Assessing taste and smell alterations in cancer patients undergoing chemotherapy according to treatment



Taste and smell changes are common side effects in cancer patients undergoing chemotherapy treatments (CT). This can lead to a reduced food enjoyment and an inadequate nutrient intake with a high impact on nutritional status and quality of life. The aim of this study was to evaluate the self-reported chemosensory alterations of patients undergoing chemotherapy according to CT type.


An observational study was conducted with 151 patients undergoing CT at Oncology Outpatient Unit from Onkologikoa Foundation. An interviewer-assisted questionnaire was designed to investigate chemosensory changes in patients undergoing CT.


Seventy-six percent patients reported taste disorders and 45% smell changes. Xerostomia is the most frequent symptom reported by patients receiving chemotherapy in our study (63.6%), and it is strongly associated to bad taste in mouth (OR = 5.96; CI = 2.37–14.94; p value = 0.000) and taste loss (OR = 5.96; CI = 2.37–14.94; p value = 0.000). Anthracyclines, paclitaxel, carboplatin, and docetaxel were the CT agents producing the highest taste disturbance rates. Cisplatin and 5-Fluorouracil are the CT resulting in the lowest complaints. Logistic regression revealed statistically significant associations between taste loss and carboplatin and docetaxel (OR = 3.50; CI = 1.12–10.90; p value = 0.031) and cold hypersensitivity and oxaliplatin (OR = 12.14; CI = 4.18–35.25; p value = 0.000). Not only platin-based CT such as carboplatin produced dysgeusia, but also anthracyclines and paclitaxel treatments.


The better knowledge of taste and smell alterations according to CT type may provide valuable information for the design of new strategies to tackle CT side effects. It is important to take into account taste and smell dysfunctions and other alterations such as xerostomia together.

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  1. 1.

    Epstein JB, Barasch A (2010) Taste disorders in cancer patients: pathogenesis, and approach to assessment and management. Oral Oncol 46(2):77–81

    Article  Google Scholar 

  2. 2.

    Porter SR, Fedele S, Habbab KM (2010) Taste dysfunction in head and neck malignancy. Oral Oncol 46(6):457–459

    CAS  Article  Google Scholar 

  3. 3.

    Ruo Redda MG, Allis S (2006) Radiotherapy-induced taste impairment. Cancer Treat Rev 32(7):541–547

    Article  Google Scholar 

  4. 4.

    Shi HB, Masuda M, Umezaki T, Kuratomi Y, Kumamoto Y, Yamamoto T, Komiyama S (2004) Irradiation impairment of umami taste in patients with head and neck cancer. Auris Nasus Larynx 31(4):401–406

    Article  Google Scholar 

  5. 5.

    Maes A, Huygh I, Weltens C, Vandevelde G, Delaere P, Evers G, Van den Bogaert W (2002) De Gustibus: time scale of loss and recovery of tastes caused by radiotherapy. Radiother Oncol 63(2):195–201

    Article  Google Scholar 

  6. 6.

    Yamashita H, Nakagawa K, Tago M, Nakamura N, Shiraishi K, Eda M, Nakata H, Nagamatsu N, Yokoyama R, Onimura M, Ohtomo K (2006) Taste dysfunction in patients receiving radiotherapy. Head Neck 28(6):508–516

    Article  Google Scholar 

  7. 7.

    Boltong A, Keast R (2015) Chemosensory science in the context of cancer treatment: implications for patient care. Chemosens Percept 8(3):117–125.

    CAS  Article  Google Scholar 

  8. 8.

    Wickham RS, Rehwaldt M, Kefer C, Shott S, Abbas K, Glynn-Tucker E, Potter C, Blendowski C (1999) Taste changes experienced by patients receiving chemotherapy. Oncol Nurs Forum 26(4):697–706

    CAS  PubMed  Google Scholar 

  9. 9.

    Hovan AJ, Williams PM, Stevenson-Moore P, Wahlin YB, Ohrn KE, Elting LS, Spijkervet FK, Brennan MT (2010) A systematic review of dysgeusia induced by cancer therapies. Support Care Cancer 18(8):1081–1087

    Article  Google Scholar 

  10. 10.

    Hong JH, Omur-Ozbek P, Stanek BT, Dietrich AM, Duncan SE, Lee YW, Lesser G (2009) Taste and odor abnormalities in cancer patients. J Support Oncol 7(2):58–65

    PubMed  Google Scholar 

  11. 11.

    Belqaid K, Tishelman C, McGreevy J, Månsson-Brahme E, Orrevall Y, Wismer W, Bernhardson B-M (2016) A longitudinal study of changing characteristics of self-reported taste and smell alterations in patients treated for lung cancer. Eur J Oncol Nurs 21:232–241.

    Article  PubMed  Google Scholar 

  12. 12.

    Pedersen AM, Bardow A, Jensen SB, Nauntofte B (2002) Saliva and gastrointestinal functions of taste, mastication, swallowing and digestion. Oral Dis 8(3):117–129

    CAS  Article  Google Scholar 

  13. 13.

    Comeau TB, Epstein JB, Migas C (2001) Taste and smell dysfunction in patients receiving chemotherapy: a review of current knowledge. Support Care Cancer 9(8):575–580

    CAS  Article  Google Scholar 

  14. 14.

    Jensen SB, Mouridsen HT, Reibel J, Brünner N, Nauntofte B (2008) Adjuvant chemotherapy in breast cancer patients induces temporary salivary gland hypofunction. Oral Oncol 44(2):162–173.

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Boltong A, Keast R (2012) The influence of chemotherapy on taste perception and food hedonics: a systematic review. Cancer Treat Rev 38(2):152–163

    CAS  Article  Google Scholar 

  16. 16.

    Steinbach S, Hummel T, Bohner C, Berktold S, Hundt W, Kriner M, Heinrich P, Sommer H, Hanusch C, Prechtl A, Schmidt B, Bauerfeind I, Seck K, Jacobs VR, Schmalfeldt B, Harbeck N (2009) Qualitative and quantitative assessment of taste and smell changes in patients undergoing chemotherapy for breast cancer or gynecologic malignancies. J Clin Oncol 27(11):1899–1905

    Article  Google Scholar 

  17. 17.

    Cohen J, Wakefield CE, Laing DG (2016) Smell and taste disorders resulting from cancer and chemotherapy. Curr Pharm Des 22(15):2253–2263

    CAS  Article  Google Scholar 

  18. 18.

    Barajas Galindo DE, Vidal-Casariego A, Calleja-Fernández A, Hernández-Moreno A, Pintor de la Maza B, Pedraza-Lorenzo M, Rodríguez-García MA, Ávila-Turcios DM, Alejo-Ramos M, Villar-Taibo R, Urioste-Fondo A, Cano-Rodríguez I, Ballesteros-Pomar MD (2017) Appetite disorders in cancer patients: impact on nutritional status and quality of life. Appetite 114:23–27.

    Article  PubMed  Google Scholar 

  19. 19.

    Capra S, Ferguson M, Ried K (2001) Cancer: impact of nutrition intervention outcome—nutrition issues for patients. Nutrition 17(9):769–772.

    CAS  Article  PubMed  Google Scholar 

  20. 20.

    Van Cutsem E, Arends J (2005) The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs 9, Supplement 2:S51-S63. doi:

    Article  Google Scholar 

  21. 21.

    Coa KI, Epstein JB, Ettinger D, Jatoi A, McManus K, Platek ME, Price W, Stewart M, Teknos TN, Moskowitz B (2015) The impact of cancer treatment on the diets and food preferences of patients receiving outpatient treatment. Nutr Cancer 67(2):339–353

    Article  Google Scholar 

  22. 22.

    Nordin S, Bramerson A, Murphy C, Bende M (2003) A Scandinavian adaptation of the Multi-Clinic Smell and Taste Questionnaire: evaluation of questions about olfaction. Acta Otolaryngol 123(4):536–542

    CAS  Article  Google Scholar 

  23. 23.

    Bernhardson BM, Olson K, Baracos VE, Wismer WV (2012) Reframing eating during chemotherapy in cancer patients with chemosensory alterations. Eur J Oncol Nurs 16(5):483–490

    Article  Google Scholar 

  24. 24.

    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 

  25. 25.

    Jensen SB, Mouridsen HT, Bergmann OJ, Reibel J, Brunner N, Nauntofte B (2008) Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106(2):217–226

    Article  Google Scholar 

  26. 26.

    Sorokowska A, Schriever VA, Gudziol V, Hummel C, Hahner A, Iannilli E, Sinding C, Aziz M, Seo HS, Negoias S, Hummel T (2015) Changes of olfactory abilities in relation to age: odor identification in more than 1400 people aged 4 to 80 years. Eur Arch Otorhinolaryngol 272(8):1937–1944

    CAS  Article  Google Scholar 

  27. 27.

    Rawson NE (2006) Olfactory loss in aging. Sci Aging Knowl Environ 8 (5)

    Article  Google Scholar 

  28. 28.

    Stevens JC, Cain WS (1993) Changes in taste and flavor in aging. Crit Rev Food Sci Nutr 33(1):27–37

    CAS  Article  Google Scholar 

  29. 29.

    Gamper EM, Giesinger JM, Oberguggenberger A, Kemmler G, Wintner LM, Gattringer K, Sperner-Unterweger B, Holzner B, Zabernigg A (2012) Taste alterations in breast and gynaecological cancer patients receiving chemotherapy: prevalence, course of severity, and quality of life correlates. Acta Oncol 51(4):490–496

    CAS  Article  Google Scholar 

  30. 30.

    Zabernigg A, Gamper E-M, Giesinger JM, Rumpold G, Kemmler G, Gattringer K, Sperner-Unterweger B, Holzner B (2010) Taste alterations in Cancer patients receiving chemotherapy: a neglected side effect? Oncologist 15(8):913–920.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  31. 31.

    Descoeur J, Pereira V, Pizzoccaro A, Francois A, Ling B, Maffre V, Couette B, Busserolles J, Courteix C, Noel J, Lazdunski M, Eschalier A, Authier N, Bourinet E (2011) Oxaliplatin-induced cold hypersensitivity is due to remodelling of ion channel expression in nociceptors. EMBO Mol Med 3(5):266–278.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  32. 32.

    IJpma I, Renken RJ, Ter Horst GJ, Reyners AK (2015) Metallic taste in cancer patients treated with chemotherapy. Cancer Treat Rev 41(2):179–186

    CAS  Article  Google Scholar 

  33. 33.

    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  Google Scholar 

  34. 34.

    Strasser F, Demmer R, Bohme C, Schmitz SF, 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

    CAS  Article  Google Scholar 

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Many thanks to the patients and their families for participating in this study. The expert assistance in statistics provided by Cristina Sarasqueta, biostatistician from Biodonostia, is gratefully acknowledged. All authors drafted, read, and approved the final version of the manuscript. This is contribution number 865 from AZTI.


This work was partially funded by the Basque Country Government (Department of the Environment, Regional Planning, Agriculture and Fisheries).

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Correspondence to Itziar Tueros.

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Amézaga, J., Alfaro, B., Ríos, Y. et al. Assessing taste and smell alterations in cancer patients undergoing chemotherapy according to treatment. Support Care Cancer 26, 4077–4086 (2018).

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  • Cancer
  • Chemotherapy
  • Xerostomia
  • Metallic taste
  • Dysgeusia