chemo is that it sometimes kills healthy cells in the body, which explains hair loss. When chemo medications are injected into the bloodstream, they get into the saliva, and most are very bitter. Experts believe chemo mouth is likely the result of chemo irritating or attacking the taste receptors on the tongue and signals getting mixed up. Unfortunately, chemo mouth can make favorite foods taste so bad, cancer patients often avoid eating, which compromises their nourishment. Some describe it as a loss of taste, while others say everything tastes metallic (metal mouth). Many patients lose weight not due to nausea, but simply because they cannot stomach the altered taste of food and beverages.


Oral Health Symptoms


In addition to killing hair cells, chemo can harm normal cells in the mouth. Side effects include problems with teeth, gums, the soft, moist lining of the mouth, and salivary glands. In addition to altering taste buds, chemo can result in the following additional oral health side effects.


  • Painful mouth and gums

  • Chemo dry mouth

  • Burning, peeling, or swollen tongue

  • Mucositis (mouth sores)

  • Infection


Chemo Mouth Oral Care Tips


  • Visit your dentist before undergoing chemo for preventive tips

  • Call your doctor or nurse if your mouth hurts

  • Keep your mouth moist by hydrating with water

  • Suck on ice chips

  • Apply lip moisturizer frequently

  • Use topical or local agents such as Orajel or gently swab vitamin E on mouth sores

  • Chew sugarless gum or suck on sugar-free hard candy

  • Use a saliva substitute to help moisten the mouth

  • Clean your mouth, tongue, and gums

  • Use an extra-soft toothbrush after every meal and at bedtime

  • Avoid alcohol-based mouthwashes because alcohol is a drying agent



Food Tips


Rebecca Katz, chef and author of The Cancer-Fighting Kitchen, has been experimenting for years on ways to combat chemotherapy’s impact on food flavor. She recommends staying away from favorite foods. “If you’re eating your favorite food and it doesn’t taste the way you want, you’re going to be disappointed and walk away from the table,” she explained. Moreover, some people have said the bad memories of favorite foods tasting drastically different resulting in them avoding them forever. Simple tweaks may be helpful in bringing the flavor back to food, or at the very least, making it palatable.


  • Add a little sweetener to foods that taste metallic (e.g. maple syrup)

  • For foods that taste too sweet, add a few drops of lemon or lime

  • Add a ¼ teaspoon of lemon juice to alleviate overly salty-tasting food

  • Add healthy fats (olive oil, coconut oil, nuts, and seeds) or sea salt to foods that taste bland

  • Introduce new spices (e.g. cumin, cinnamon, coriander)

  • Choose nutritious foods that are easy to chew and swallow

  • Eat soft, moist foods such as cooked cereals, mashed potatoes, pudding, and scrambled eggs

  • Avoid sharp, rough, or coarse-textured foods

  • Do not eat hot, spicy, or acidic foods such as citrus fruits and juices, because they can irritate the mouth

  • Avoid all tobacco and alcohol products

  • Use liquid supplements (e.g. Ensure®, Boost®)


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