The elephant under the rug: transient taste changes with cancer therapy

It all started with a raisin.

My challenge at a recent seminar at Stanford University Hospital was to convince a room full of scientists, oncologists, nurses, and registered dietitians of the important role food plays in helping people navigate through cancer treatment. While the science is clinically relevant, I knew that we needed to reach their taste buds.

Each participant was given a raisin. They chewed and experienced the expected delicious sweetness. Then they chewed a bit of an herb, Gymnema sylvestre, which suppresses the

sensation of sweet. And then they ate another raisin. Faces puckered. I asked them, “How many people think the raisin tastes different now? How many think it tastes worse (bitter, metallic, weird)?” Eight-five “light bulbs” went off in the room.

That’s when I announced, “Welcome to your cancer patient’s mouth during chemotherapy.”

The elephant under the rug. Most doctors have never experienced what most cancer patients have: transient taste changes and total disconnect from the very food they need to help them survive and thrive through their cancer treatments. The solution? Culinary alchemy and the magic of flavor.

I’m teaching doctors that taste is important to patients buying in to a health-supportive diet during cancer treatment. Really, the trick is to always go through people’s tastebuds to get them to yum AND to healthy. If you can’t reach their tastebuds, it doesn’t matter how healthy the food sitting on the plate in front of them might be.

I want doctors to understand that our mouths are FULL of thousands of taste receptors. If you don’t have an understanding of how much is normally going on in the tongue, then you don’t have an understanding of what’s going on with only 20% taste capacity. Healthy adults have 80% capacity, by the way, while kids have 100%, which explains why their taste world is a little different than ours. And taste is critical to thriving, at any age.

Enter FASS, my approach to teaching flavor through fat, acid, salt and sweet. I empower people -- cancer patients, caregivers cooking for someone with cancer, and all of us getting behind the stove in our kitchen -- with a little lemon, a little sea salt, a little olive oil, a little sweet -- and that’s a HUGE thing! It can be life saving.

See below for my Fixes for Troubled Taste Buds, to help you or a loved one through cancer therapy.

I learned at the knee of my nana, who did FASS instinctively. Not everyone’s as lucky to have one such as her! In the past 14 years, I would say I’ve worked directly with 3,600 people and indirectly through lecturing with 25,000 or more. The MOST amazing thing that’s so heartening to me is that some of the nurses, healthcare practitioners, friends and family have shared it with other people. I call it the FASS effect. People spread this, so the ripple is MUCH bigger.

You try! Grab my quick FASS lesson, and most importantly, try it out! You’ll be amazed at how you can transform a dish that’s blah to one that sings beautifully to your tastebuds. Get your partner, kids or friend in the kitchen, try topping the soup up with just a hint of sea salt or lemon, healthy fat or sweet, and watch your taster’s face. At some point, it will light up. Bingo! You have arrived at yummmmm. What EVERY cook needs to know to make healthy food taste great.

The fun thing about FASS is that it’s all an experiment. There’s no right or wrong. Go for it! Gaining confidence in front of that pot in the kitchen is learning how to enchant AND heal, my friends.

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FASS Fixes for Troubled Taste Buds

If your taste buds are saying ______ , use this FASS fix.

Things have a metallic taste. Add a little sweetener, like maple syrup or agave nectar, and a squeeze of lemon. You could also try adding fat, such as a nut cream or butter.

Things taste too sweet. Start by adding 6 drops of lemon or lime juice. Keep adding it in small increments until the sweet taste becomes muted.

Things taste too salty. Add 1/4 teaspoon of lemon juice. It erases the taste of salt.

Things taste too bitter. Add a little sweetener, like maple syrup or agave nectar.

Everything tastes like cardboard. Add more sea salt until the flavor of the dish moves toward the front of the mouth. A spritz of fresh lemon juice also helps.

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For more on this topic listen to my comments on NPR, featured in the report Chemo Can Make Food Taste Like Metal. Here's Help.