Management of learned food aversions in cancer patients receiving chemotherapy.

Aversions that form towards foods after their ingestion has been associated with illness are termed learned food aversions (LFA). This adverse treatment side effect has been implicated in the anorexia of cancer and can compromise the quality of patients' lives. In an attempt to block the formation or ameliorate the manifestations of this treatment sequela, a nutritionally inconsequential "scapegoat" food was presented to patients just prior to their first course of therapy. The hypothesis was that treatment-related aversions would be targeted towards the scapegoat, thereby sparing acceptable and nutrient-dense items in the patient's typical diet. LFA were observed in 55.3% of 76 patients receiving chemotherapy for different cancers. Following formation of a scapegoat aversion, the incidence of LFA was only 11.1% (two of 18) during the 6-month follow-up period. In contrast, 48.4% (15 of 31) of the patients not exposed to the scapegoat formed LFA. More than twice as many patients with treatment-related LFA had a pretreatment histology of the problem, suggesting the presence of a subgroup of high-risk patients. Strategies for improving upon the present results are discussed.