Supportive Care in Cancer

, Volume 1, Issue 6, pp 326–330 | Cite as

Food avoidance in patients undergoing cancer chemotherapy

  • Susan Holmes
Original Articles


Cancer and its treatment are known to cause malnutrition in significant numbers of patients. Although a variety of contributory factors have been identified it is clear that the aetiology of malnutrition is complex and multifactorial. Taste aberrations are believed to be amongst the causative factors and to contribute to the development of food avoidance/aversion in affected patients. The study described investigates the incidence of food avoidance in a random sample of 72 patients undergoing cancer chemotherapy. The results show that 59 (82%) had avoided one or more foods since the instigation of treatment. The foods most commonly affected were coffee, tea, citrus fruit, chocolate and red meat. Changes were noted in the consumption of both sweet and salty foods. In terms of food avoidance no apparent relationships were demonstrated between its incidence and either the type of disease or the drugs used in therapy. In men, the pattern of avoidance showed no differences between the younger (up to 49 years) and older (50 years and older) patients; marked differences were observed between younger and older women. Although the foods avoided in general have little nutritional implication their omission may affect the quality of the patient's life. Food avoidance per se may, however, affect nutritional status; suggestions for overcoming its effects are made. The results of this study, obtained by subjective assessment of food acceptability, highlight the individual anture of food avoidance in affected patients and suggest that each must be individually assessed if appropriate nutritional advice is to be given.

Key words

Chemotherapy Taste changes Food avoidance/aversion Nutritional status 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Begg RW, Lotz F (1956) Clearing factor and hyperlipidaemia in tumour-bearing rats. Proc Am Assoc Cancer Res 2:93–97Google Scholar
  2. 2.
    Begg RW, Lotz F (1957) Further studies on clearing activity in tumour-bearing rats. Proc Am Assoc Cancer Res 2:187–195Google Scholar
  3. 3.
    Bernstein IL (1982) Physiological and psychological mechanisms of cancer anorexia. Cancer Res 42 [Suppl]:715–720Google Scholar
  4. 4.
    Bernstein IL, Bernstein ID (1981) Learned food aversions and cancer anorexia. Cancer Treat Rep 65 [Suppl]:43–47Google Scholar
  5. 5.
    Bloch AS (1990) Nutrition management of the cancer patient. Aspen, MarylandGoogle Scholar
  6. 6.
    Bolles RC (1975) Learning theory. Rhinehart and Wilson, New YorkGoogle Scholar
  7. 7.
    Brightman VJ (1977) Disordered oral sensation and appetite. In: Kare MR, Maller O (eds) The chemical senses and nutrition. Academic Press, New York, pp 363–380Google Scholar
  8. 8.
    Calman KC (1982) Cancer cachexia. Br J Hosp Med 27:28–34Google Scholar
  9. 9.
    Carson JAS, Gormican A (1977) Taste acuity and food attitudes of selected patients with cancer. J Am Diet Assoc 70:361–364Google Scholar
  10. 10.
    DeWys WD (1974) Abnormalities of taste as a remote effect of malignancy. Ann N Y Acad Sci 230:427–434Google Scholar
  11. 11.
    DeWys WD (1977) Anorexia in cancer patients. Cancer Res 37:2354–2358Google Scholar
  12. 12.
    DeWys WD (1980) Nutritional care of the cancer patients. J Am Med Assoc 244:374–376Google Scholar
  13. 13.
    DeWys WD, Pascuccio-Cimino M (1978) Anorexia, taste changes and diet in cancer. Compr Ther 4:7–12Google Scholar
  14. 14.
    DeWys WD, Walters K (1975) Abnormalities of taste sensation in cancer patients. Cancer 36:1888–1896Google Scholar
  15. 15.
    Glanville EV, Kaplan AR, Fischer R, (1964) Age, sex and taste sensitivity. J Gerontol 19:474–477Google Scholar
  16. 16.
    Harvey KB, Bothe A, Blackburn GL (1979) Nutritional assessment and patient outcome during oncological therapy. Cancer 43:2065–2069Google Scholar
  17. 17.
    Heber D, Byerly LO, Chlebowski RT (1985) Metabolic abnormalities in the cancer patient. Cancer 55 [Suppl]:225–229Google Scholar
  18. 18.
    Holmes S (1986) Malnutrition, well-being and quality of life. In: Holmes S (ed) Nutrition in nursing practice. Conference Proceedings, Division of Nursing Studies. University of Surrey, Guildford, pp 30–35Google Scholar
  19. 19.
    Holmes S, Dickerson JWT (1987) Malignant disease: nutritional implications of disease and treatment. Cancer Metastasis Rev 6:357–381Google Scholar
  20. 20.
    Holmes S, Dickerson JWT (1991) Food intake and quality of life in cancer patients. J Nutr Med 2:359–368Google Scholar
  21. 21.
    Huldij A, Giesbers A, Klein Poelhuis EN, Hart AAM, Hulshof KFAM, Bruning PF (1986) Alterations in taste appreciation in cancer patients during treatment. Cancer Nurs 9:38–42Google Scholar
  22. 22.
    Jordan HA, Spiegal TA (1977) Palatability and oral factors and their role in obesity. In: Kare MR, Maller O (eds) The chemical senses and nutrition. Academic Press, New York, pp 393–410Google Scholar
  23. 23.
    Landel AM, Hammond WG, Meguid MM (1985) Aspects of amino acid and protein metabolism in cancer-bearing states. Cancer 55 [Suppl]:230–237Google Scholar
  24. 24.
    Lundholm K, Holm G, Schersten T (1978) Insulin resistance in patients with cancer. Cancer Res 38:4665–4670Google Scholar
  25. 25.
    Lundholm K, Edstrom S, Karlberg I, Ekman L, Schersten T (1982) Glucose turnover, gluconeogenesis from glycerol, and estimation of net glucose cycling in cancer patients. Cancer 50:1142–1150Google Scholar
  26. 26.
    Morrison SD (1976) Control of food intake in cancer cachexia: a challenge and a tool. Physiol Behav 17:705–711Google Scholar
  27. 27.
    Naim M, Kare MR (1977) Taste stimuli and pancreatic functions. In: Kare MR, Maller O (eds) The chemical senses and nutrition. Academic Press, New York, pp 145–163Google Scholar
  28. 28.
    Nielsen SS, Theologides A, Vickers ZM (1980) Influence of food odours on food aversions and preferences in patients with cancer. Am J Clin Nutr 33:2253–2261Google Scholar
  29. 29.
    Norton JA, Shamberger R, Stein TP, Milne GWA, Brennan MF (1981) The influence of tumour bearing on protein metabolism in the rat. J Surg Res 30:456–462Google Scholar
  30. 30.
    Settle RG, Quinn MR, Brand JG, Kare M, Muller JL, Brown R (1979) Gustatory evaluation of cancer patients: preliminary results. In: Van Eys J, Seelig MS, Nichols BL (eds) Nutrition and cancer. Medical and Scientific Books, London New York, pp 171–185Google Scholar
  31. 31.
    Sharma KN, Jacobs HL, Gopal V, Dua-Sharma S (1977) Nutritional state/taste interactions in food intake: behavioural and physiological evidence for gastric/taste modulation. In: Kare MR, Maller O (eds) The chemical senses and nutrition. Academic Press, New York, pp 167–188Google Scholar
  32. 32.
    Shils ME (1977) Nutritional problems induced by cancer. Med Clin North Am 63:1009–1025Google Scholar
  33. 33.
    Stein TP, Oram-Smith JC, Leskiw MJ, Wallace HW, Miller EE (1976) Tumour-caused changes in host protein synthesis under different dietary situations. Cancer Res 36:3926–3940Google Scholar
  34. 34.
    Theologides A (1974) The anorexia-cachexia syndrome. Ann N Y Acad Sci 230:14–22Google Scholar
  35. 35.
    Theologides A (1978) Cancer and anorexia. N Y State J Med 78:1514–1557Google Scholar
  36. 36.
    Theologides A (1979) Cancer cachexia. Cancer 43:2004–2013Google Scholar
  37. 37.
    Twycross RG, Lack SA (1986) Control of alimentary symptoma in far advanced cancer. Churchill Livingstone, EdinburghGoogle Scholar
  38. 38.
    Vickers ZM, Nielsen SS (1981) Odor aversions in cancer patients. Minn Med 64:277–279Google Scholar
  39. 39.
    Williams LR, Cohen MH (1978) Altered taste thresholds in lung cancer. Am J Clin Nutr 31:122–125Google Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • Susan Holmes
    • 1
  1. 1.Department of Nursing and MidwiferyUniversity of SurreyGuildfordUK

Personalised recommendations