The impact of taste and smell alterations on quality of life in head and neck cancer patients
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Taste and smell alterations (TSAs) are among the most frequent and troublesome symptoms reported by head and neck cancer (HNC) patients after treatment. Little is known about the relationship between TSAs and quality of life (QoL) among HNC patients. The aim of this study was to determine the effect of TSAs on overall QoL among tube-fed and orally fed HNC patients before treatment, at end of treatment and at 2.5-month follow-up.
Data were collected in a longitudinal study prior to treatment (n = 126), at end of treatment (n = 100) and at 2.5-month follow-up (n = 85). Chemosensory Complaint Score (CCS) and the University of Washington Quality of Life Questionnaire version 3 were used to assess TSAs and QoL, respectively. Generalized estimated equation modeling was used to estimate the effect of CCS on QoL.
At end of treatment, QoL and CCS had declined for both tube-fed and orally fed patients and thereafter improved, but not to pre-treatment levels. Neither QoL nor CCS mean scores were different between the two groups at any time point. CCS was a significant predictor of overall QoL (β = −1.82, p < 0.0001), social-emotional (β = −1.76, p < 0.0001), physical (β = −1.12, p < 0.0001) and overall functions (β = −1.15, p < 0.0001) at a multivariate level. Taste was reported as an important symptom for both tube-fed and orally fed groups at end of treatment and follow-up.
TSAs are an important symptom and an independent predictor of QoL for both tube-fed and orally fed HNC patients. HNC patients need support to manage TSAs, regardless of the method of nutritional intake.
KeywordsHead and neck cancer Quality of life Taste Smell Radiation therapy Self-report Tube feeding
The authors thank Asifa Mawani for her help with data collection, Danielle Wiese, Michelle Wong and Lindsay Gervais for their support with data entry and food records analysis and financial support from the Canadian Institutes of Health Research (CIHR) and Alberta Cancer Foundation (ACF) (WW), Secretaría de Educación Pública (SEP), the Government of Mexico and Consejo Nacional de Ciencia y Tecnología (CONACyT Mexico) (MAC).
Mirey Alvarez-Camacho, Silvia Gonella and Sunita Ghosh contributed to conception and design; Wendy V. Wismer financially supported the article; Rufus A. Scrimger and Karen P. Chu contributed to provision of study materials or patients; Mirey Alvarez-Camacho and Catherine Kubrak contributed to collection and assembly of data; Mirey Alvarez-Camacho, Silvia Gonella and Sunita Ghosh analyzed and interpreted the data; Mirey Alvarez Camacho, Silvia Gonella and Wendy Wismer wrote the manuscript ; Mirey Alvarez Camacho, Silvia Gonella, Sunita Ghosh, Catherine Kubrak, Rufus A. Scrimger, Karen P. Chu and Wendy V. Wismer finally approved the manuscript.
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest to declare.
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