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Nutrition Therapy

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    While undergoing cancer therapy, patients may experience taste changes or develop sudden dislikes for certain foods. Their sense of taste may return partially or completely, but it may be a year after therapy ends before their sense of taste is normal again. A randomized clinical trial found that zinc sulfate during treatment may be helpful in expediting the return of taste after head and neck irradiation.[39][Level of evidence: I]

    Suggestions for helping cancer patients manage taste changes include the following:

    • Eat small, frequent meals and healthy snacks.
    • Be flexible. Eat meals when hungry rather than at set mealtimes.
    • Use plastic utensils if foods taste metallic.
    • Try favorite foods.
    • Plan to eat with family and friends.
    • Have others prepare the meal.
    • Try new foods when feeling best.
    • Substitute poultry, fish, eggs, and cheese for red meat.
    • A vegetarian or Chinese cookbook can provide useful nonmeat, high-protein recipes.
    • Use sugar-free lemon drops, gum, or mints when experiencing a metallic or bitter taste in the mouth.
    • Add spices and sauces to foods.
    • Eat meat with something sweet, such as cranberry sauce, jelly, or applesauce.

    Xerostomia

    Xerostomia (dry mouth) is most commonly caused by radiation therapy that is directed at the head and neck.[35] A number of medications may also induce xerostomia. Dry mouth may affect speech, taste sensation, ability to swallow, and use of oral prostheses. There is also an increased risk of cavities and periodontal disease because less saliva is produced to cleanse the teeth and gums.

    A primary method of coping with xerostomia is to drink plenty of liquids (25–30 mL/kg per day) and eat moist foods with extra sauces, gravies, butter, or margarine.[25,36,40] In addition, hard candy, frozen desserts such as frozen grapes, chewing gum, flavored ice pops, and ice chips may be helpful.[32] Oral care is very important to help prevent infections. Irradiation to the head and neck of a patient who has permanent dry mouth symptoms may result in reduced intake of energy, iron, zinc, selenium, and other key nutrients.[41][Level of evidence: II] Special efforts should be made to help tailor meals and snacks for individuals with xerostomia.

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