ABSTRACT
Chemosensory dysfunctions, most notably alterations in taste or smell, are common in individuals undergoing cancer treatment, with prevalence rates that can reach up to 90% (Wickham et al. 1999; Ravasco 2005; Brisbois et al. 2006; Hong et al. 2009). Chemosensory alterations reported by cancer patients can be generally classified into three main categories: changes in taste acuity, changes in taste quality, and changes in olfaction (Farmer et al. 2009; Hong et al. 2009; Brisbois et al. 2011). More specifically, cancer patients may experience hypogeusia (diminished sense of taste), hyposmia (diminished sense of smell), ageusia (complete loss of taste), or anosmia (complete loss of smell). Changes in taste acuity are often reported by cancer patients in the form of an increase in the threshold for taste perception, and frequently, reported taste quality alterations are perceptions of metallic or bitter taste for both food and liquids. Smell alterations are less frequently reported by cancer patients and include reports of smells being unpleasant or different. Studies on chemosensory alterations are limited in number, sample size, and overall methodological approach. However, cancer patients appear to experience taste and smell alterations both jointly and independently, and studies document a highly variable array of alterations. For example, a study of 192 advanced cancer patients found that 60% reported both taste and smell alterations, while 26% reported taste alterations
14.1 Chemosensory Alterations in Cancer Patients .............................................309 14.2 Assessment of Chemosensory Alterations in Cancer Patients ..................... 310 14.3 Dietary and Food Delivery Modifications for Managing Chemosensory
Alterations in Cancer Patients ...................................................................... 312 14.4 Additional Strategies for Managing Chemosensory Alterations in
Cancer Patients ............................................................................................. 316 14.4.1 Pharmacological Interventions ......................................................... 316 14.4.2 Psychosocial Interventions ............................................................... 317
14.5 Limitations and Future Directions ............................................................... 319 References .............................................................................................................. 320
only, and 3% reported olfactory alterations only. A number of these patients reported an increase in the threshold for taste acuity, while others experienced a decrease in threshold values for some tastes such as bitterness; some cancer patients might experience a mixed pattern of changes with some sensations becoming stronger and others weaker (Brisbois et al. 2011).
