When cancer alters the senses: New insights into malnutrition

New evidence shows how changes in taste, smell, and texture perception shape the eating experience and nutrition of people living with cancer.

For many people living with cancer, eating becomes unexpectedly difficult. Foods that once brought pleasure can suddenly taste different, feel uncomfortable in the mouth, or trigger nausea and aversion. These changes are about more than appetite — they are deeply linked to how cancer and its treatments alter the senses.

New research published in Clinical Nutrition Open Science sheds light on this often-overlooked dimension of cancer-related malnutrition. By looking beyond taste and smell alone, the study reveals how broader sensory changes—including texture, temperature and oral sensations—play a critical role in eating difficulties and food avoidance.

Eating is a complex, multisensory process–taste and smell are only part of the story. Texture, temperature, spiciness, cooling sensations, and the overall comfort of food in the mouth—known collectively as “oral somatosensation”—all shape whether eating feels pleasant or effortful.

Cancer and its treatments can disrupt these sensory pathways. Patients may experience: heightened sensitivity to certain sensations, reduced perception of others, or a mix of both. 

These changes can make foods feel irritating, bland, unpleasant or physically hard to manage — and that can be a serious issue when patients need nutrition the most.

“Patients often tell us that eating becomes work,” explains Camille Kwiecien, sensory scientist at Danone and a key contributor to the study. “Food may taste unfamiliar, feel uncomfortable, or even make you feel uneasy. But because these are sensory changes, they might not be taken seriously. And that’s a slippery slope to malnutrition.” 

“When patients simply cannot comply with the nutrition advice they receive, when they struggle to eat enough, the risk is rapid weight loss – and that can lead to malnutrition. The impact can be serious, from delaying the next chemo treatment to, in the most extreme cases, death.” adds Nathalie Boireau, Director of User Experience for Specialty Nutrition at Danone. 

The study, based on a large patient-reported survey across multiple cancer types, paints a nuanced picture of how sensory alterations affect eating:

• Around half of participants reported noticeable sensory changes after cancer treatment.
• Some people experienced increased sensitivity, others decreased sensitivity, and many a combination across different senses.
• Taste, smell, texture perception, temperature sensitivity, and sensations like spiciness or cooling were all frequently affected. 
• Dry mouth, sensitive teeth, nausea, and mouth discomfort often co-occurred with sensory changes.

Crucially, these sensory and oral changes were strongly associated with eating difficulties, like eating smaller portions, avoiding certain foods, losing pleasure in eating, or finding meals too physically demanding.

The new findings show a major gap in addressing malnutrition in cancer: if food does not feel acceptable at a sensory level, patients may struggle to eat enough, regardless of nutritional quality.

“It’s also about how food is perceived and tolerated. If texture, temperature or oral comfort are off, intake can drop dramatically. And if nutrition is already compromised, that means patients are even more vulnerable.” says Reisya Rizki Riantiningtyas of the Institut Lyfe Research Center in Lyon, France, a joint PhD student with Danone and lead author on the paper.

The findings help explain why some patients avoid certain foods, even when they understand their nutritional importance. The somatosensory changes (texture, temperature, irritation), chewing and swallowing difficulty, and discomfort in the mouth all play a part.

These insights point toward a more personalised, sensory-profile-based approach to nutrition in oncology. Addressing the full patient experience could help restore the pleasure and dignity of eating, making it easier for patients to improve intake.

• Adapt texture, temperature and mouthfeel to individual sensitivities.
• Balance flavor intensity for people with heightened or reduced. perception.
• Design foods that are easier to chew, swallow, and tolerate.
• Integrate sensory evaluation into nutritional assessment and counselling.

This study clarifies important eating challenges during and after cancer treatment. By documenting sensory alterations across a diverse cancer population, it provides quantitative evidence for something patients have long described.

Integrating sensory science into oncology nutrition is a meaningful step toward helping people living with cancer eat better, feel better, and maintain strength when they need it most.

This article is based on research published in Clinical Nutrition Open Science (2026) and supported by a broader body of scientific work on oral sensory perception and cancer related eating difficulties. It was funded by the National Association for Research and Technology (Association Nationale Recherche et Technologie), Danone, and the National League Against Cancer (Ligue Contre le Cancer). Publication funding was provided by University Claude Bernard Lyon 1.

1. (2026) Oral sensory alterations and influence on food preferences and eating difficulties in oncology patients : a quantitative descriptive study. Clinical Nutrition Open Science
2. 1. Riantiningtyas RR, et al. (2024) A review of assessment methods for measuring individual differences in oral somatosensory perception. Journal of Texture Studies; DOI: 10.1111/jtxs.12849
3. 2. Riantiningtyas RR, et al. (2024) Investigating oral somatosensory perception and oral symptoms of head and neck cancer patients: insights on eating behaviour. Supportive Care in Cancer; DOI: 10.1007/s00520-024-08512-4
4. 3. Riantiningtyas RR, et al. (2023) Oral Somatosensory Alterations in Head and Neck Cancer Patients—An Overview of the Evidence and Causes. Cancers; DOI: 10.3390/cancers15030718
5. 4. Riantiningtyas RR, et al. (2023) Oral somatosensory alterations and salivary dysfunction in head and neck cancer patient. Supportive Care in Cancer; DOI: 10.1007/s00520-023-08086-7

Posters & abstracts