Skip to main content

Advertisement

SpringerLink
Log in

Taste and smell disturbances in cancer patients: a scoping review of available treatments

  • Review Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Taste and smell disturbances in patients affected by cancer are very common, but often under-recognized symptoms. If not addressed properly, they may impact nutritional status, food enjoyment, and quality of life. Treatment tools available for clinicians to manage chemosensory alterations are limited and are often based on personal clinical experiences. The aim of this study was to assess current oncological and palliative care literature through a scoping review, in order to identify available treatments for taste and smell alterations in cancer patients.

Methods

Medline, Embase, CINAHL, ProQuest Dissertations and Theses, and Google Scholar were searched from inception until January 2020, with subject headings relevant to the domains of chemosensory alterations, palliative, and cancer care. A total of 10,718 English and French language publications were reviewed, yielding 43 articles on the researched topic.

Results

The heterogeneity of selected articles led to difficulties in interpretation and analysis of the available evidence. Included publications differed in study design, population sample, anticancer treatments, and measures of assessment for taste and smell disturbances. A broad variety of treatment options were described including zinc and polaprezinc, radio-protectors, vitamins and supplements, anti-xerostomia agents, active swallowing exercises, nutritional interventions, delta-9-tetrahydrocannabinol, and photobiomodulation.

Conclusion

This scoping review identifies the current state of knowledge regarding chemosensory alterations within supportive cancer care. Despite not reaching firm conclusions, this article offers therapeutic venues to further explore in larger and more methodologically sound studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Spotten LE, Corish CA, Lorton CM, Ui Dhuibhir PM, O’Donoghue NC, O’Connor B, Walsh TD (2017) Subjective and objective taste and smell changes in cancer. Ann Onc 28(5):969–984

    Article  CAS  Google Scholar 

  2. Gamper EM, Zabernigg A, Wintner LM, Giesinger JM, Oberguggenberger A, Kemmler G, Sperner-Unterweger B, Holzner B (2012) Coming to your senses: detecting taste and smell alterations in chemotherapy patients. A systematic review. J. Pain Symptom Manag 44(6):880–895

    Article  Google Scholar 

  3. Gill SS, Frew J, Fry A, Adam J, Paleri V, Dobrowsky W, Chatterjee S, Kelly CG (2011) Priorities for the head and neck cancer patient, their companion and members of the multidisciplinary team and decision regret. Clinical Oncology 23(8):518–524

    Article  CAS  PubMed  Google Scholar 

  4. Hutton JL, Baracos VE, Wismer VW (2007) Chemosensory dysfunction is a primary factor in the evolution of declining nutritional status and quality of life in patients with advanced cancer. J Pain Symptom Manag 33(2):156–165

    Article  Google Scholar 

  5. Boltong A, Keast R, Aranda S (2012) Experiences and consequences of altered taste, flavour and food hedonics during chemotherapy treatment. Support Care Cancer 20(11):2765–2774

    Article  PubMed  Google Scholar 

  6. Wrobel BB, Leopold DA (2004) Clinical assessment of patients with smell and taste disorders. Otolaryngol Clin N Am 37(6):1127–1142

    Article  Google Scholar 

  7. Epstein JB, Smutzer G, Doty RL (2016) Understanding the impact of taste changes in oncology care. Support Care Cancer 24(4):1917–1931

  8. Amézaga J, Alfaro B, Rios Y, Larraiox A, Ugartemendia G, Urruticoechea A, Tueros I (2018) Assessing taste and smell alterations in cancer patients undergoing chemotherapy according to treatment. Support Care Cancer 26(12):4077–4086

    Article  PubMed  Google Scholar 

  9. van der Werf A, Rovithi M, Langius JA, de van der Schueren MA, Verheul HM (2017) Insight in taste alterations during treatment with protein kinase inhibitors. Eur J Cancer 86:125–134

    Article  PubMed  CAS  Google Scholar 

  10. Murtaza B, Hichami A, Khan AS, Ghiringhelli F, Khan NA (2017) Alteration in taste perception in cancer: causes and strategies of treatment. Front Physiol 8:134

    Article  PubMed  PubMed Central  Google Scholar 

  11. Spotten L, Corish C, Lorton C, Dhuibhir PU, O’Donoghue N, O’Connor B, Cunningham M, El Beltagi N, Gillham C, Walsh D (2016) Subjective taste and smell changes in treatment-naive people with solid tumours. Support Care Cancer 24(7):3201–3208

    CAS  PubMed  Google Scholar 

  12. Doty RL, Shah M, Bromley SM (2008) Drug-induced taste disorders. Drug Saf 31(3):199–215

    Article  CAS  PubMed  Google Scholar 

  13. Arksey H, O’Malley L (2005) Scoping studies: towards a methodological framework. Int J Soc 8(1):19–32

    Google Scholar 

  14. Erkurt E, Erkisi M, Tunali C (2000) Supportive treatment in weight-losing cancer patients due to the additive adverse effects of radiation treatment and/or chemotherapy. J Exp Clin Cancer Res 19(4):431–439

    CAS  PubMed  Google Scholar 

  15. Thorne T, Olson K, Wismer W (2015) A state-of-the-art review of the management and treatment of taste and smell alterations in adult oncology patients. Support Care Cancer 23(9):2843–2851

    Article  PubMed  Google Scholar 

  16. Ripamonti C, Zecca E, Brunelli C, Fulfaro F, Villa S, Balzarini A, Bombardieri E, Conno FD (1998) A randomized, controlled clinical trial to evaluate the effects of zinc sulfate on cancer patients with taste alterations caused by head and neck irradiation. Cancer 82(10):1938–1945

    Article  CAS  PubMed  Google Scholar 

  17. Najafizade N, Hemati S, Gookizade A, Berjis N, Hashemi M, Vejdani S, Ghannadi A, Shahsanaee A, Arbab N (2013) Preventive effects of zinc sulfate on taste alterations in patients under irradiation for head and neck cancers: a randomized placebo-controlled trial. J Res Med Sci 18(2):123–126

    PubMed  PubMed Central  Google Scholar 

  18. Yamagata T, Nakamura Y, Yamagata Y, Nakanishi M, Matsunaga K, Nakanishi H, Nishimoto T, Minakata Y, Mune M, Yukawa S (2003) The pilot trial of the prevention of the increase in electrical taste thresholds by zinc containing fluid infusion during chemotherapy to treat primary lung cancer. J Exp Clin Cancer Res 22(4):557–563

    CAS  PubMed  Google Scholar 

  19. Silverman JE (1983) Zinc supplementation and taste in head and neck cancer patients undergoing radiation therapy. J Oral Med 38:14–16

    CAS  PubMed  Google Scholar 

  20. Silverman S Jr, Thompson JS (1984) Serum zinc and copper in oral/oropharyngeal carcinoma. A study of seventy-five patients. Oral Surg Oral Med Oral Pathol 57(1):34–36

    Article  PubMed  Google Scholar 

  21. Khan AH, Safdar J, Siddiqui SU (2019) Efficacy of zinc sulfate on concurrent chemoradiotherapy induced taste alterations in oral cancer patients: a double blind randomized controlled trial. Pak J Med Sci 35(3):624–629

    PubMed  PubMed Central  Google Scholar 

  22. Halyard MY, Jatoi A, Sloan JA, Bearden JD III, Vora SA, Atherton PJ, Perez EA, Soori G, Zalduendo AC, Zhu A, Stella PJ (2007) Does zinc sulfate prevent therapy-induced taste alterations in head and neck cancer patients? Results of phase III double-blind, placebo-controlled trial from the North Central Cancer Treatment Group (N01C4). Int J Radiat Oncol Biol Phys 67(5):1318–1322

    Article  CAS  PubMed  Google Scholar 

  23. Lyckholm L, Heddinger SP, Parker G, Coyne PJ, Ramakrishnan V, Smith TJ, Henkin RI (2012) A randomized, placebo-controlled trial of oral zinc for chemotherapy-related taste and smell disorders. J Pain Palliat Care Pharmacother 26(2):111–114

    Article  PubMed  PubMed Central  Google Scholar 

  24. Fujii H, Hirose C, Ishihara M, Iihara H, Imai H, Tanaka Y, Matsuhashi N, Takahashi T, Yamaguchi K, Yoshida K, Suzuki A (2018) Improvement of dysgeusia by polaprezinc, a zinc-L-carnosine, in outpatients receiving cancer chemotherapy. Anticancer Res 38(11):6367–6373

    Article  CAS  PubMed  Google Scholar 

  25. Watanabe T, Ishihara M, Matsuura K, Mizuta K, Itoh Y (2010) Polaprezinc prevents oral mucositis associated with radiochemotherapy in patients with head and neck cancer. Int J Cancer 127(8):1984–1990

    Article  CAS  PubMed  Google Scholar 

  26. Hayashi H, Kobayashi R, Suzuki A, Ishihara M, Nakamura N, Kitagawa J, Kanemura N, Kasahara S, Kitaichi K, Hara T, Tsurumi H (2014) Polaprezinc prevents oral mucositis in patients treated with high-dose chemotherapy followed by hematopoietic stem cell transplantation. Anticancer Res 34(12):7271–7277

    CAS  PubMed  Google Scholar 

  27. Büntzel J, Riesenbeck D, Glatzel M, Berndt-Skorka R, Riedel T, Mücke R, Kisters K, Schönekaes KG, Schäfer U, Bruns F, Micke O (2010) Limited effects of selenium substitution in the prevention of radiation-associated toxicities. Results of a randomized study in head and neck cancer patients. Anticancer Res 30(5):1829–1832

    PubMed  Google Scholar 

  28. Büntzel J, Schuth J, Küttner K, Glatzel (1998) Radiochemotherapy with amifostine cytoprotection for head and neck cancer. Support Care Cancer 6(2):155–160

    Article  PubMed  Google Scholar 

  29. Büntzel J, Glatzel M, Muecke R, Micke O, Bruns F (2007) Influence of amifostine on late radiation-toxicity in head and neck cancer-a follow-up study. Anticancer Res 27(4A):1953–1956

    PubMed  Google Scholar 

  30. Brisbois TD, De Kock IH, Watanabe SM, Mirhosseini M, Lamoureux DC, Chasen M, MacDonald N, Baracos VE, Wismer WV (2011) Delta-9-tetrahydrocannabinol may palliate altered chemosensory perception in cancer patients: results of a randomized, double-blind, placebo-controlled pilot trial. Ann Oncol 22(9):2086–2093

    Article  CAS  PubMed  Google Scholar 

  31. Strasser F, Demmer R, Böhme C, Schmitz SFH, Thuerlimann B, Cerny T, Gillessen S (2008) Prevention of docetaxel- or paclitaxel-associated taste alterations in cancer patients with oral glutamine: a randomized, placebo-controlled, double-blind study. Oncologist 13(3):337–346

    Article  CAS  PubMed  Google Scholar 

  32. Wang A, Duncan SE, Lesser GJ, Ray WK, Dietrich AM (2018) Effect of lactoferrin on taste and smell abnormalities induced by chemotherapy: a proteome analysis. Food Funct 9(9):4948–4958

    Article  CAS  PubMed  Google Scholar 

  33. Pattison R (1999) Alteration in taste perception and its relationship with nutritional status and quality of life in patients with advanced cancer. Dissertation, The Open University

  34. Andersson G, Johansson G, Attström R, Edwardsson S, Glantz PO, Larsson K (1995) Comparison of the effect of the linseed extract Salinum® and a methyl cellulose preparation on the symptoms of dry mouth. Gerodontology 12(1):12–17

    Article  CAS  PubMed  Google Scholar 

  35. Jordan WO, Duckert A, Borberg SK, Trog D, Wildfang I (2012) Management of xerostomia with artificial saliva (Xerotin). Eur Arch Oto-Rhino-L 269(4):1384

    Google Scholar 

  36. Nakada K, Ishibashi T, Takei T, Hirata K, Shinohara K, Katoh S, Zhao S, Tamaki N, Noguchi Y, Noguchi S (2005) Does lemon candy decrease salivary gland damage after radioiodine therapy for thyroid cancer? J. Nucl. Med 46(2):261–266

    PubMed  Google Scholar 

  37. Banava S, Houshyari M, Safaie T (2015) The effect of casein phosphopeptide amorphous calcium phosphate fluoride paste (CPP-ACPF) on oral and salivary conditions of patients undergoing chemotherapy: a randomized controlled clinical trial. Electron Physician 7(7):1535–1541

    Article  PubMed  PubMed Central  Google Scholar 

  38. Epstein JB, Emerton S, Le ND, Stevenson-Moore P (1999) A double-blind crossover trial of Oral Balance gel and Biotene toothpaste versus placebo in patients with xerostomia following radiation therapy. Oral Oncol 35(2):132–137

    Article  CAS  PubMed  Google Scholar 

  39. Momm F, Volegova-Neher NJ, Schulte-Möntig J, Guttenberger R (2005) Different saliva substitutes for treatment of xerostomia following radiotherapy. A prospective crossover study. Strahlenther Onkol 181(4):231–236

    Article  PubMed  Google Scholar 

  40. Schuller DE, Stevens P, Clausen KP, Olsen J, Gahbauer R, Martin M (1989) Treatment of radiation side effects with oral pilocarpine. J Surg Oncol 42(4):272–276

    Article  CAS  PubMed  Google Scholar 

  41. Fisher J, Scott C, Scarantino CW, Leveque FG, White RL, Rotman M, Hodson DI, Meredith RF, Foote R, Bachman DG, Lee N (2003) Phase III quality-of-life study results: impact on patients’ quality of life to reducing xerostomia after radiotherapy for head-and-neck cancer-RTOG 97-09. Int J Radiat Oncol Biol Phys 56(3):832–836

    Article  PubMed  Google Scholar 

  42. Jham BC, Chen H, Carvalho AL, Freire AR (2009) A randomized phase III prospective trial of bethanechol to prevent mucositis, candidiasis, and taste loss in patients with head and neck cancer undergoing radiotherapy: a secondary analysis. J Oral Sci 51(4):565–572

    Article  CAS  PubMed  Google Scholar 

  43. Wilhelm-Buchstab T, Thelen C, Amecke-Mönnighoff F, Schmeel LC, Simon B, Müdder T, Schoroth F, Garbe S, Röhner F, Vornholt S, Schröck A (2019) Pilot study: protective effect on mucosal tissue using dental waterjet and dexpanthenol rinsing solution during radiotherapy in head and neck tumor patients. Oral Cancer 3(3–4):59–67

    Article  Google Scholar 

  44. Mastroianni C, Magnani C, Giannarelli D, Stefanelli MC, Di Cienzo V, Valerioti T, Casale G, Levano M, Castelli M, Altariva R, Palumbo S, De Leo E, Bosso F, Santilli S, Failla A, Fiumara S, Graziani M (2018) Oral care in a sample of patients undergoing palliative care: a prospective single-centre observational study: Igor study. Palliat Med 32(1):45–46

    Google Scholar 

  45. El Mobadder M, Farhat F, El Mobadder W, Nammour S (2019) Photobiomodulation therapy in the treatment of oral mucositis, dysgeusia and oral dryness as side-effects of head and neck radiotherapy in a cancer patient: a case series. Int J Environ Res Public Health 16(22):4505

    Article  PubMed Central  CAS  Google Scholar 

  46. Morais MO, Martins AF, de Jesus AP, de Sousa Neto SS, da Costa AW, Pereira CH, Oton-Leite AF, de Freitas NM, Leles CR, Mendonça EF (2020) A prospective study on oral adverse effects in head and neck cancer patients submitted to a preventive oral care protocol. Support Care Cancer 3(1):1–11

    Google Scholar 

  47. Carnaby-Mann G, Crary MA, Schmalfuss I, Amdur R (2012) “Pharyngocise”: randomized controlled trial of preventative exercises to maintain muscle structure and swallowing function during head-and-neck chemoradiotherapy. Int J Radiat Oncol Biol Phys 83(1):210–219

    Article  PubMed  Google Scholar 

  48. Risberg-Berlin B, Karlsson TR, Tuomi L, Finizia C (2014) Effectiveness of olfactory rehabilitation according to a structured protocol with potential of regaining pre-operative levels in laryngectomy patients using nasal airflow-inducing manoeuvre. Eur Arch Oto-Rhino-L 271(5):1113–1119

    Article  Google Scholar 

  49. Von Grundherr J, Koch B, Grimm D, Salchow J, Valentini L, Hummel T, Bokemeyer C, Stein A, Mann J (2019) Impact of taste and smell training on taste disorders during chemotherapy–TasTe trial. Cancer Manag Res 11:4493–4504

    Article  Google Scholar 

  50. Ravasco P, Monteiro-Grillo I, Marques Vidal P, Camilo ME (2005) Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck 27(8):659–668

    Article  PubMed  Google Scholar 

  51. Rehwaldt M, Wickham R, Purl S, Tariman J, Blendowski C, Shott S, Lappe M (2009) Self-care strategies to cope with taste changes after chemotherapy. Oncol Nurs Forum 36(2):E47–E56

    Article  PubMed  PubMed Central  Google Scholar 

  52. Williams SA, Schreier AM (2004) The effect of education in managing side effects in women receiving chemotherapy for treatment of breast cancer. Oncol Nurs Forum 31(1):E16–E23

    Article  PubMed  Google Scholar 

  53. Schiffman SS, Sattely-Miller EA, Taylor EL, Graham BG, Landerman LR, Zervakis J, Campagna LK, Cohen HJ, Blackwell S, Garst JL (2007) Combination of flavor enhancement and chemosensory education improves nutritional status in older cancer patients. J Nutr Health Aging 11(5):439–454

    CAS  PubMed  Google Scholar 

  54. Russ JE, DeWys WD (1978) Correction of taste abnormality of malignancy with intravenous hyperalimentation. Arch of Intern Med 138(5):799–800

    Article  CAS  Google Scholar 

  55. Wilken MK, Satiroff BA (2012) Pilot study of “miracle fruit” to improve food palatability for patients receiving chemotherapy. Clin J Oncol Nurs 16(5):E173–E177

    Article  PubMed  Google Scholar 

  56. Cusnir M, Soares H, Schwartz M, Pizzolato J, Ludsky J, Campbell R, Lilenbaum R (2012) Treatment of taste alterations in chemotherapy patients using “miracle fruit”: P1-31. Psycho-Oncology 21:58

    Google Scholar 

  57. Velargo PA, Samant S (2012) Synsepalum dulcificum and varied taste occurring postradiation trial. Otolaryngol Head Neck Surg 147(2_suppl):178

    Article  Google Scholar 

  58. Yanagimoto H, Satoi S, Toyokawa H, Yamamoto T, Hirooka S, Yamao J, Araki H, Matsui Y, Kwon AH (2009) The beneficial effect of active hexose correlated compound (AHCC), a health food component, in patients with pancreatic or biliary tract cancer who underwent chemotherapy. Pancreas. Conference: Joint 40th Anniversary Meeting of American Pancreatic Association and Japan Pancreas Society. 38(8):1063

  59. Ikeda M, Hirai R, Shigihara S, Ikui A (2008) Taste disorders and zinc deficiency. Int J Med Sci 6(3):105–111

    Google Scholar 

  60. Dajani EZ, Klamut MJ (2000) Novel therapeutic approaches to gastric and duodenal ulcers: an update. Expert Opin Investig Drugs 9(7):1537–1544

    Article  CAS  PubMed  Google Scholar 

  61. Arthur JR (2000) The glutathione peroxidases. Cell Mol Life Sci 57(13–14):1825–1835

    CAS  PubMed  Google Scholar 

  62. Savarese DM, Savy G, Vahdat L, Wischmeyer PE, Corey B (2003) Prevention of chemotherapy and radiation toxicity with glutamine. Cancer Treat Rev 29(6):501–513

    Article  CAS  PubMed  Google Scholar 

  63. Heckmann JG, Heckmann SM, Lang CJ, Hummel T (2003) Neurological aspects of taste disorders. Arch Neurol 60(5):667–671

    Article  PubMed  Google Scholar 

  64. Siqueiros-Cendón T, Arévalo-Gallegos S, Iglesias-Figueroa BF, García-Montoya IA, Salazar-Martínez J, Rascón-Cruz Q (2014) Immunomodulatory effects of lactoferrin. Acta Pharmacol Sin 35(5):557–566

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  65. Ömür-Özbek P, Dietrich AM, Duncan SE, Lee Y (2012) Role of lipid oxidation, chelating agents, and antioxidants in metallic flavor development in the oral cavity. J Agric Food Chem 60(9):2274–2280

    Article  PubMed  CAS  Google Scholar 

  66. Wong JM, Kern M (2011) Miracle fruit improves sweetness of a low-calorie dessert without promoting subsequent energy compensation. Appetite 56(1):163–166

    Article  PubMed  Google Scholar 

  67. Schiffman SS, Graham BG, Sattely-Miller EA, Zervakis J, Welsh-Bohmer K (2002) Taste, smell and neuropsychological performance of individuals at familial risk for Alzheimer’s disease. Neurobiol Aging 23(3):397–404

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Dr. Robin Cohen for supervision and contribution toward the final version of the manuscript.

Author information

Authors and Affiliations

  1. Supportive and Palliative Care Division, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3J1, Canada

    Olga Sevryugin, Popi Kasvis & Antonio Vigano

  2. McGill Nutrition and Performance Laboratory (MNUPAL), Suite 105B, Place Vendome, 5252 de Maisonneuve Blvd West, Montreal, Quebec, H4A 3S5, Canada

    Popi Kasvis, MariaLuisa Vigano & Antonio Vigano

  3. Faculty of Science, McGill University, Montreal, Quebec, Canada

    MariaLuisa Vigano

Authors
  1. Olga Sevryugin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Popi Kasvis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. MariaLuisa Vigano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Antonio Vigano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Antonio Vigano.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix

Appendix

Table 3 Literature search strategy
Full size table

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sevryugin, O., Kasvis, P., Vigano, M. et al. Taste and smell disturbances in cancer patients: a scoping review of available treatments. Support Care Cancer 29, 49–66 (2021). https://doi.org/10.1007/s00520-020-05609-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-020-05609-4

Keywords

Search

Navigation