Taste disorders following cancer treatment: report of a case series
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To present the findings of combined oral assessment and gustometry testing of a series of head and neck and hematologic malignancies in patients with self-reported taste change after cytotoxic therapies.
Patients with acute myeloid leukemia (AML), multiple myeloma (MM), and head and neck cancer (HNC) were evaluated for taste function. Chemical gustometry was conducted assessing chemosensory qualities that included sweet, sour, salty, bitter, umami, and spicy. NCI Common Terminology Criteria for Adverse Events (CTCAE) 4.0 and the Scale of Subjective Total Taste Acuity (STTA) were used to describe taste symptoms. Saliva flow rates were measured to determine the presence of hyposalivation. Patients were provided treatment trials for taste dysfunction, including zinc supplements, or medications that included clonazepam, megestrol acetate, and the cannabinoid dronabinol.
According to STTA, hematology cases reported the incidence of grades 2 and 3 taste disturbances as 60% and 40%, respectively. For HNC patients, the incidence of grades 2 and 3 was 44% each. Gustometry tests confirmed dysgeusia in all patients evaluated. In the hematology group, 80% of patients exhibited a decrease in sweet taste perception, and no patients correctly identified umami taste. In the HNC group, most patients could not identify salt taste, 66% of patients reported “no sensation” with spicy taste, bitter taste was reduced in some, and increased or altered in others, while only one patient could identify umami taste. In the hematologic and HNC patient groups, 80% and 66% reported grade 2 dry mouth, respectively, according to CTCAE 4.0. After treatment for taste dysfunction, 71% of all patients in the present study reported improvements in taste function.
Persisting dysgeusia in cancer survivors may be assessed by patient report and taste testing. The taste most affected in our patients was umami. Treatment trials with current interventions for dysgeusia appeared effective and should be considered in cancer survivors. Understanding taste and flavor function during and following cancer treatment is important in developing rational prospective preventive and interventional strategies.
KeywordsDysgeusia Taste tasting Chemotherapy Radiotherapy
Taste strips were developed with funding from a Targeted Small Grant from Temple University.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest. The authors have full control of all primary data and agree to allow the journal to review the data if requested.
- 2.Nguyen HM, Reyland ME, Barlow LA (2012) Mechanisms of taste bud cell loss after head and neck irradiation. J Neurosci 32:3474–3484Google Scholar
- 6.Hawkes CH (2002) Anatomy and physiology of taste sense. Smell and taste complaints. Butterworth Heinemann, Amsterdam, pp 123–45Google Scholar
- 8.Boyce JM, Shone GR (2006) Effects of ageing on smell and taste. Postgrad Med J 82:239–241Google Scholar
- 9.Abasaeed R, Coldwell SE, Lloid ME, Soliman SH, Macris PC, Schubert MM (2018) Chemosensory changes and quality of life in patients undergoing hematopoietic stem cell transplantation. Support Care Cancer 26:3552–3561Google Scholar
- 13.Schiffman SS, Warwick ZS (1993) Effect of flavor enhancement of foods for the elderly on nutritional status: food intake, biochemical indices, and anthropometric measures. Physiol Behav 53:395–402Google Scholar
- 17.Epstein JB, Beier Jensen S (2015) Management of hyposalivation and xerostomia: criteria for treatment strategies. Compend Contin Educ Dent 36:600–603Google Scholar
- 23.Mattsson T, Arvidson K, Heimdahl A, Ljungman P, Dahllof G, Ringden O (1992) Alterations in taste acuity associated with allogeneic bone marrow transplantation. J Oral Pathol Med 21:33–37Google Scholar
- 25.Marinone MG, Rizzoni D, Ferremi P, Rossi G, Izzi T, Brusotti C (1991) Late taste disorders in bone marrow transplantation: clinical evaluation with taste solutions in autologous and allogeneic bone marrow recipients. Haematologica 76:519–522Google Scholar
- 26.Ruo Redda MG, Allis S (2006) Radiotherapy induced taste impairment. Cancer Treat Rev 32:541–547Google Scholar
- 29.Epstein JB, Emerton S, Kolbinson DA, Le ND, Phillips N, Stevenson-Moore P, Osoba D (1999) Quality of life and oral function following radiotherapy for head and neck cancer. Head Neck 21:1–11Google Scholar
- 34.Yamashita H, Nakagawa K, Nakamura N, Abe K, Asakage T, Ohmoto M, Okada S, Matsumoto I, Hosoi Y, Sasano N, Yamakawa S, Ohtomo K (2006) Relation between acute and late irradiation impairment of four basic tastes and irradiated tongue volume in patients with head-and-neck cancer. Int J Radiat Oncol Biol Phys 66:1422–1429CrossRefGoogle Scholar
- 37.Takaoka T, Sarukura N, Ueda C, Kitamura Y, Kalubi B, Toda N, Abe K, Yamamoto S, Takeda N (2010) Effects of zinc supplementation on serum zinc concentration and ratio of apo/holo-activities of angiotensin converting enzyme in patients with taste impairment. Auris Nasus Larynx 37:190–194CrossRefGoogle Scholar
- 41.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 22:2086–2093CrossRefGoogle Scholar
- 45.Heintze U, Birkhed D, Bjorn H (1983) Secretion rate and buffer effect of resting and stimulated whole saliva as a function of age and sex. Swed Dent J 7:227–238Google Scholar