Hope Unscripted
Hope Unscripted is a podcast from Hope Cancer Resources that brings real conversations to the forefront of health, prevention, and community care. Through honest discussions, expert insights, and personal stories, we explore what it means to live well, before, during, and beyond cancer. Each episode dives into topics like cancer prevention and education, survivorship, wellness, and the realities people face every day. You’ll hear from survivors, caregivers, healthcare professionals, and community voices, all sharing perspectives that inform, empower, and inspire. Whether you’re looking to learn, support someone you love, or simply take better care of your health, Hope Unscripted creates space for meaningful conversations that meet people where they are — unscripted, supportive, and rooted in hope.
Hope Unscripted
Ep. 14 - Fueling Hope: Food, Supplements, & Common Questions
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Altered taste and severe dry mouth turn basic nutrition into a daily struggle during active cancer treatment. When even plain water tastes off, maintaining adequate weight and caloric intake feels almost impossible. Registered dietitian Erin Moore sits down to share practical strategies for navigating these severe nutritional side effects.
We get into the specific mechanics behind treatment-induced taste changes and why so many patients describe their food as tasting like cardboard. Erin highlights the use of umami flavor profiles to stimulate dulled taste buds, explains why vanilla shakes offer superior versatility over chocolate variants, and breaks down the proper use of baking soda and salt rinses to cut through thick saliva. She also evaluates popular dietary trends, offering clarity on electrolyte replacement, mushroom powders, and zinc supplementation risks.
Cancer treatment requires managing severe physical discomfort, but navigating daily nutrition should not involve excessive guilt or anxiety. Listeners will walk away with a better understanding of how to protect their body's nutrient absorption without falling for unregulated supplement claims or blaming past dietary choices for a diagnosis.
If you care about clinical oncology nutrition, managing treatment side effects, and evidence-based dietary strategies, you’ll get a lot from this. Be sure to subscribe and share this episode with anyone currently supporting a loved one through treatment. What is the most surprising food or flavor change you or someone you know experienced during medical treatment? Tell us in the comments below.
Welcome back to Hope Unscripted, a podcast of Hope Cancer Resources. I'm your co-host, Jamie Dietrich, and with me, Brittany Harman. And we're back for episode two, where we're talking about all things nutrition oncology related with Miss Erin Moore. We're very excited to have her back and that she came back. Thank you for having me. So our last episode, we talked a lot about the different myths and things like that, and a lot about what you do and the patients that you see. Sometimes once patients come to you, if they're still eating food at that time, when their taste starts to change, what do they tell you during that time? Because I've heard metallic, when there's blood in my mouth, things like that. Oh gosh, we hear all sorts of things.
SPEAKER_01It really depends on um if the side effect is from radiation or from one of their medications or chemo. And what I hear a lot of is everything tastes like cardboard.
SPEAKER_00Yeah.
SPEAKER_01Just water. Which is something that I've heard over and over and I thought, hmm, that's interesting. This cardboard tastes money. Sometimes people just say it doesn't taste right like it should, or I can taste it, but only for a few seconds and then it goes away.
SPEAKER_00Yeah.
unknownOkay.
SPEAKER_00So that's an interesting one. I know we've had a patient come on and tell us like there's certain some of her favorite foods, she shouldn't eat them anymore because that's the same. There used to be. And so that's been years after, too. So those side effects can still remain. That's crazy. Yeah.
SPEAKER_01There's uh a really interesting website that I was directed to called Tasting, T-A-S-T-I-N-G notes. And it was developed by a chef who had head and neck cancer. And what better person to help people with taste than someone who is in the culinary field and been through it themselves? And so there's recipes and tips and things on that website, and there's a flavor that they speak of, and there's now a seasoning that you can buy over the counter called umami U-M-A-M-I. I've seen that, yeah. Yeah. And so in general, we are taught that taste is sweet, salty, bitter, or sour. And um, those are the tastes. And if there's too much of one, we can kind of cut it with another one. If things are too, you know, sour, we can cut it with adding sweet, or vice versa. Um, if things are too metallic, don't eat eat off of metal silverware. Um, canned foods can make that worse, etc. But the umami is kind of like the fifth flavor or the fifth taste bud. And so um they recommend that. And then I've seen some umami flavored seasonings at different grocery stores and um have bought some recently to take home and try just so that I can see what they're like and what kind of flavor. Um, but they're not all just a generic one. Some of them are more mushroom flavored or lean one way or the other. But um, I will recommend that site to patients that are struggling. But a lot of the patients that I deal with, especially the head and neck cancer patients who have lost their taste during radiation treatment, for example, um, you know, we know that they're going to recover their taste as they begin healing from treatment after treatment is finished. And so a lot of times it's just giving it time and then helping them work through what are the major taste obstacles right now just to make it palatable so that they can eat and drink what they need to. But um, it's very interesting because everybody has different preferences. A lot of times patients will come in and maybe they were a lifelong smoker, so they already had diminished taste to begin with. Um, then we have COVID thrown in the mix. Some people had COVID, lost their sense of taste, never got it back. Oh. So it's not an issue for them. Yeah.
SPEAKER_00I that would be awful. I my husband lost his sense of smell and he had it. Yeah. It was like six months later. And it was actually kind of handy at my house because I could light my candles and he couldn't say anything, and then all of a sudden he smelled it one day. And I was like, well, that's bad.
SPEAKER_01That's the one thing I wish I knew the key to is it a certain nerve? Is it a what is it that you know triggers the the loss of taste and when the taste comes back or if it's altered? Yeah. Um, I wish I could have that secret key to be able to people, yeah. Yeah, yeah.
SPEAKER_00I imagine that would just be so frustrating. Like to not taste ice cream or like whatever your favorite food. For me, that's queso. But like that would be so hard and frustrating.
unknownYeah.
SPEAKER_00So something I was thinking about as you were talking about that, we have a lot of different patients come in to see the care closet, and we talked about that a little in the last episode. Um, we try to keep stock nutrition shakes. And so I've seen chocolate in there and I've seen vanilla in there, and I noticed that we started stalking vanilla a lot more. And so I asked, you know, why are we doing vanilla? And so what I was told is that patients actually ask for the vanilla because they can't handle the chocolate taste because their taste buds are off or different. That several patients have mentioned that they can really only stomach the vanilla and they need to get, you know, obviously they need to get nutrition and protein in their body. Have you heard about anything like that or any thoughts on that?
SPEAKER_01I have in general. Um, chocolate is one that you you either prefer it or you don't, but it does tend to be the favorite or the most common flavor. Um, the vanilla, if a patient doesn't care for it, I always say, you know, vanilla can become vanilla caramel, it can become butterscotch, it can become maybe that's part of orange cream. Uh you could add strawberry syrup to it and make it the strawberry flavor if we don't have it, or add chocolate sora, make it the chocolate flavor. I feel like it's the most versatile, but it's also a little more mild, and that may be why um they tend to go for that one.
SPEAKER_00I could see chocolate too, and especially chocolate protein drinks. Um I I love a protein drink in the morning too. That's my go-to. But some of the chocolate wines just aren't as good as some of the others, too.
SPEAKER_01Yeah, that could be. And there's a lot of people out there um that are just people who don't like chocolate or they love chocolate. But I don't hear as often people who I love vanilla, but I don't like vanilla. You know, I don't hear as much of that. So I will say too, the vanilla is more versatile, versatile for patients who just don't like the taste or have a weird aftertaste with um protein or nutrition shakes. And so that one's an easy one to throw into a milkshake or a smoothie and use it as a base, blend it with fruit, you know, change up the flavor profile that way as well.
SPEAKER_00Interesting. So, do you deal, do you help navigate, I guess, some of the side effects with nutrition as far as nausea, mouth sores are always a big one we hear about pretty frequently. The dry mouths, fix saliva. Like I've heard that one too.
unknownYeah.
SPEAKER_00So what does that look like?
SPEAKER_01Those are things we talk about every week throughout treatment and post-treatment with some populations or some cancer diagnoses and treatments more than others, but um, dry mouth feeds into the taste thing. Our saliva has enzymes, the same type of enzymes that our pancreas secretes to help break down and digest fat and sugar. We have what's called salivary amylase and salivary lipase, and those break down carbohydrate and fat respectively. And so part of not being able to taste is lack of saliva and lack of enzymes to break down that piece of cheese or that chip that has a lot of flavor normally, but not right now. So, you know, in in certain instances, we know that the saliva will come back to some degree or improve after treatment. Um, and until then, we have to use other strategies like avoiding dry foods or adding moisture to them. So um more tender meats instead of the dried meats or using condiments and sauces, gravies, dips, things like that, taking frequent sips of liquids because you don't have the saliva that's usually there to help chew and emulsify your food. And none of us think about that on a regular basis. It just comes naturally until you're in this scenario and you realize, oh, I don't have that, and that's why.
SPEAKER_00Well, and I do think that that, I mean, sometimes you wake up with cotton mouse, your mouth is so dry, and it hurts almost to try to get you sit back in there and even dealing with that on a daily basis. I know what that tastes like in my mouth, and I can't imagine having to taste that every day.
SPEAKER_01Yeah, and we have, I mean, you can always drink lots of sips of water and ice chips and things, but that's very, very temporary, and it does kind of help with dehydration uh during treatment, which is another issue. But um we have other things that we often use. There's dry mouth gels, mouth rinses, sprays that you can keep in your pocket or by your nightstand, there's lozenges. A lot of those have something called xylitol, which is an artificial or a sugar alcohol, and that helps with a moisture layer. Um, even using humidifiers at night so that the air you breathe in through your mouth or nose is more, has more moisture. Or a lot of patients who already use a CPAP telling them to add the humidifier so that their mouth isn't so dry in the morning. And then we have little rinses that we give recipes for that has uh baking soda and salt. They use those a lot, and that helps with the dry mouth. It also helps with the icky taste to some degree and it helps break up that thick saliva.
SPEAKER_00So chewing gum, would that I mean, would that be something that would be helpful or hurtful because you already have a lack of saliva words that it depends.
SPEAKER_01Um, some of my patients chew it and they feel like it helps. Um, the issue is, you know, if if your saliva glands just don't have saliva in them, then any sort of stimulation like gum or a sour candy or a hard candy just may not work during that that time.
SPEAKER_00It's so interesting how every case, every patient, every cancer is just so different. And it's really like throughout all these conversations in episode one, I just keep thinking like there's not a single repetitive it build like um situation. Like everything is so different. And that has to one, keep your jaw very interesting and two, make your jaw very difficult.
SPEAKER_01I mean, it's yeah, oftentimes you you can head into a room and know the general picture, diagnosis, treatment, um, and have a few other patients who are kind of in that same scenario and think, okay, this is what I think I'm gonna be dealing with. It's you know, week four of radiation and you know, after cycle four of chemo, and and then you walk in, you're like, Oh, I wasn't expecting that. Yeah. Or you're like, so you're not having any of this, this, this, like, wow, okay, that's great. You know, I was expecting to have to really help you troubleshoot, but um, you know, we'll take it that you're not having that. So interesting.
SPEAKER_00So in episode one, we talked a little bit about supplements and kind of how you handle that. Are there ever any supplements that you do recommend? And if so, what are those and when would you recommend them?
SPEAKER_01So supplements are uh a little bit tricky because um it's kind of a broad term. Um, so we may say oral nutrition supplement meaning a shake, or we may say supplement meaning a vitamin, or it could mean an herbal supplement. So in general, um the ones that would typically be recommended are vitamin D. Um, it plays a role in our immune system and our ability to, you know, fight things similar to cancer illness indirectly helps with that. And a lot of people are just vitamin D deficient. And we've learned over the years that what we thought was a normal range is is not gonna cut it. And so, you know, we want levels to be in a more therapeutic range, especially if you're a cancer patient. And so if those levels are low when we check them, then yes, that's something we would recommend a supplement. Same with B12 or iron or any of those, like folate. Um, and so I work with the medical oncologist to, you know, monitor those levels and um make sure patients are taking, you know, their recommended supplements if they have a deficiency or if we're trying to prevent a deficiency because they're borderline. When it comes to herbal supplements, um there's a really good database that I use from Memorial Sloan Kettering. It's called About Herbs. And so they've taken all of the science and literature that's out there that's available on certain herbs or plants, and it's there for consumers or the patient, and it's also there for providers. And it takes you through what is it, where does it come from, like what type of plant or what's the extract. Um, turmeric is an example, and the active compound in turmeric is uh curcumin. So taking a turmeric supplement may not be the same if you get one and you get one, um, because your yours just may have the curcumin in it and yours may have full-on turmeric and you may not absorb it as well. Or yours may be one that irritates your GI tract, depending on the form it's in. But this database helps people make more of an informed decision. It helps us as providers know are there any potential interactions? Does it interact with drug pathways? Um, does it cause any side effects? Does it make labs look weird? Like, does it make it look like your liver is inflamed when it's not? So we we try to be mindful of that. And if a patient really wants to take it, then we educate them on what's known. But also herbs, vitamins, any of those, none of them are regulated.
SPEAKER_02Right.
SPEAKER_01Um, whether by the FDA or anybody else, um, some of them do hire a third-party company to um sort of third-party testing and through in the TikTok rabbit hole and all seem to be. Yeah, some of them you can you can trust because they're they're regulated and heavily, and they test them to show you, and their their uh data is available that this pill and this pill have exactly what they say. But a lot of times over the years, they've done studies and they find that one pill may have zero of the ingredient it said, one may have five times that, and that could be really harmful to somebody. So another thing is it can be contaminated with mold or bacteria or fungus. You don't know where it was stored, where it came from, how it was shipped, the environment. So you really run that risk, especially when you're immune compromised. And so it really has to be something that you're you're dead set on that you really think would be beneficial or that you've always taken and you notice you don't do as well without. And then you just have to weigh the risk versus benefit.
SPEAKER_00Yeah, not big stuff. One of the big ones that's huge hype this past year and and now currently is electrolytes. Like they are everywhere. Yeah, I'd be like, Oh, it's not a drinker. May take all day. I mean, well, not all day, but I mean every day I have probably drink more than I should, like be honest. Like this is true. Yeah, like I can't even drink plain water anymore. Yeah, I know that's bad.
SPEAKER_01Electrolytes have become a trend and for multiple reasons. It used to be that you just had your Gatorade, Powerade, and then when you're sick, you might grab some PLIT. Um, and then there's a couple that are marketed towards cancer patients that aren't pediatric products. But in recent years, it's been marketed for people who are active, for people who feel tired, for people who feel like their diet isn't very um complete. Um, and then also we've had a slew of people with diagnoses like POTS, um, which is a cardiac condition where they require a lot more fluid and more electrolytes to help their condition. And so um there's so many out there. Uh, myself, I was looking the other day at an electrolyte supplement that came from the field house where my husband coaches. And I thought, oh, this looks like a good one. There's some that have sugar, there's some that are sugar free. And I thought, oh, well, I don't really care for this flavor. I'm gonna see what else is out there. When I was just looking for online grocery shopping at, you know, Walmart, Target, wherever. And then I realized, oh, this one doesn't have any magnesium, and this one does, or this one has zinc, or this one has a bunch of niacin, which is a B vitamin, but it was well over a hundred percent of the daily needs, and it can cause something called flushing. It's like you're having a hot flash when you take too much of it. And so I was like, I definitely don't want that. It's a hundred degrees outside. So I realized quickly that there's so many out there it's hard to keep up with, and they all have different electrolyte profiles. But, you know, in general, we're taught less sodium, more potassium. So less processed foods, don't add salt to your food, don't cook with a lot of sodium, use herbs and spices, eat more fruits and vegetables because potassium is sort of a counterbalance in some ways to sodium. Like Americans get way too much sodium and not enough potassium. And then you throw these electrolytes in the mix and they all have sodium in them and they all have different amounts. And I mean, it gets really complex because, from a medical nutrition standpoint, I I've worked with patients who have absorptive uh disorders. Maybe they're missing a large portion of their intestine and they don't absorb fluid like they should, or electrolytes. And so we normally give them something that is a specific ratio and concentration of sugar, sodium, potassium, so that it'll be optimally absorbed. And just plain old Gatorade doesn't cut it. That's like a watered-down version of what we need. But then from day to day, if you're just trying to add in extra electrolytes, you know, you're just grabbing a packet. Um, it could have any number of those.
SPEAKER_00Yeah, I know what the ones we have at home right now, it's what they're called fire salt. They're great. We love them, they taste delicious. Yeah. And it does, it says sodium, magnesium, potassium right on the on the thing. So I know at least what I'm getting, but I'm like, am I drinking too many of these? Like, is there a point of expensive urine or exactly?
SPEAKER_01Yeah. And then there's populations that have heart disease and they're very mindful that too much potassium can be almost lethal to them. Yeah. Or that if they have kidney disease, they know that they're limited on sodium and potassium, so they stay away from those electrolyte drinks completely. Um, so it's very interesting now that it's become more mainstream and not just in sports or certain conditions to see all the different varieties out there. But I find them helpful to some of my patients who lose a lot of electrolytes from um having a lot of GI losses. So whether it be um diarrhea or they have a drain coming from their GI tract or their biliary tract, we know those fluids are concentrated in certain electrolytes, and that helps steer me to okay, based on how much they're putting out, what their labs look like, um, how can I help, you know, replace that? One of the interesting things that um has been handy is patients who need potassium replacement for whatever reason, whether it's their their chemo depletes their potassium or they're on a drug that depletes it, um, or they're just losing a lot. They the potassium replacement pills are so big. And a lot of and even patients who don't have much difficulty with swallowing are just like, I can't take them. And so we found ways to use electrolyte drinks and replacements to get the same dose of potassium safely and without choking.
SPEAKER_00Talked about all the different brands and some of the legals and stuff that you read. Is there one if you're comfortable answering that you recommend or a brand that you found that you're just like, oh, like this one, I really like what's in it? Or maybe it's a personal preference?
SPEAKER_01Yeah, I think mostly it comes down to personal preference and also like availability and cost. Some of them can be very expensive. Yeah. Um, I've tried and true, always had access to PediALite just because, you know, having a hospital formulary and that being available even for adults. Um, and it's it's got a pretty mainstream profile as far as electrolytes. Um, the other ones, like I said, just kind of go off in various directions. So I'm I'm just most familiar with that one. There's interraid, which is one that is recommended or made for adults, um, and a lot of cancer um patients will use, but really I think it's just personal preference. Um, and I really don't recommend one unless I know what's in it and I know the patient's history and and all of that.
SPEAKER_00Well, and the pediolite, they make packets now too. But I know when my son has been sick and that up, they do. They started doing it, I don't know, probably about a year ago when the trend probably took off. Because I know my little boy was sick once. If they do, they tell you just pump them full of some p. But he hated the bottle. He would not drink it whatsoever. And I found those packets, and it makes it a lot of things.
SPEAKER_01The packets are helpful too because patients who are fed through a tube, they have to get water through their tube too. And so sometimes we can just give, you know, the pea light as part of their electrolytes through the tube if it's indicated, you know.
SPEAKER_00So cool. You are just a wealth of knowledge. And just so you know, I'm over here wrapping though like as you're painting. Yes. Um, so two other supplements I want to mention real quick. One is mushrooms. I hear a lot about um turkey tail and cancer prevention, and then zinc being another boosting immunity. And I just wanted to get you to talk about those two real quick, and then we'll move on.
SPEAKER_02Yeah.
SPEAKER_01Um, mushrooms have also become more common in the last several years, more so through mushroom blends. People are putting them in their coffee and doing all sorts of fun things with coffee or their morning drinks and mushroom powders and things. I've seen so many.
SPEAKER_00That's why I have to ask.
SPEAKER_01Again, there's there's so many different mushroom varieties. And then there's so many ways to to process them. And then you hear growing up, mushrooms are dangerous. If you don't, if they didn't come from the grocery store, you don't know where they're from, they can make you hallucinate. But no, there's there, there's different blends, there's um different purported benefits. Um I mean, they're a staple in a lot of cooking, but in the powder form or a supplement form, it's really hard to say. Like I said, because it's not regulated. Um, again, I go to that database and and see what's available. Yeah. And if I don't know enough, I usually advise against it, at least, you know, when when someone's going through treatment or when they're sick, um, or unless they can find more information to review. Um, but yeah, there are certain mushrooms specifically, like the turkey tail that that some people say, you know, it has protective effects from uh from liver disease or helps with certain cancers. And there may be some studies that showed that, but are they controlled trials? Are they peer-reviewed?
SPEAKER_00I mean, are they human trials?
SPEAKER_01Exactly. We just, you know, and and when you look into it most of the time, no.
SPEAKER_02Yes.
SPEAKER_01Um, if something were to become evidence-based, of course, it would have all of that to back it and it would be something recommended by the larger entities, you know.
SPEAKER_00I got a crunchy brain, she knows who she is. I know she's probably gonna listen to this. She used to make that coffee or the mushroom coffee in the morning and the smell of it. I just how can how you translate it? Does it have it is an interesting smell? So I don't more power to you, you can choke it down. But she loves it and she made she says it helps her body every day. I was like, yeah, I've done for you, not not for me. I've seen so much on I bring it up because of like Instagram and Facebook and like all the different social media platforms. It feels like it's everywhere right now, and so I really appreciate your constantly yeah in your face. And it's like what a billion-dollar market on supplements, and so people just people sometimes are grasping for hope. And it marketed a certain way, it's so quick and easy to be like, Yep, order, I'll try it.
SPEAKER_0130 bucks, yeah, I'll do it. And now that we have algorithms and we have AI, you search a certain thing and it could be unrelated, and then it starts putting things in your feed or in front of you, and your ads start changing, or you start seeing testimonials or posts from people, and it kind of puts you on the train whether you were looking for it or not.
SPEAKER_00The rabbit hole is like, yeah, I'm right there. Now all of our phones are gonna be simple.
SPEAKER_01And then when it comes to supplements like zinc, for example, a lot of patients will say, Oh, I take zinc when it's cold in flu season because I want to help boost my immune system. Um, or I take it for XYZ to prevents things. Um, zinc is one of the, it's a mineral. Um, and it's one of those that in general is not harmful, but it when taken in excess, can compete with other minerals. So another mineral that we don't think about that we need, but in very small amounts, is copper. And so too much zinc can lead to a copper deficiency because they compete for absorption. And no one's thinking about, oh, I have a copper deficiency. Well, no, because you don't hear outside of hematology, oncology, or maybe functional medicine, you you're not gonna see someone even looking for that. Um, but but it can happen. And so that's that's one thing I say, yeah, it's okay to take. It's probably not gonna hurt you if you take a little bit over the the daily limit because we don't really know. But I would take breaks from it because you want to make sure that you're not, you know, becoming deficient in copper because that can lead to other anemias and things.
SPEAKER_00So well, we just have a couple of minutes here left, and so I just want to turn it over to you. You've been such a wealth of knowledge. I mean, literally been writing that keep going very forever, yeah. Um, but with you know, two minutes left, uh is there anything that you would share just with our listeners out there that is just something you know special from you and your expertise? Like you you've blown me away today. So I'm just gonna turn this over to you.
SPEAKER_01Yeah, I would just say that um nutrition is very complex. It's not a one size fits all. And when you have a cancer diagnosis or you've beat cancer and are in survivorship or you're trying to prevent cancer, um, you really can't put all of the weight or any weight into a decision that you made regarding food or nutrition. You can't beat yourself up and say that because I did this, it might have led to this, because I didn't eat all organic or I didn't, you know, um, avoid hot dogs or something, you know, it could be anything. Um, you really can't beat yourself up. And then there's nothing that you can do that is going to make your cancer worse or kill it or make it go away as far as food is concerned for the most part. And so not to put too much weight in that and try to beat yourself up and control what you're eating and drinking. You should do what feels right for your body, what's going to nourish your body, what sounds good to you, what's affordable to you. Um right now. And there is so much misinformation, but there's also so much good information out there. So, you know, sites like the American Cancer Society, um, a lot of the larger cancer institutions, and then there are different support groups and sites for specific cancers like head and neck cancer, pancreatic cancer, breast cancer. Those are wonderful resources that have um support groups and forums where you can share experiences and get information from people who have been there done that. And so I highly recommend those versus just searching the web in general or scrolling and hearing from complete strangers, um, unless they're just giving their personal experience. It can lead to a lot of harm and misinformation and confusion. And it can be scary. Yeah, yeah.
SPEAKER_00Sound awesome. Well, thank you for sharing that. Thank you for joining us. This is for not one but two episodes this month, which is amazing. And thank you, listeners and watchers, for being out there. We hope you took something away from today's episode. And Brittany, anything that you want to add? We just appreciate Aaron and everything Highlands does. And if you guys have any questions, you can reach us, um, visit our website, hope cancer resources.org. We can do what we can with our wellness specialist, uh, Miss Hannah. She knows some about the nutrition education too, and connect with everybody that we need to. So I thank you. Thank you guys. Bye.