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Mukohara T, Park YH, Sommerhalder D, Yonemori K, Hamilton E, Kim SB, Kim JH, Iwata H, Yamashita T, Layman RM, Mita M, Clay T, Chae YS, Oakman C, Yan F, Kim GM, Im SA, Lindeman GJ, Rugo HS, Liyanage M, Saul M, Le Corre C, Skoura A, Liu L, Li M, LoRusso PM. Inhibition of lysine acetyltransferase KAT6 in ER +HER2 - metastatic breast cancer: a phase 1 trial. Nat Med 2024; 30:2242-2250. [PMID: 38824244 PMCID: PMC11333285 DOI: 10.1038/s41591-024-03060-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/10/2024] [Indexed: 06/03/2024]
Abstract
Inhibition of histone lysine acetyltransferases (KATs) KAT6A and KAT6B has shown antitumor activity in estrogen receptor-positive (ER+) breast cancer preclinical models. PF-07248144 is a selective catalytic inhibitor of KAT6A and KAT6B. In the present study, we report the safety, pharmacokinetics (PK), pharmacodynamics, efficacy and biomarker results from the first-in-human, phase 1 dose escalation and dose expansion study (n = 107) of PF-07248144 monotherapy and fulvestrant combination in heavily pretreated ER+ human epidermal growth factor receptor-negative (HER2-) metastatic breast cancer (mBC). The primary objectives of assessing the safety and tolerability and determining the recommended dose for expansion of PF-07248144, as monotherapy and in combination with fulvestrant, were met. Secondary endpoints included characterization of PK and evaluation of antitumor activity, including objective response rate (ORR) and progression-free survival (PFS). Common treatment-related adverse events (any grade; grades 3-4) included dysgeusia (83.2%, 0%), neutropenia (59.8%, 35.5%) and anemia (48.6%, 13.1%). Exposure was approximately dose proportional. Antitumor activity was observed as monotherapy. For the PF-07248144-fulvestrant combination (n = 43), the ORR (95% confidence interval (CI)) was 30.2% (95% CI = 17.2-46.1%) and the median PFS was 10.7 (5.3-not evaluable) months. PF-07248144 demonstrated a tolerable safety profile and durable antitumor activity in heavily pretreated ER+HER2- mBC. These findings establish KAT6A and KAT6B as druggable cancer targets, provide clinical proof of concept and reveal a potential avenue to treat mBC. clinicaltrial.gov registration: NCT04606446 .
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Affiliation(s)
- Toru Mukohara
- National Cancer Center Hospital East, Kashiwa, Japan
| | - Yeon Hee Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | | | | | - Sung-Bae Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jee Hyun Kim
- Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hiroji Iwata
- Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Rachel M Layman
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Monica Mita
- Hoag Family Cancer Institute, Newport Beach, CA, USA
| | - Timothy Clay
- Saint John of God Subiaco Hospital, Perth, Western Australia, Australia
| | - Yee Soo Chae
- Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Catherine Oakman
- Western Health, Sunshine Hospital, St Albans, Victoria, Australia
| | - Fengting Yan
- Swedish Cancer Institute, First Hill-True Family Women's Cancer Center, Seattle, WA, USA
| | - Gun Min Kim
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seock-Ah Im
- Seoul National University Hospital, Seoul National University College of Medicine, Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Geoffrey J Lindeman
- Peter MacCallum Cancer Centre and Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Hope S Rugo
- University of California, San Francisco, CA, USA
| | | | | | | | | | - Li Liu
- Pfizer, San Diego, CA, USA
| | - Meng Li
- Pfizer, San Francisco, CA, USA.
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Seiki Y, Ikezawa K, Watsuji K, Urabe M, Kai Y, Takada R, Yamai T, Mukai K, Nakabori T, Uehara H, Ishibashi M, Ohkawa K. Zinc supplementation for dysgeusia in patients with unresectable pancreatic cancer. Int J Clin Oncol 2024; 29:1173-1181. [PMID: 38724773 DOI: 10.1007/s10147-024-02544-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/30/2024] [Indexed: 07/26/2024]
Abstract
BACKGROUND Although patients with advanced pancreatic cancer (PC) often experience dysgeusia with zinc deficiency during chemotherapy, data on zinc supplementation for dysgeusia and its effects on nutritional status are scarce. We aimed to examine the efficacy of zinc supplementation in patients with advanced PC. METHODS Thirty-three patients with unresectable PC who presented with dysgeusia and zinc deficiency during chemotherapy and received zinc acetate hydrate between January 2018 and December 2022 were included. We evaluated the changes in serum zinc levels and the improvement in dysgeusia. Among the 26 patients who received zinc supplementation for 12 weeks, we also compared patient characteristics and changes in serum zinc and albumin levels between patients who showed improvement in dysgeusia (effective group) and those who did not (non-effective group). RESULTS The serum zinc level increased significantly after zinc supplementation (median: 60 µg/dL at baseline, 99.5 µg/dL at 4 weeks, 101 µg/dL at 8 weeks and 101 µg/dL at 12 weeks). The rate of improvement in dysgeusia increased over time (18.2% at 4 weeks, 33.3% at 8 weeks, and 42.4% at 12 weeks). Comparing the effective group and non-effective group revealed that while the median serum albumin level of the effective group did not change, the non-effective group showed a significant decrease from baseline to 12 weeks (3.2 g/dL to 3.0 g/dL, p = 0.03). CONCLUSION Zinc supplementation significantly increased serum zinc levels, improving dysgeusia. Zinc supplementation might also contribute to maintaining nutritional status in patients with unresectable PC.
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Affiliation(s)
- Yusuke Seiki
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan
| | - Kenji Ikezawa
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan.
| | - Ko Watsuji
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan
| | - Makiko Urabe
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan
| | - Yugo Kai
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan
| | - Ryoji Takada
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan
| | - Takuo Yamai
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan
| | - Kaori Mukai
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan
| | - Tasuku Nakabori
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan
| | - Hiroyuki Uehara
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan
| | - Miki Ishibashi
- Department of Dentistry, Osaka International Cancer Institute, Osaka, Japan
| | - Kazuyoshi Ohkawa
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan
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Rosati D, Mastino P, Romeo M, de Soccio G, Pentangelo D, Petrella C, Barbato C, Minni A. Taste and Smell Alterations (TSAs) in Cancer Patients. Diseases 2024; 12:130. [PMID: 38920562 PMCID: PMC11203271 DOI: 10.3390/diseases12060130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/30/2024] [Accepted: 06/19/2024] [Indexed: 06/27/2024] Open
Abstract
Recently, smell and taste disorders have seen renewed interest, as these symptoms are frequent complications of SARS-CoV-2 infection, since approximately 60% of patients affected by COVID-19 have shown olfactory and gustatory alterations. Otolaryngology pays attention to taste and smell abnormalities (TSAs), especially when associated with oncology. TSAs are common symptoms in people affected by cancer, yet they are ignored and underestimated. The clinical outcome of TSAs in cancer evidences the importance of identifying them with chemotherapy or radiotherapy in general, and they are associated with many types of cancer. We recognize the findings of the literature on TSAs in cancer, evaluating how it is important to consider and identify these disorders concerning reduced food enjoyment or inappropriate nutrient intake, and modulating the nutritional status, quality of life, and impact of therapy. This review aims to critically evaluate and recognize the assessment and clinical perspectives of taste and smell disorders in a cancer population.
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Affiliation(s)
- Davide Rosati
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Pierluigi Mastino
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Martina Romeo
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Giulia de Soccio
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Daniele Pentangelo
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Carla Petrella
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Roma, Italy;
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Roma, Italy;
| | - Antonio Minni
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
- Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
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Al-Amouri FM, Badrasawi M. Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study. PLoS One 2024; 19:e0302990. [PMID: 38723006 PMCID: PMC11081316 DOI: 10.1371/journal.pone.0302990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/16/2024] [Indexed: 05/13/2024] Open
Abstract
The aim of this study is to determine the prevalence of taste alterations (TAs) during chemotherapy and their association with nutritional status and malnutrition. In addition to the associated factors with TA, including sociodemographic health-related factors and clinical status, and to investigate coping strategies to manage TA. A multicenter cross-sectional design study was conducted on 120 cancer patients aged at least 18 who had been undergoing at least one round of chemotherapy. TAs were evaluated using the chemotherapy-induced taste alteration scale (CiTAS), the malnutrition universal screening tool (MUST) was used for nutritional screening, the antineoplastic side effects scale (ASES) was used for subjective assessment of chemotherapy side effects, and the Charlson comorbidity index (CCI) was used for comorbidity assessment. SPSS21 software was used to analyze the data, and the independent T-test and one-way ANOVA test were used to determine the association between TAs and a variety of related variables. The prevalence of TAs was 98.3%. Among participants, 48.3% were at low risk of malnutrition, 20% at medium risk, and 31.7% at high risk. Malnutrition risk was associated with taste disorders (p<0.05). Patients' age, gender, educational level, and physical status were associated with TAs (p<0.05). Type of cancer, chemotherapy regimen, and number of chemotherapy cycles were also associated with TAs (p<0.05). A variety of antineoplastic side effects were associated with TAs (p<0.05), including nausea, vomiting, dry mouth, sore mouth and throat, excessive thirst, swallowing difficulty, appetite changes, weight loss, dizziness, lack of energy, disturbed sleep, anxiety, and difficulty concentrating. TAs were associated with an increased number of comorbidities, and individuals with diabetes, pulmonary diseases, and hypertension were associated with TAs (P<0.05). Patients in this study rarely practice self-management strategies to cope with TAs. A high prevalence (98.3%) of TAs in cancer patients receiving chemotherapy was found, and it was linked to a variety of negative outcomes. Chemotherapy-induced TAs are an underestimated side effect that requires more attention from patients and health care providers.
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Affiliation(s)
- Fatima Masoud Al-Amouri
- Department of Nutrition and Food Technology, An-Najah National University, Nablus, Palestine
| | - Manal Badrasawi
- Department of Nutrition and Food Technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, Palestine
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Riantiningtyas RR, Dougkas A, Bredie WLP, Kwiecien C, Bruyas A, Philouze P, Giboreau A, Carrouel F. Investigating oral somatosensory perception and oral symptoms of head and neck cancer patients: insights on eating behaviour. Support Care Cancer 2024; 32:320. [PMID: 38691143 PMCID: PMC11062985 DOI: 10.1007/s00520-024-08512-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/16/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE Sensory alterations and oral manifestations are prevalent among head and neck cancer (HNC) patients. While taste and smell alterations have been thoroughly investigated, studies on their oral somatosensory perception remain limited. Building upon our previous publication that primarily focused on objective somatosensory measurements, the present work examined self-reported sensory perception, including somatosensation and oral symptoms, in HNC patients and evaluated their link with eating behaviour. METHODS A cross-sectional study was conducted using self-reported questionnaires on sensory perception, oral symptoms, sensory-related food preference, and eating behaviour among HNC patients (n = 30). Hierarchical clustering analysis was performed to categorise patients based on their sensory perception. Correlations between oral symptoms score, sensory perception, sensory-related food preference, and eating behaviour were explored. RESULTS Two distinct sensory profiles of patients were identified: no alteration (n = 14) and alteration (n = 16) group. The alteration group showed decreased preference towards several sensory modalities, especially the somatosensory. Concerning eating behaviour, more patients in the alteration group agreed to negatively connotated statements (e.g. having food aversion and eating smaller portions), demonstrating greater eating difficulties. In addition, several oral symptoms related to salivary dysfunction were reported. These oral symptoms were correlated with sensory perception, sensory-related food preference, and eating behaviour. CONCLUSION This study presented evidence demonstrating that sensory alterations in HNC patients are not limited to taste and smell but cover somatosensory perception and are linked to various aspects of eating. Moreover, patients reported experiencing several oral symptoms. Those with sensory alterations and oral symptoms experienced more eating difficulties.
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Affiliation(s)
- Reisya Rizki Riantiningtyas
- Institute Lyfe (Formerly Institut Paul Bocuse) Research Centre, Chateau Du Vivier, BP 25 - 69131, Ecully Cedex, France.
- Health Systemic Process (P2S), Research Unit UR4129, University of Lyon, University Claude Bernard Lyon 1, 69008, Lyon, France.
- Section for Food Design and Consumer Behaviour, Department of Food Science, Faculty of Science, University of Copenhagen, 1958, Frederiksberg C, Denmark.
| | - Anestis Dougkas
- Institute Lyfe (Formerly Institut Paul Bocuse) Research Centre, Chateau Du Vivier, BP 25 - 69131, Ecully Cedex, France
- Laboratoire Centre Européen Nutrition Et Santé (CENS), Université Claude Bernard Lyon 1, 106069310, CarMeNPierre-Bénite, Unité INSERM, France
| | - Wender L P Bredie
- Section for Food Design and Consumer Behaviour, Department of Food Science, Faculty of Science, University of Copenhagen, 1958, Frederiksberg C, Denmark
| | - Camille Kwiecien
- Danone Global Research & Innovation Center, 3584 CT, Utrecht, The Netherlands
| | - Amandine Bruyas
- Institute of Cancerology, Hôpital Croix Rousse, Hospices Civils de Lyon, 69004, Lyon, France
| | - Pierre Philouze
- ORL Service and Cervico-Facial Surgery, Hospices Civils de Lyon, 69004, Lyon, France
| | - Agnès Giboreau
- Institute Lyfe (Formerly Institut Paul Bocuse) Research Centre, Chateau Du Vivier, BP 25 - 69131, Ecully Cedex, France
- Health Systemic Process (P2S), Research Unit UR4129, University of Lyon, University Claude Bernard Lyon 1, 69008, Lyon, France
| | - Florence Carrouel
- Health Systemic Process (P2S), Research Unit UR4129, University of Lyon, University Claude Bernard Lyon 1, 69008, Lyon, France
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Liu Y, Ding H, Zhang T, Chen Y, Huang Z. 68 Ga-DOTA-Ibandronic Acid PET/CT in a Patient With Chemotherapy-Induced Salivary Gland Hypofunction. Clin Nucl Med 2024; 49:470-471. [PMID: 38465977 DOI: 10.1097/rlu.0000000000005133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
ABSTRACT DOTA-ibandronic acid (IBA) is a novel precursor targeting bone metastasis. It can be radiolabeled with 68 Ga for the diagnosis of bone metastases. However, extraosseous lesions can also show increased DOTA-IBA uptake. We report the 68 Ga-DOTA-IBA PET/CT findings in a case with cholangiocarcinoma with multiple bone metastases. 68 Ga-DOTA-IBA PET/CT revealed increased uptake of DOTA-IBA in bone metastases. Besides, symmetrical and diffuse increased DOTA-IBA uptake in bilateral salivary glands was observed. 99m TcO 4- salivary gland scintigraphy showed impaired salivary gland function.
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Affiliation(s)
| | | | - Ting Zhang
- General Medicine, Southwest Medical University, Luzhou, Sichuan, People's Republic of China
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Adamczyk D, Maison D, Lignou S, Oloyede OO, Clegg M, Methven L, Fairfield C, Gosney M, Hernando MJ, Amézaga J, Caro M, Tueros I. The role of food during oncology treatment: perspectives of cancer patients, caregivers and healthcare professionals. Support Care Cancer 2024; 32:303. [PMID: 38647717 PMCID: PMC11035385 DOI: 10.1007/s00520-024-08469-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 03/27/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE Many cancer patients have problems eating which are usually connected to taste and smell alterations due to side effects of cancer treatment. These problems have consequences both in terms of malnutrition and reduced quality of life. In order to explore social and psychological consequences of eating problems in cancer patients, qualitative interviews were conducted with cancer patients, their caregivers and healthcare professionals. METHODS The study was conducted in three European countries (Poland, Spain and the UK) that differed in culture, oncology care approaches and availability of nutritional products targeted to cancer patients in the market. RESULTS Differences in the social role of eating between the three European countries were observed which subsequently influenced the impact of eating problems for cancer patients in these countries. Furthermore, the study found that problems with food affect not only the quality of life of cancer patients, but can also distress their caregivers, who are often unable to cope with such food-related problems. In addition, the study showed that commercially available nutritional products for cancer patients focus on nutritional value but tend to neglect an important aspect of eating, which is the enjoyment of food, both individually and socially.
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Affiliation(s)
- Dominika Adamczyk
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.
| | - Dominika Maison
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland
| | - Stella Lignou
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Pepper Lane, Whiteknights, Reading, RG6 6DZ, UK
| | - Omobolanle O Oloyede
- Department of Nutrition, Food and Exercise Sciences, Dorothy Hodgkin Building, University of Surrey, Stag Hill, Guilford, GU2 7XH, UK
| | - Miriam Clegg
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Lisa Methven
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Pepper Lane, Whiteknights, Reading, RG6 6DZ, UK
| | - Carol Fairfield
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Margot Gosney
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Maria José Hernando
- AZTI, Food Research, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Astondo Bidea, Edificio 609, 48160, Derio-Bizkaia, Spain
| | - Javier Amézaga
- AZTI, Food Research, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Astondo Bidea, Edificio 609, 48160, Derio-Bizkaia, Spain
| | - Mercedes Caro
- AZTI, Food Research, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Astondo Bidea, Edificio 609, 48160, Derio-Bizkaia, Spain
| | - Itziar Tueros
- AZTI, Food Research, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Astondo Bidea, Edificio 609, 48160, Derio-Bizkaia, Spain
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Mohamed MAER, Ibrahim NMI, Elezaby HH, Shehab MS. Chemosensory changes during chemotherapy. Int J Palliat Nurs 2024; 30:147-155. [PMID: 38517848 DOI: 10.12968/ijpn.2024.30.3.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
BACKGROUND Chemosensory changes that occur during chemotherapy can significantly impact food enjoyment, quality of life and recovery. AIM To investigate chemosensory changes reported by oncology patients during chemotherapy. METHODS A mixed-method cross-sectional study design was used to explore 100 cancer patients' experiences of chemosensory changes during chemotherapy. All patients completed a questionnaire assessing their taste and smell preferences. A purposive sample of 30 patients underwent a semi-structured interview to elicit their thoughts on their experienced chemosensory changes. Descriptive statistics and themes were examined. FINDINGS The mean age of the sample was 50.56 years, and the majority of participants were female. The most stated taste alteration was bitter, while altered food preferences were also commonly experienced. Furthermore, most patients experienced unpleasant odours around food, while some experienced these odours even when food was not present. Overall, five themes were identified: changes in taste, changes in smell, changes in social life, altered comfort and food preferences. CONCLUSION Chemosensory changes related to cancer and its treatment impact a person's nutrient intake, food-related behaviours, quality of life and treatment response. Patients who experience chemotherapy-associated chemosensory changes require specialised nutritional therapy to increase their eating-related pleasure. As part of the nutritional assessment, chemosensory alterations should be evaluated regularly.
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Affiliation(s)
| | | | - Hanan Hassan Elezaby
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University
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Fistikçi Y, Bilsin Kocamaz E. Eating Behavior, Nutritional Status, and Taste Perception Alteration in Children with Cancer. J Pediatr Hematol Oncol 2024; 46:88-95. [PMID: 38237000 DOI: 10.1097/mph.0000000000002814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/27/2023] [Indexed: 02/28/2024]
Abstract
The aim of this study was to investigate eating behavior, nutritional status, and taste alterations in children with cancer. The population of the study consisted of children 8 to 18 years of age and their parents who were followed up and received chemotherapy in the pediatric hematology and oncology clinic and outpatient clinic of a University Faculty of Medicine Oncology Hospital. Data were collected using the Child Identification Form, the Children's Eating Behavior Questionnaire (CEBQ), the Taste Alteration Scale for Children Receiving Chemotherapy (TAC-TAS), and the Subjective Total Taste Acuity Scale (STTA). Body Mass Index (BMI) Z score was between -2 and +2 (normal) in 92.5% of the children and below ≤-2 (malnutrition) in 7.5%. The mean CEBQ subdimensions scores were food craving 12.48±5.36, emotional overeating 5.28±1.45, enjoyment of food 16.83±5.41, passion for drinking 9.72±5.13, satiety enthusiasm 22.93±6.65, slow eating 9.81±4.95, emotional undereating 16.38±4.41, and food selectivity 10.72±2.86, and the mean total TAC-TAS score was 8.66±10.22. A negative, moderate correlation was determined between food craving and enjoyment of food and taste alteration, with food craving and enjoyment decreasing as food alteration increased. A positive moderate correlation was observed between slow eating and taste alteration, with eating slowing down as taste alteration increased.
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Affiliation(s)
- Yasemin Fistikçi
- Blood Collection Department, Nizip Public Hospital, Gaziantep, Turkey
| | - Elif Bilsin Kocamaz
- Department of Child Health and Diseases Nursing, Dicle University Atatürk Health Science Faculty, Sur, Diyarbakir, Turkey
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Loves R, Green G, Joseph-Frederick Z, Palmert S, Plenert E, Schechter T, Tomlinson D, Vettese E, Zahra S, Zupanec S, Dupuis LL, Sung L. Describing taste changes and their potential impacts on paediatric patients receiving cancer treatments. BMJ Support Palliat Care 2023; 13:e382-e388. [PMID: 34049968 DOI: 10.1136/bmjspcare-2021-002951] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/12/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Taste changes are common among paediatric patients receiving cancer treatments although specific descriptions and associations are uncertain. Primary objective was to describe the number of paediatric patients receiving cancer therapies who experienced taste changes, its impact on food intake and enjoyment of eating, and coping strategies. METHODS This was a cross-sectional study that included English-speaking paediatric patients aged 4-18 years with a diagnosis of cancer or haematopoietic stem cell transplantation recipients receiving active treatment. Using a structured interview, we asked participants about their experience with taste changes, impacts and coping strategies. The respondent was the paediatric patient. RESULTS We enrolled 108 patients; median age was 11 years (IQR 8-15). The taste changes reported yesterday or today were food tasting bland (34%), bad (31%), different (27%), bitter (25%), extreme (19%), metallic (15%) or sour (12%). Taste changes were associated with decreased food intake (31%) and decreased enjoyment in eating (25%) yesterday or today. The most common coping strategies were eating food they liked (42%), eating strong-tasting food (39%), drinking liquids (35%), brushing teeth (31%) and sucking on candy (25%). Factors significantly associated with food tasting bad were as follows: older age (p=0.003), shorter time since cancer diagnosis (p=0.027), nausea and vomiting (p=0.008) and mucositis (p=0.009). CONCLUSIONS Among paediatric patients receiving cancer treatments, taste changes were common and were associated with decreased food intake and enjoyment in eating. Common coping strategies were described. Reducing nausea, vomiting and mucositis may improve taste changes.
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Affiliation(s)
- Robyn Loves
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Gloria Green
- Division of Clinical Dietetics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Zakia Joseph-Frederick
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Sasha Palmert
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Erin Plenert
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Tal Schechter
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Deborah Tomlinson
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Emily Vettese
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Serena Zahra
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Sue Zupanec
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - L Lee Dupuis
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
- Department of Pharmacy, The Hospital for Sick Children, Leslie Dan Faculty of Pharmacy at the University of Toronto, Toronto, Ontario, Canada
| | - Lillian Sung
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
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11
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Wang M, Xu Y, Wu Y, Liu C, Chen Y, Hua D, Liu Q. Evaluating the efficacy of auricular acupuncture for chemotherapy-induced taste alterations: A pilot randomized controlled trial. Eur J Oncol Nurs 2023; 67:102458. [PMID: 37951073 DOI: 10.1016/j.ejon.2023.102458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/06/2023] [Accepted: 10/27/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE Irrespective of the development of acupuncture-based interventions, clinical evidence regarding their efficacy remains controversial owing to issues with the study design and an unclear risk of bias. This study aimed to evaluate the efficacy of auricular acupuncture in managing taste alterations in patients with cancer undergoing platinum-based chemotherapy. METHODS We conducted a pilot randomized controlled trial involving 73 patients randomly assigned to an auricular acupuncture or a control group. The primary outcome was the severity of chemotherapy-induced taste alterations, and the secondary outcomes included quality of life and negative emotions of the patients. RESULTS A total of 49 participants completed the study. Compared to the control group, patients in the auricular acupuncture group showed significant reductions in discomfort, general taste alterations, and total scores on the Chemotherapy-induced Taste Alteration Scale (all p < 0.05). Furthermore, we observed significant improvements in quality of life, including physical function (p = 0.007), role function (p = 0.006), emotional function (p = 0.016), nausea and vomiting (p = 0.021), appetite loss (p = 0.046), and significant improvements in anxiety and depression (p < 0.01). CONCLUSIONS Our findings suggest that auricular acupuncture may be a beneficial intervention for managing chemotherapy-induced taste alterations in patients with cancer receiving platinum-based chemotherapy. It may also contribute to improvements in quality of life and negative emotions. However, these results are preliminary, and further evaluation with larger randomized controlled trials is necessary.
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Affiliation(s)
- Meng Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Yongping Xu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
| | - Yaoyao Wu
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Chao Liu
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China.
| | - Ying Chen
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
| | - Dong Hua
- Department of Oncology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China.
| | - Quan Liu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
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Tharakan T, Piccirillo JF, Miller B, Reed DR, Kallogjeri D, Paniello R, Puram SV, Jackson RS. Acute Taste Dysfunction in Oropharyngeal Cancer Patients after Transoral Robotic Surgery. Laryngoscope 2023; 133:3520-3528. [PMID: 37551882 PMCID: PMC10843268 DOI: 10.1002/lary.30939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/23/2023] [Accepted: 07/17/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES To compare taste changes after transoral robotic surgery (TORS) to taste changes in healthy controls. METHODS Oropharyngeal cancer patients receiving TORS and healthy controls were recruited. Participants underwent posterolateral and whole-mouth psychophysical taste testing (identification, intensity, and hedonics) at baseline and at 2 weeks postoperatively (patients) or follow-up (controls). Surgeons reported suspension time and glossopharyngeal nerve injury (GNI) based on the identification and sacrifice of the nerve. A Clinical Global Impression (CGI) of taste symptoms was completed at each session ("My sense of taste bothers me" on a 5-point scale from Never [1] to Always [5]). A taste disorder (TD) was a CGI of 3 (Sometimes) or worse. Within-subject changes in CGI and psychophysical scores were computed. "Worsened taste" was a CGI increase by ≥1 point at follow-up. RESULTS Of 69 participants, most (33/37 tumor, 31/32 controls) had normal baseline taste (CGI < 3). 14/33 (42%) TORS patients and no controls developed new TDs at follow-up. More smokers (7/9) had worsened taste than nonsmokers (19/60, difference = 46% [95% CI 16%-76%]). More patients without GNI (6/22) than with GNI (0/15) had postoperative phantogeusia (difference = 27% [95% CI 9-45%]). Tumor-ipsilateral taste identification (TI) decreased more in patients (-11.3%) than controls (0.8%, difference = 12.2% [95% CI 5.0-19.3%]). Suspension time was not associated with worsened taste symptoms or psychophysical changes. CONCLUSIONS Patient-reported taste changes after TORS are frequent. Compared to healthy controls, TORS patients have decreased tumor-ipsilateral TI. Suspension time and GNI are unlikely to cause symptomatic TDs. Further investigations of the etiology and long-term symptom burden of TORS-associated TDs will aid in the management of oropharyngeal cancer patients. LEVEL OF EVIDENCE 3 (non-randomized controlled cohort study) Laryngoscope, 133:3520-3528, 2023.
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Affiliation(s)
- Theresa Tharakan
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Jay F. Piccirillo
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Brevin Miller
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
- School of Medicine, University of Missouri Kansas City, Kansas City, MO
| | | | - Dorina Kallogjeri
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Randall Paniello
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Sidharth V. Puram
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
- Department of Genetics, Washington University School of Medicine, St Louis, MO
| | - Ryan S. Jackson
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
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13
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Ho PJ, Khng AJ, Tan BKT, Lim GH, Tan SM, Tan VKM, Tan RSYC, Lim EH, Iau PTC, Chew YJ, Lim YY, Hartman M, Tan EY, Li J. Alterations to DNA methylation patterns induced by chemotherapy treatment are associated with negative impacts on the olfactory pathway. Breast Cancer Res 2023; 25:136. [PMID: 37932858 PMCID: PMC10626732 DOI: 10.1186/s13058-023-01730-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/15/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Exposure to cytotoxic chemotherapy treatment may alter DNA methylation (DNAm) in breast cancer patients. METHODS We performed DNAm analysis in 125 breast cancer patients with blood drawn before and after chemotherapy, using the Illumina MethylationEPIC array. DNAm changes of 588,798 individual CpGs (including 41,207 promoter regions) were evaluated using linear regression models adjusted for monocyte proportion. Gene set enrichment analyses (GSEA) were conducted to identify key Gene Ontology (GO) biological processes or Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways associated with chemotherapy. Results were validated in a separate cohort of breast cancer patients who were treated (n = 1273) and not treated (n = 872) by chemotherapy (1808 blood, 337 saliva). RESULTS A total of 141 differentially methylated CpGs and 11 promoters were significantly associated with chemotherapy after multiple testing corrections in both the paired sample and single time point analyses. GSEA of promoter regions (pre-ranked by test statistics) identified six suppressed biological processes (p < 4.67e-8) related to sensory perception and detection of chemical stimuli, including smell perception (GO:0007606, GO:0007608, GO:0009593, GO:0050906, GO:0050907, and GO:0050911). The same six biological processes were significantly suppressed in the validation dataset (p < 9.02e-14). The KEGG pathway olfactory transduction (hsa04740) was also found to be significantly suppressed (ppaired-samples = 1.72e-9, psingle-timepoint-blood = 2.03e-15 and psingle-timepoint-saliva = 7.52e-56). CONCLUSION The enrichment of imprinted genes within biological processes and pathways suggests a biological mechanism by which chemotherapy could affect the perception of smell.
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Affiliation(s)
- Peh Joo Ho
- Genome Institute of Singapore (GIS), Agency for Science, Technology and Research (A*STAR), 60 Biopolis Street, Genome, Singapore, 138672, Republic of Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore
| | - Alexis Jiaying Khng
- Genome Institute of Singapore (GIS), Agency for Science, Technology and Research (A*STAR), 60 Biopolis Street, Genome, Singapore, 138672, Republic of Singapore
| | - Benita Kiat-Tee Tan
- Department of Breast Surgery, Singapore General Hospital, Singapore, Republic of Singapore
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Republic of Singapore
- Department of General Surgery, Sengkang General Hospital, Singapore, Republic of Singapore
| | - Geok Hoon Lim
- KK Breast Department, KK Women's and Children's Hospital, Singapore, 229899, Republic of Singapore
| | - Su-Ming Tan
- Division of Breast Surgery, Changi General Hospital, Singapore, Republic of Singapore
| | - Veronique Kiak Mien Tan
- Department of Breast Surgery, Singapore General Hospital, Singapore, Republic of Singapore
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Republic of Singapore
| | - Ryan Shea Ying Cong Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Republic of Singapore
- Oncology Academic Programme, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Elaine Hsuen Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Republic of Singapore
| | - Philip Tsau-Choong Iau
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore, 119228, Singapore
- Department of General Surgery, Ng Teng Fong General Hospital, 1 Jurong East St 21, Singapore, 609606, Republic of Singapore
| | - Ying Jia Chew
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore, 119228, Singapore
- Department of General Surgery, Ng Teng Fong General Hospital, 1 Jurong East St 21, Singapore, 609606, Republic of Singapore
| | - Yi Ying Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore, 119228, Singapore
| | - Ern Yu Tan
- Department of General Surgery, Tan Tock Seng Hospital, Singapore, 308433, Republic of Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Republic of Singapore
| | - Jingmei Li
- Genome Institute of Singapore (GIS), Agency for Science, Technology and Research (A*STAR), 60 Biopolis Street, Genome, Singapore, 138672, Republic of Singapore.
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore.
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López-Plaza B, Gil Á, Menéndez-Rey A, Bensadon-Naeder L, Hummel T, Feliú-Batlle J, Palma-Milla S. Effect of Regular Consumption of a Miraculin-Based Food Supplement on Taste Perception and Nutritional Status in Malnourished Cancer Patients: A Triple-Blind, Randomized, Placebo-Controlled Clinical Trial-CLINMIR Pilot Protocol. Nutrients 2023; 15:4639. [PMID: 37960292 PMCID: PMC10648678 DOI: 10.3390/nu15214639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Taste disorders are common among cancer patients undergoing chemotherapy, with a prevalence ranging from 20% to 86%, persisting throughout treatment. This condition leads to reduced food consumption, increasing the risk of malnutrition. Malnutrition is associated not only with worse treatment efficacy and poor disease prognosis but also with reduced functional status and quality of life. The fruit of Synsepalum dulcificum (Daniell), commonly known as miracle berry or miracle fruit, contains miraculin, a taste-modifying protein with profound effects on taste perception. The CLINMIR Protocol is a triple-blind, randomized, placebo-controlled clinical trial designed to evaluate the regular consumption of a food supplement containing a miraculin-based novel food, dried miracle berry (DMB), on the taste perception (measured through electrogustometry) and nutritional status (evaluated through the GLIM Criteria) of malnourished cancer patients under active antineoplastic treatment. To this end, a pilot study was designed with 30 randomized patients divided into three study arms (150 mg DMB + 150 mg freeze-dried strawberries, 300 mg DMB, or placebo) for three months. Throughout the five main visits, an exhaustive assessment of different parameters susceptible to improvement through regular consumption of the miraculin-based food supplement will be conducted, including electrical and chemical taste perception, smell perception, nutritional and morphofunctional assessment, diet, quality of life, the fatty acid profile of erythrocytes, levels of inflammatory and cancer-associated cytokines, oxidative stress, antioxidant defense system, plasma metabolomics, and saliva and stool microbiota. The primary anticipated result is that malnourished cancer patients with taste distortion who consume the miraculin-based food supplement will report an improvement in food taste perception. This improvement translates into increased food intake, thereby ameliorating their nutritional status and mitigating associated risks. Additionally, the study aims to pinpoint the optimal dosage that provides maximal benefits. The protocol adheres to the SPIRIT 2013 Statement, which provides evidence-based recommendations and is widely endorsed as an international standard for trial protocols. The clinical trial protocol has been registered at the platform for Clinical Trials (NCT05486260).
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Affiliation(s)
- Bricia López-Plaza
- Nutrition Research Group, La Paz University Hospital Institute for Health Research (IdiPAZ), 28046 Madrid, Spain;
- Medicine Department, Faculty of Medicine, Complutense University of Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, Armilla, 18016 Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | | | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany;
| | - Jaime Feliú-Batlle
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain;
- CIBERONC (CIBER Cancer), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Medicine Department, Faculty of Medicine, Autonomous University of Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain;
| | - Samara Palma-Milla
- Medicine Department, Faculty of Medicine, Autonomous University of Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain;
- Nutrition Department, Hospital University La Paz, 28046 Madrid, Spain
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15
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Grain A, Camuset M, Gras-Leguen C, Hardouin JB, Scherdel P, Caldari D. Taste and smell alterations affect nutritional status in children under chemotherapy. Acta Paediatr 2023; 112:2231-2238. [PMID: 37376794 DOI: 10.1111/apa.16889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 06/29/2023]
Abstract
AIM This study aimed to evaluate the incidence of self-reported taste and smell alterations (TSA) in cancer paediatric patients and evaluate the impact of TSA on nutritional status in this population. We also developed and validated a composite score to detect TSA in children undergoing chemotherapy. METHODS Paediatric patients who were undergoing chemotherapy in a paediatric oncology unit were included. TSA were assessed from the Gustonco questionnaire from which a composite score was developed and internally validated, eating behaviour was assessed using Child Eating Behaviour Questionnaire, and major weight loss was defined from nutritional status. All data were calculated at 1, 3 and 6 months after chemotherapy start. Associations between nutritional status and scores were studied by using logistic models. RESULTS Among 49 patients included, TSA occurred in 71.7% of patients at 1 month after chemotherapy start and persisted at 3 and 6 months. TSA led to altered appetite since 1 month after chemotherapy start. The occurrence of a major weight loss at 6 months seemed to be associated with a high Gustonco score. CONCLUSION Taste and smell alterations often occurred in paediatric cancer patients after chemotherapy start and seemed to be associated with impaired nutrition at 6 months after chemotherapy.
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Affiliation(s)
- Audrey Grain
- Paediatric Haematology and Oncology Department, CHU of Nantes, Nantes, France
- Inserm UMR 1307, CNRS UMR 6075, CRCINA2 Nantes Université, Angers, France
| | - Margaux Camuset
- Paediatric Haematology and Oncology Department, CHU of Nantes, Nantes, France
| | | | - Jean-Benoit Hardouin
- INSERM UMR 1246-SPHERE, Nantes Université, Nantes, France
- Public Health Department, CHU of Nantes, Nantes, France
| | | | - Dominique Caldari
- Paediatric Haematology and Oncology Department, CHU of Nantes, Nantes, France
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Dominiak HSH, Hasselsteen SD, Nielsen SW, Andersen JR, Herrstedt J. Prevention of Taste Alterations in Patients with Cancer Receiving Paclitaxel- or Oxaliplatin-Based Chemotherapy-A Pilot Trial of Cannabidiol. Nutrients 2023; 15:3014. [PMID: 37447339 DOI: 10.3390/nu15133014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
INTRODUCTION Taste alteration is a common adverse effect of chemotherapy. This study aimed to investigate the effect of cannabidiol (CBD) on Lean Body Mass (LBM), and taste alterations during oxaliplatin- or paclitaxel-based chemotherapy. METHODS LBM was estimated by bioelectrical impedance analysis (BIA), and taste perception was evaluated by a randomized sensory test of six samples: sweet, salt, and umami, all in weak and strong concentrations. Taste perceptions were scored on visual analog scales. Patients in the intervention group received oral CBD 300 mg/day for 8 days; patients in the control group did not. Patients were followed for three cycles of chemotherapy. RESULTS Twenty-two/ten patients (intervention/control group) were eligible. No effects on LBM were demonstrated. At baseline, the control group was able to differentiate between weak and strong saltiness and weak and strong sweetness but lost this ability after three cycles of chemotherapy. At baseline, the intervention group was unable to differentiate between the concentrations but gained the ability to significantly differentiate between weak and strong sweetness (p = 0.03) and weak and strong saltiness (p = 0.04) after three cycles of chemotherapy and treatment with CBD. CONCLUSIONS CBD may improve patients' ability to differentiate taste strengths during chemotherapy.
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Affiliation(s)
- Helena S H Dominiak
- Department of Clinical Oncology, Zealand University Hospital, 4000 Roskilde, Denmark
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 2200 Frederiksberg, Denmark
| | - Simone D Hasselsteen
- Department of Clinical Oncology, Zealand University Hospital, 4000 Roskilde, Denmark
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 2200 Frederiksberg, Denmark
| | - Sebastian W Nielsen
- Department of Clinical Oncology, Zealand University Hospital, 4000 Roskilde, Denmark
| | - Jens Rikardt Andersen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 2200 Frederiksberg, Denmark
| | - Jørn Herrstedt
- Department of Clinical Oncology, Zealand University Hospital, 4000 Roskilde, Denmark
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, 2200 Frederiksberg, Denmark
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17
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Zhu M, Wang T, Sun J, Zhou Z, Wang D, Teng L. Heterogeneity of vulnerability and taste changes in older cancer patients undergoing chemotherapy: a latent class analysis. Support Care Cancer 2023; 31:392. [PMID: 37310497 DOI: 10.1007/s00520-023-07862-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/04/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE Taste changes and vulnerability are commonly co-occurring in oncology patients undergoing chemotherapy. However, few studies explored the association and the inter-individual variability of these two conditions. This study aimed to identify heterogeneous subtypes of vulnerability and taste changes in older cancer patients undergoing chemotherapy, and explore individuals' characteristics and risk factors. METHODS In this cross-sectional study, the latent class analysis (LCA) was conducted to identify the heterogeneous subgroups of patients with distinct vulnerability and taste change profiles. Differences in sociodemographic and clinical characteristics among the subpopulation were evaluated using parametric and nonparametric tests. Multinomial logistic regression was performed to investigate predictors of taste change-vulnerability subgroup classification. RESULTS Three subgroups of those older cancer survivors were identified from the LCA: Class 1 (27.5%)-"Moderate taste change and low vulnerability", Class 2 (29.0%)-"Low taste change and moderate vulnerability", Class 3 (43.5%)-"High taste change and high vulnerability". 98.9% of Class 3 reported taste changes and 54.0% reported vulnerability. Results from multinomial logistic regression indicated that patients in Class 3 were more likely to report experiencing mouth dryness and high blood pressure, and have received more than 3 cycles of chemotherapy. CONCLUSION The findings could provide new insights into the association between taste changes and vulnerability in older cancer adults receiving chemotherapy. Identifying different latent classes of taste changes and vulnerability would be helpful for developing interventions tailored to the heterogeneous survivors.
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Affiliation(s)
- Min Zhu
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Teng Wang
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Jun Sun
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Zhou Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Danhui Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Liping Teng
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China.
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Pimenta BV, Madrid RRM, Mathews PD, Riske KA, Loh W, Angelov B, Angelova A, Mertins O. Interaction of polyelectrolyte-shell cubosomes with serum albumin for triggering drug release in gastrointestinal cancer. J Mater Chem B 2023; 11:2490-2503. [PMID: 36852541 DOI: 10.1039/d2tb02670h] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Nano-structured and functionalized materials for encapsulation, transport, targeting and controlled release of drugs are of high interest to overcome low bioavailability in oral administration. We develop lipid-based cubosomes, which are surface-functionalized with biocompatible chitosan-N-arginine and alginate, displaying internal liquid crystalline structures. Polyelectrolyte-shell (PS) cubosomes have pH-responsive characteristics profitable for oral delivery. The obtained PScubosomes can strongly interact with serum albumin, a protein which is released in the stomach under gastric cancer conditions. An effective thermodynamic PScubosome-protein interaction was characterized at pH 2.0 and 7.4 by isothermal titration calorimetry at 37 °C. A high increment of the albumin conformation transition temperature was evidenced by differential scanning calorimetry upon incubation with PScubosomes. The performed structural studies by synchrotron small-angle X-ray scattering (SAXS) revealed essential alterations in the internal liquid crystalline topology of the nanocarriers including an Im3m to Pn3m transition and a reduction of the cubic lattice parameters. The PScubosome nanoparticle interaction with serum albumin, leading to inner structural changes in a range of temperatures, promoted the release of water from the cubosomal nanochannels. Altogether, the results revealed effective interactions of the PScubosomes with albumin under simulated gastrointestinal pH conditions and suggested promising nanocarrier characteristics for triggered oral drug release.
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Affiliation(s)
- Barbara V Pimenta
- Laboratory of Nano Bio Materials (LNBM), Department of Biophysics, Paulista Medical School, Federal University of Sao Paulo (UNIFESP), 04023-062 Sao Paulo, Brazil.
| | - Rafael R M Madrid
- Laboratory of Nano Bio Materials (LNBM), Department of Biophysics, Paulista Medical School, Federal University of Sao Paulo (UNIFESP), 04023-062 Sao Paulo, Brazil.
| | - Patrick D Mathews
- Laboratory of Nano Bio Materials (LNBM), Department of Biophysics, Paulista Medical School, Federal University of Sao Paulo (UNIFESP), 04023-062 Sao Paulo, Brazil.
| | - Karin A Riske
- Laboratory of Nano Bio Materials (LNBM), Department of Biophysics, Paulista Medical School, Federal University of Sao Paulo (UNIFESP), 04023-062 Sao Paulo, Brazil.
| | - Watson Loh
- Institute of Chemistry, State University of Campinas (UNICAMP), 13083-970 Campinas, Brazil
| | - Borislav Angelov
- Institute of Physics, ELI Beamlines, Academy of Sciences of the Czech Republic, CZ-18221 Prague, Czech Republic
| | - Angelina Angelova
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 91400 Orsay, France.
| | - Omar Mertins
- Laboratory of Nano Bio Materials (LNBM), Department of Biophysics, Paulista Medical School, Federal University of Sao Paulo (UNIFESP), 04023-062 Sao Paulo, Brazil. .,Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 91400 Orsay, France.
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19
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Śledzińska A, Śledzińska P, Bebyn M, Komisarek O. Title: Chemotherapy-Induced Oral Complications and Prophylaxis Strategies. Cancer Invest 2023:1-24. [PMID: 36892292 DOI: 10.1080/07357907.2023.2188558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Cancer is currently a significant therapeutic challenge and is frequently connected with numerous adverse effects. Despite many improvements in chemotherapy, oral complications are common, leading to poor quality of life and chemotherapeutic dose reduction, which impair survival. This review summarizes the most common dental complications in patients receiving chemotherapy. We mainly focus on oral mucositis as it is a major cause of dose-limiting toxicity. Furthermore, oral candidiasis, viral infections, and xerostomia will be discussed. Conclusions: preventing complications is significantly more important than treating them. All patients beginning systemic anticancer treatment should undergo a thorough oral examination and get appropriate prophylaxis.
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Affiliation(s)
- Aleksandra Śledzińska
- Faculty of Medicine, Poznan University of Medical Sciences, Fredry 10, 61-701 Poznań, Poland
| | - Paulina Śledzińska
- Molecular Oncology and Genetics Department, Innovative Medical Forum, The F. Lukaszczyk Oncology Center, 85-796 Bydgoszcz, Poland
| | - Marek Bebyn
- Molecular Oncology and Genetics Department, Innovative Medical Forum, The F. Lukaszczyk Oncology Center, 85-796 Bydgoszcz, Poland
| | - Oskar Komisarek
- Department of Maxillofacial Orthopedics and Orthodontics, Fredry 10, 61-701 Poznań University of Medical Sciences, Poznan, Poland
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20
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Buttiron Webber T, Briata IM, DeCensi A, Cevasco I, Paleari L. Taste and Smell Disorders in Cancer Treatment: Results from an Integrative Rapid Systematic Review. Int J Mol Sci 2023; 24:ijms24032538. [PMID: 36768861 PMCID: PMC9916934 DOI: 10.3390/ijms24032538] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/31/2023] Open
Abstract
Taste and smell disorders (TSDs) are common side effects in patients undergoing cancer treatments. Knowing which treatments specifically cause them is crucial to improve patients' quality of life. This review looked at the oncological treatments that cause taste and smell alterations and their time of onset. We performed an integrative rapid review. The PubMed, PROSPERO, and Web of Science databases were searched in November 2022. The article screening and study selection were conducted independently by two reviewers. Data were analyzed narratively. Fourteen studies met the inclusion criteria and were included. A high heterogeneity was detected. Taste disorders ranged between 17 and 86%, while dysosmia ranged between 8 and 45%. Docetaxel, paclitaxel, nab-paclitaxel, capecitabine, cyclophosphamide, epirubicin, anthracyclines, and oral 5-FU analogues were found to be the drugs most frequently associated with TSDs. This review identifies the cancer treatments that mainly lead to taste and smell changes and provides evidence for wider studies, including those focusing on prevention. Further studies are warranted to make conclusive indication possible.
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Affiliation(s)
| | - Irene Maria Briata
- Division of Medical Oncology, E.O. Galliera Hospital, 16128 Genoa, Italy
| | - Andrea DeCensi
- Division of Medical Oncology, E.O. Galliera Hospital, 16128 Genoa, Italy
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London E1 4NS, UK
| | - Isabella Cevasco
- Department of Health Professions, E.O. Galliera Hospital, 16128 Genoa, Italy
| | - Laura Paleari
- Research, Innovation and HTA Unit, (A.Li.Sa.) Liguria Health Authority, 16121 Genoa, Italy
- Correspondence: ; Tel.: +39-010-5484-243
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21
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O'Donoghue A, Barrett M, Dhuibhir PU, Kennedy A, O'Leary N, Walsh D. Taste and smell abnormalities in advanced cancer: Negative impact on subjective food intake. Nutr Clin Pract 2023. [PMID: 36617307 DOI: 10.1002/ncp.10943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/08/2022] [Accepted: 11/21/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Taste and smell abnormalities (TSAs) are present in all cancer stages and may contribute to malnutrition. Despite this, they are rarely screened for. This study examined the prevalence and characteristics of TSAs and their influence on subjective food intake in advanced cancer. METHODS Consecutive patients with advanced cancer were recruited. A modified Taste and Smell Survey assessed subjective TSAs. Objective TSAs were assessed with validated taste strips and "Sniffin Sticks." A six-item food intake questionnaire identified any effect TSAs had on food preferences/aversions. Nutrition status was evaluated with the abridged Patient-Generated Subjective Global Assessment. RESULTS All 30 participants had either subjective or objective TSAs. The prevalence of TSAs varied based on the assessment tool used. Participants were more aware of taste changes (TCs) than smell changes (SCs). TCs caused reduced food intake in 13 participants. Six reported SCs affected food intake. Food choices caused by TSAs were inconsistent. Some foods preferred because of TSAs were avoided by other participants. None received nutrition counseling on TSA management. Almost all were at malnutrition risk (97%). Almost half (47%) felt TSAs reduced quality of life (QoL). Participants reported "not looking forward to meals" and "can't sit down and eat anything" because of TSAs. CONCLUSION TSAs were highly prevalent and impactful on food intake. Both TCs and SCs were complex and varied on an individual basis. Despite the effect on health and QoL, no patients received any nutrition counseling on TSA management. Individualized screening and advice are needed for TSAs in advanced cancer.
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Affiliation(s)
- Aidan O'Donoghue
- School of Medicine, Trinity College Dublin, Dublin, Ireland.,Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland
| | - Michelle Barrett
- Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland
| | - Pauline Ui Dhuibhir
- Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland
| | - Aileen Kennedy
- School of Biological and Health Sciences, Technological University Dublin, Dublin, Ireland
| | - Norma O'Leary
- Department of Palliative Medicine, St James's Hospital, Dublin, Ireland.,Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland
| | - Declan Walsh
- Department of Supportive Oncology, Levine Cancer Institute, Charlotte, North Carolina, USA
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22
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Shang YF, Shen YY, Zhang MC, Lv MC, Wang TY, Chen XQ, Lin J. Progress in salivary glands: Endocrine glands with immune functions. Front Endocrinol (Lausanne) 2023; 14:1061235. [PMID: 36817607 PMCID: PMC9935576 DOI: 10.3389/fendo.2023.1061235] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
The production and secretion of saliva is an essential function of the salivary glands. Saliva is a complicated liquid with different functions, including moistening, digestion, mineralization, lubrication, and mucosal protection. This review focuses on the mechanism and neural regulation of salivary secretion, and saliva is secreted in response to various stimuli, including odor, taste, vision, and mastication. The chemical and physical properties of saliva change dynamically during physiological and pathophysiological processes. Moreover, the central nervous system modulates salivary secretion and function via various neurotransmitters and neuroreceptors. Smell, vision, and taste have been investigated for the connection between salivation and brain function. The immune and endocrine functions of the salivary glands have been explored recently. Salivary glands play an essential role in innate and adaptive immunity and protection. Various immune cells such as B cells, T cells, macrophages, and dendritic cells, as well as immunoglobins like IgA and IgG have been found in salivary glands. Evidence supports the synthesis of corticosterone, testosterone, and melatonin in salivary glands. Saliva contains many potential biomarkers derived from epithelial cells, gingival crevicular fluid, and serum. High level of matrix metalloproteinases and cytokines are potential markers for oral carcinoma, infectious disease in the oral cavity, and systemic disease. Further research is required to monitor and predict potential salivary biomarkers for health and disease in clinical practice and precision medicine.
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Affiliation(s)
- Yu Feng Shang
- Department of Stomatology, Key Laboratory of Oral Biomedical Research of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang University School of Stomatology, Hangzhou, China
| | - Yi Yang Shen
- Department of Stomatology, Key Laboratory of Oral Biomedical Research of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang University School of Stomatology, Hangzhou, China
| | - Meng Chen Zhang
- National Health Commission and Chinese Academy of Medical Sciences Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain Machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
| | - Min Chao Lv
- Department of Orthopedics, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Tong Ying Wang
- National Health Commission and Chinese Academy of Medical Sciences Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain Machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
- Department of Neurobiology, Department of Neurology of the Second Affiliated Hospital, School of Brain Science and Brain Medicine, Hangzhou, China
| | - Xue Qun Chen
- National Health Commission and Chinese Academy of Medical Sciences Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain Machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
- Department of Neurobiology, Department of Neurology of the Second Affiliated Hospital, School of Brain Science and Brain Medicine, Hangzhou, China
| | - Jun Lin
- Department of Stomatology, Key Laboratory of Oral Biomedical Research of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang University School of Stomatology, Hangzhou, China
- *Correspondence: Jun Lin,
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23
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Invitto S, Leucci M, Accogli G, Schito A, Nestola C, Ciccarese V, Rinaldi R, Boscolo Rizzo P, Spinato G, Leo S. Chemobrain, Olfactory and Lifestyle Assessment in Onco-Geriatrics: Sex-Mediated Differences between Chemotherapy and Immunotherapy. Brain Sci 2022; 12:brainsci12101390. [PMID: 36291323 PMCID: PMC9599735 DOI: 10.3390/brainsci12101390] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 11/16/2022] Open
Abstract
A possible link between chemotherapy and cognitive impairment has been identified. In the literature, this condition is usually called chemobrain and can mostly affect some memory domain but can lead also to other cognitive impairments. Olfaction, which is known to be linked with cognitive domain and the nociception system, can also be affected by chemotherapy. The aim of this study was to investigate the main cognitive and olfactory abilities and the functional and nutritional state of a cohort of chemotherapy and immunotherapy onco-geriatric patients and control geriatrics subjects. Cognitive, olfactory, geriatric and nutritional assessments were performed through the Mini Mental State Examination (MMSE), Sniffin' Sticks Screening 12, G8 test and a questionnaire on the adherence of the Mediterranean diet, respectively. Our findings show a gender effect on the MMSE. Overall results indicate more pronounced impairments both at the cognitive and frailty level regardless of the type of therapy. On the other hand, the Sniffin' Sticks performances highlight a significant decrease in olfactory perception ability of subjects following immunotherapy. Significant correlations between olfactory performance and MMSE and G8 scores were also found, as well as between MMSE and G8 measures.
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Affiliation(s)
- Sara Invitto
- INSPIRE LAB-Laboratory of Cognitive and Psychophysiological Olfactory Processes, DiSTeBA, University of Salento, 73100 Lecce, Italy
- Correspondence:
| | - Mariangela Leucci
- INSPIRE LAB-Laboratory of Cognitive and Psychophysiological Olfactory Processes, DiSTeBA, University of Salento, 73100 Lecce, Italy
| | - Giuseppe Accogli
- INSPIRE LAB-Laboratory of Cognitive and Psychophysiological Olfactory Processes, DiSTeBA, University of Salento, 73100 Lecce, Italy
| | - Andrea Schito
- INSPIRE LAB-Laboratory of Cognitive and Psychophysiological Olfactory Processes, DiSTeBA, University of Salento, 73100 Lecce, Italy
| | - Claudia Nestola
- Department of Medical Oncology, Vito Fazzi Hospital, 73100 Lecce, Italy
| | | | - Ross Rinaldi
- Department of Mathematics and Physics “Ennio De Giorgi”, University of Salento, Via Monteroni, 73100 Lecce, Italy
| | - Paolo Boscolo Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34129 Trieste, Italy
| | - Giacomo Spinato
- Section of Otolaryngology, Regional Centre for Head and Neck Cancer, Department of Neurosciences, University of Padova, 31100 Treviso, Italy
| | - Silvana Leo
- Department of Medical Oncology, Vito Fazzi Hospital, 73100 Lecce, Italy
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24
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The role of saliva in taste dysfunction among cancer patients: Mechanisms and potential treatment. Oral Oncol 2022; 133:106030. [PMID: 35868097 DOI: 10.1016/j.oraloncology.2022.106030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/21/2022] [Accepted: 07/15/2022] [Indexed: 01/17/2023]
Abstract
Two of the highest prevalent symptoms reported by cancer patients are taste dysfunction (17.6-93%) and dry mouth/xerostomia (40.4-93%). While it has been hypothesized that reduced saliva may impair taste function, few studies investigate the co-occurrence of taste and dry mouth symptoms in cancer patients. This review provides a summary of the physiological relationship between saliva and taste, focusing on taste transduction mechanism, regulation of the taste sensitivity, and protection of taste receptor cells, including the impact of cancer treatments and malignancy on saliva function, salivary components, and the mechanisms in which it can negatively impact the taste function. Here, the authors present a scoping review of the recent literature reporting on the association between taste dysfunction and dry mouth in cancer patients, including reports of non-pharmaceutical liposomal agents or drugs taken to improve dry mouth symptoms that also assess taste dysfunction. Considering the complexities of cancer and cancer treatment, understanding the physiological relationship between saliva and taste function may provide important insight into identifying treatments for alleviating taste dysfunction and dry mouth symptoms. There are substantial research gaps given the limited studies assessing the co-occurrence of taste loss and dry mouth and inconsistencies in the assessment of these symptoms. Clinical studies examining taste dysfunction will provide a foundational groundwork that will help understand the relationship between taste and saliva. Considering the increased rates in survivorship and the significant negative impact of taste dysfunction on quality of life, more research is needed to reduce the suffering of cancer patients.
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25
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Corremans M, Mortelmans D, Geurden B, Luyten S, Bekkering G. Prevalence and incidence of chemotherapy-induced taste alterations in adult cancer patients: a systematic review protocol. JBI Evid Synth 2022; 20:1338-1343. [PMID: 35199656 DOI: 10.11124/jbies-21-00197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This study will synthesize the available evidence on the prevalence and incidence of chemotherapy-induced taste alterations in adult cancer patients. INTRODUCTION Taste and smell alterations in cancer patients due to chemotherapy affect patients' quality of life and can cause malnutrition. Recent knowledge about the incidence and prevalence of chemotherapy-induced taste alterations may enable tailored food interventions for this specific population. Describing variations in taste changes in subgroups of chemotherapy is important to inform taste steering interventions. INCLUSION CRITERIA The review will consider studies that include adult cancer patients who are receiving or have received chemotherapy as a treatment for an oncologic issue. It will include studies that investigate the prevalence and incidence of chemotherapy-induced taste alterations that have been assessed objectively or subjectively by patient-reported outcomes. METHODS A systematic search will be performed of the following databases: MEDLINE (PubMed), CINAHL (Ovid), Embase, and OpenSIGLE. Analytical, observational, and cross-sectional studies will be considered. All studies will undergo critical appraisal, data extraction, and synthesis. Data will be extracted using the JBI standardized data extraction tool for prevalence and incidence. Type and frequency of treatment and cytostatic agent will be extracted. The population will be described by age and gender. In addition, study methods and proportions of interest to the review question will be extracted. Pooled prevalence estimates will be calculated using a random effects model. SYSTEMATIC REVIEW PROSPERO CRD42020136706.
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Affiliation(s)
- Marleen Corremans
- Karel de Grote University College (KdG), Antwerp, Belgium
- Belgian Interuniversity Collaboration for Evidence-based Practice (BICEP): A JBI Affiliated Group, Leuven, Belgium
- Belgian Center for Evidence-Based Medicine (CEBAM), Leuven, Belgium
| | | | - Bart Geurden
- Belgian Interuniversity Collaboration for Evidence-based Practice (BICEP): A JBI Affiliated Group, Leuven, Belgium
- Belgian Center for Evidence-Based Medicine (CEBAM), Leuven, Belgium
- University of Antwerp, Antwerp, Belgium
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26
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Taste and smell function in long-term survivors after childhood medulloblastoma/CNS-PNET. Support Care Cancer 2022; 30:6155-6162. [PMID: 35426047 PMCID: PMC9135811 DOI: 10.1007/s00520-022-07048-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/06/2022] [Indexed: 11/25/2022]
Abstract
Purpose To investigate taste and smell function in survivors, with a minimum of 2 years since treatment of childhood medulloblastoma (MB)/central nervous system supratentorial primitive neuroectodermal tumor (CNS-PNET). Methods This cross-sectional study included 40 survivors treated ≤ 20 years of age. Taste strips with four concentrations of sweet, sour, salt, and bitter were used to assess taste function in all participants. Score from 0 to 16; ≥ 9 normogeusia, < 9 hypogeusia, and complete ageusia which equals no sensation. No sensation of a specific taste quality equals ageusia of that quality. Thirty-two participants conducted smell testing using three subtests of Sniffin’ sticks: threshold, discrimination, and identification. Together they yield a TDI-score from 1 to 48; functional anosmia ≤ 16.00, hyposmia > 16.00– < 30.75, normosmia ≥ 30.75– < 41.50, and ≥ 41.50 hyperosmia. Results were compared with normative data. Survivors rated their taste and smell function using a numerical rating scale (NRS) score 0–10. Results Forty survivors with a mean time since treatment of 20.5 years, 13 (32.5%) were diagnosed with hypogeusia, nine (22.5%) of these being ageusic to one or more taste qualities. Seventeen (53%) of 32 participants were diagnosed with hyposmia. The mean scores of the olfactory subtests, and TDI score were significantly lower than normative data (P < 0.0001). The mean NRS scores of smell and taste function were 7.9 ± 1.5 and 8 ± 1.3, respectively. Conclusion Our study showed impaired taste and smell function in survivors of childhood MB/CNS-PNET using objective measurements. However, subjective ratings did not reflect objective findings. Supplementary information The online version contains supplementary material available at 10.1007/s00520-022-07048-9.
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27
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Connolly-Schoonen J, Biamonte SF, Danowski L, Montrose DC. Modifying dietary amino acids in cancer patients. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2022; 373:1-36. [PMID: 36283763 DOI: 10.1016/bs.ircmb.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Limiting nutrient utilization by cancer cells in order to disrupt their metabolism and suppress their growth represents a promising approach for anti-cancer therapy. Recently, studies demonstrating the anti-neoplastic effects of lowering amino acid (AA) availability have opened up an exciting and quickly growing field of study. Although intracellular synthesis can often provide the AAs necessary to support cancer cells, diet and the tumor microenvironment can also be important sources. In fact, studies carried out in vitro and in animal tumor models have supported the anti-cancer potential of restricting exogenous sources of AAs. However the potential benefit of reducing AA intake in cancer patients requires further investigation. Furthermore, implementation of such an approach clinically, even if proven useful, could be challenging. In the enclosed review, we (1) summarize the pre-clinical studies showing the anti-tumorigenic effects of restricting exogenously available AAs, including through reducing dietary protein, (2) consider the role of microbiota in this process, (3) report on current recommendations for protein intake in cancer patients and studies that applied these guidelines, and (4) propose considerations for studies to test the potential therapeutic benefit of reducing protein/AA consumption in patients with cancer.
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Affiliation(s)
- Josephine Connolly-Schoonen
- Department of Family, Population & Preventive Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Steven F Biamonte
- Department of Family, Population & Preventive Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Lorraine Danowski
- Department of Family, Population & Preventive Medicine, Stony Brook University, Stony Brook, NY, United States
| | - David C Montrose
- Department of Pathology, Stony Brook University, Stony Brook, NY, United States; Stony Brook Cancer Center, Stony Brook, NY, United States.
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28
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Honma O, Watanabe C, Fukuchimoto H, Kashiwazaki J, Tateba M, Wagatsuma S, Ogata K, Maki K, Sonou H, Shiga K, Otsuka E, Hiruta M, Hirasawa Y, Hosonuma M, Murayama M, Narikawa Y, Toyoda H, Tsurui T, Kuramasu A, Kin M, Kubota Y, Sambe T, Horiike A, Ishida H, Shimada K, Umeda M, Tsunoda T, Yoshimura K. Verification of the Usefulness of an Assessment and Risk Control Sheet that Promotes Management of Cancer Drug Therapy. Front Pharmacol 2022; 13:744916. [PMID: 35222016 PMCID: PMC8864067 DOI: 10.3389/fphar.2022.744916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 01/20/2022] [Indexed: 12/22/2022] Open
Abstract
Background: Proper management of adverse events is crucial for the safe and effective implementation of anticancer drug treatment. Showa University Hospital uses our interview sheet (assessment and risk control [ARC] sheet) for the accurate evaluation of adverse events. On the day of anticancer drug treatment, a nurse conducts a face-to-face interview. As a feature of the ARC sheet, by separately describing the symptoms the day before treatment and the day of treatment and sharing the information on the medical record, it is possible to clearly determine the status of adverse events. In this study, we hypothesized that the usefulness and points for improvement of the ARC sheet would be clarified by using and evaluating a patient questionnaire. Methods: This study included 174 patients (144 at Showa University Hospital (Hatanodai Hospital) and 30 at Showa University Koto Toyosu Hospital (Toyosu Hospital) who underwent pre-examination interviews by nurses and received cancer chemotherapy at the outpatient center of Hatanodai and Toyosu Hospital. In the questionnaire survey, the ARC sheet’s content and quality, respondents’ satisfaction, structural strengths, and points for improvement were evaluated on a five-point scale. Results: The patient questionnaire received responses from 160 participants, including the ARC sheet use group (132 people) and the non-use group (28 people). Unlike the ARC sheet non-use group, the ARC sheet use group recognized that the sheet was useful to understand the adverse events of aphthous ulcers (p = 0.017) and dysgeusia (p = 0.006). In the satisfaction survey questionnaire, there was a high sense of security in the pre-examination interviews by nurses using the ARC sheet. Conclusions: The ARC sheet is considered an effective tool for comprehensively evaluating adverse events. Pre-examination interviews by nurses using ARC sheets accurately determined the adverse events experienced by patients with anxiety and tension due to confrontation with physicians.
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Affiliation(s)
- O Honma
- Department of Nursing, Showa University Hospital, Tokyo, Japan.,Department of Nursing, Showa University School of Nursing and Rehabilitation Sciences, Kanagawa, Japan
| | - C Watanabe
- Department of Nursing, Showa University School of Nursing and Rehabilitation Sciences, Kanagawa, Japan
| | - H Fukuchimoto
- Department of Nursing, Showa University School of Nursing and Rehabilitation Sciences, Kanagawa, Japan.,Department of Nursing, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - J Kashiwazaki
- Faculty of Nursing, Kyoritsu Women's University, Tokyo, Japan
| | - M Tateba
- Department of Nursing, Showa University Hospital, Tokyo, Japan.,Department of Nursing, Showa University School of Nursing and Rehabilitation Sciences, Kanagawa, Japan
| | - S Wagatsuma
- Department of Nursing, Showa University Hospital, Tokyo, Japan.,Department of Nursing, Showa University School of Nursing and Rehabilitation Sciences, Kanagawa, Japan
| | - K Ogata
- Department of Nursing, Showa University Hospital, Tokyo, Japan
| | - K Maki
- Department of Nursing, Showa University Hospital, Tokyo, Japan
| | - H Sonou
- Department of Nursing, Showa University Hospital, Tokyo, Japan
| | - K Shiga
- Department of Nursing, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - E Otsuka
- Department of Nursing, Showa University Hospital, Tokyo, Japan
| | - M Hiruta
- Department of Nursing, Showa University Hospital, Tokyo, Japan
| | - Y Hirasawa
- Department of Medical Oncology, Showa University, Tokyo, Japan
| | - M Hosonuma
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - M Murayama
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - Y Narikawa
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - H Toyoda
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - T Tsurui
- Department of Medical Oncology, Showa University, Tokyo, Japan
| | - A Kuramasu
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - M Kin
- Department of Pharmacy, Showa University Hospital, Tokyo, Japan
| | - Y Kubota
- Department of Medical Oncology, Showa University, Tokyo, Japan
| | - T Sambe
- Division of Clinical Pharmacology, Department of Pharmacology, Showa University School of Medicine, Shinagawa-ku, Japan
| | - A Horiike
- Department of Medical Oncology, Showa University, Tokyo, Japan
| | - H Ishida
- Division of Medical Oncology, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - K Shimada
- Division of Medical Oncology, Internal Medicine Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - M Umeda
- Family Hospice Co., Ltd., Tokyo, Japan
| | - T Tsunoda
- Department of Medical Oncology, Showa University, Tokyo, Japan
| | - K Yoshimura
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
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29
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Buiret G, Thomas-Danguin T, Feron G. Metallic taste prevalence in patients treated for cancer: a systematic literature review and meta-analysis. Support Care Cancer 2022; 30:5691-5702. [PMID: 35192057 DOI: 10.1007/s00520-022-06904-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 02/09/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Metallic taste (MT) is a taste abnormality often reported by cancer patients. The aim of this systematic review was to exhaustively report MT incidences in cancer patients and to evaluate the risk of bias in the pertinent studies in accordance with a meta-analysis approach. METHODS The research objective was to determine the prevalence of MT in patients treated for cancer. A literature search was conducted using PubMed, Web of Science, and Embase. The authors each screened articles and evaluated the eligibility and individual risk of bias for each article. Then, all of the results were compared. A meta-analysis was conducted on studies that specifically focused on MT evaluation. RESULTS Very few articles have been published on the incidence of MT among taste and smell abnormalities in cancerology (22 of 1674, 1.3%), and the quality of the reports on MT was often low. The most common bias was the methodology used for MT evaluation. Pooling the results of the 22 studies led to an estimated MT incidence in the cancer patient population of 29% (95% CI [0.21; 0.39]) with high and significant heterogeneity observed among the studies. A heterogeneity analysis was performed to identify the causal factors of this heterogeneity. The specific impact of MT on nutritional status (two) and quality of life (five) studies were reported, respectively, and without a specific evaluation of MT. There was no mention of oral health in any of the studies. CONCLUSION Although in clinical practice cancer patients often report MT, its incidence has only been reported in 22 studies, most of which have a moderate to severe risk of bias. Considering the rather high prevalence of MT, more research should be conducted in this field to better identify its causes and mechanisms.
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Affiliation(s)
- Guillaume Buiret
- Service ORL Et Chirurgie Cervicofaciale, Centre Hospitalier de Valence, 179 Boulevard du Maréchal Juin, 26953, Valence, France.
| | - Thierry Thomas-Danguin
- Centre Des Sciences du Goût Et de L'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, 21000, Dijon, France
| | - Gilles Feron
- Centre Des Sciences du Goût Et de L'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, 21000, Dijon, France
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Ruiz-Ceamanos A, Spence C, Navarra J. Individual Differences in Chemosensory Perception Amongst Cancer Patients Undergoing Chemotherapy: A Narrative Review. Nutr Cancer 2022; 74:1927-1941. [PMID: 35102800 DOI: 10.1080/01635581.2021.2000625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Chemotherapy is an aggressive form of treatment for cancer and its toxicity directly affects the eating behavior of many patients, usually by adversely affecting their sense of smell and/or taste. These sensory alterations often lead to serious nutritional deficiencies that can jeopardize the patient's recovery, and even continue to affect their lives once treatment has terminated. Importantly, however, not all patients suffer from such alterations to their chemical senses; and those who do, do not necessarily describe the side effects in quite the same way, nor suffer from them with equal intensity. The origin of these individual differences between cancer patients undergoing chemotherapy treatment has not, as yet, been studied in detail. This review is therefore designed to encourage future research that can help to address the perceptual/sensory problems (and the consequent malnutrition) identified amongst this group of patients in a more customized/personalized manner. In particular, by providing an overview of the possible causes of these large individual differences that have been reported in the literature. For this reason, in addition to the narrative bibliographic review, several possible strategies that could help to improve the chemosensory perception of food are proposed.
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Affiliation(s)
- Alba Ruiz-Ceamanos
- Faculty of Psychology, Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.,CETT-UB, Barcelona School of Tourism, Hospitality and Gastronomy, Barcelona, Spain
| | - Charles Spence
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Jordi Navarra
- Faculty of Psychology, Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
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31
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Spencer AS, da Silva Dias D, Capelas ML, Pimentel F, Santos T, Neves PM, Mäkitie A, Ravasco P. Managing Severe Dysgeusia and Dysosmia in Lung Cancer Patients: A Systematic Scoping Review. Front Oncol 2021; 11:774081. [PMID: 34881185 PMCID: PMC8646025 DOI: 10.3389/fonc.2021.774081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/04/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Lung cancer (LC) is highly prevalent worldwide, with elevated mortality. In this population, taste and smell alterations (TSAs) are frequent but overlooked symptoms. The absence of effective therapeutic strategies and evidence-based guidelines constrain TSAs’ early recognition, prevention and treatment (Tx), promoting cancer-related malnutrition and jeopardizing survival outcomes and quality of life. Objectives To systematically review the literature on TSAs in LC patients, understand the physiopathology, identify potential preventive and Tx strategies and to further encourage research in this area. Methods Literature search on English language articles indexed to PubMed, CINALH, SCOPUS and Web of Science using MeSH terms “Lung neoplasms”,”Dysgeusia”, “Olfaction Disorders”, “Carcinoma, Small Cell”,”Carcinoma, Non- Small-Cell Lung “Adenocarcinoma of Lung”,”Carcinoma, Large Cell”, and non-MeSH terms “Parageusia”, “Altered Taste”, “Smell Disorder”, “Paraosmia”, “Dysosmia”,”Lung Cancer” and “Oat Cell Carcinoma”. Results Thirty-four articles were reviewed. TSAs may follow the diagnosis of LC or develop during cancer Tx. The estimated prevalence of self-reported dysgeusia is 35-38% in treatment-naïve LC patients, and 35-69% in those undergoing Tx, based on studies involving LC patients only. One prospective pilot trial and 1 RCT demonstrated a clinically significant benefit in combining flavor enhancement, smell and taste training and individualized nutritional counselling; a systematic review, 1 RCT and 1 retrospective study favored using intravenous or oral zinc-based solutions (150mg 2-3 times a day) for the prevention and Tx of chemotherapy (CT) and radiotherapy (RT) -induced mucositis and subsequent dysgeusia. Conclusions This is the first review on dysgeusia and dysosmia in LC patients to our knowledge. We propose combining taste and smell training, personalized dietary counselling and flavor enhancement with oral zinc-based solutions (150mg, 2-3 times a day) during CT and/or RT in this population, in order to prevent and help ameliorate Tx-induced dysgeusia and mucositis. However due to study heterogeneity, the results should be interpreted with caution. Developing standardized TSA measurement tools and performing prospective randomized controlled trials to evaluate their effect are warranted.
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Affiliation(s)
- Ana Sofia Spencer
- Department of Medical Oncology, Centro Hospitalar Universitário de Lisboa Central, Hospital de Santo António dos Capuchos, Lisbon, Portugal
| | - David da Silva Dias
- Department of Medical Oncology, Centro Hospitalar Universitário do Algarve, Hospital de Faro, Faro, Portugal.,Centre for Interdisciplinary Research in Health of Universidade Católica Portuguesa (UCP), Lisbon, Portugal.,CatolicaMed Platform of of Universidade Católica Portuguesa (UCP), Lisbon, Portugal
| | - Manuel Luís Capelas
- Centre for Interdisciplinary Research in Health of Universidade Católica Portuguesa (UCP), Lisbon, Portugal.,Universidade Católica Portuguesa (UCP), Institute of Health Sciences, Centre for Interdisciplinary Research in Health (CIIS), Lisbon, Portugal
| | | | - Teresa Santos
- Centre for Interdisciplinary Research in Health of Universidade Católica Portuguesa (UCP), Lisbon, Portugal.,CatolicaMed Platform of of Universidade Católica Portuguesa (UCP), Lisbon, Portugal.,European University, Lisbon, Portugal.,Católica Medical School, Universidade Católica Portuguesa (UCP), Lisbon, Portugal
| | - Pedro Miguel Neves
- Centre for Interdisciplinary Research in Health of Universidade Católica Portuguesa (UCP), Lisbon, Portugal.,CatolicaMed Platform of of Universidade Católica Portuguesa (UCP), Lisbon, Portugal
| | - Antti Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Paula Ravasco
- Centre for Interdisciplinary Research in Health of Universidade Católica Portuguesa (UCP), Lisbon, Portugal.,CatolicaMed Platform of of Universidade Católica Portuguesa (UCP), Lisbon, Portugal.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.,Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Quinta da Granja, Monte de Caparica, Caparica, Portugal
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Photobiomodulation therapy prevents dysgeusia chemotherapy induced in breast cancer women treated with doxorubicin plus cyclophosphamide: a triple-blinded, randomized, placebo-controlled clinical trial. Support Care Cancer 2021; 30:2569-2580. [PMID: 34799776 DOI: 10.1007/s00520-021-06642-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate the effectiveness of photobiomodulation (PBMT) in preventing dysgeusia in breast cancer patients treated with doxorubicin-cyclophosphamide (AC). METHODS This is a phase II, randomized, triple-blind, placebo-controlled clinical trial involving 112 breast cancer patients treated with AC. The patients were divided equally into two groups: a test group treated with 2 J red laser and 3 J infrared laser on 21 points that were symmetrically distributed on the tongue on day 0 of four cycles of AC, and an equal placebo group treated with simulated PBMT to blind the patient, evaluator, and statistician. The clinicopathological and sociodemographic data, results of taste test, and subjective taste analysis, and the QoL, ECOG performance status, body mass index, and other side effects were recorded. The data were analyzed using ANOVA-RM/Bonferroni, Friedman/Dunn, and chi-square/Fisher's exact tests. RESULTS PBMT patients showed less objective and subjective taste loss (p<0.05). On the other hand, the placebo group showed a higher ECOG status (p=0.037) and more significant weight loss (p<0.001) after four cycles of AC. The QoL was significantly higher in the PBMT group (p<0.05) at all assessment periods, and PBMT treatment also reduced the incidence of cachexia (p=0.020), anorexia (p<0.001), diarrhea (p=0.040), oral mucositis (p=0.020), and vomiting (p=0.008). CONCLUSION PBMT reduced the taste loss and improved the overall health status and QoL of patients with breast cancer treated with AC. TRIAL REGISTRATION Brazilian Clinical Trials Registry ( www.ensaiosclinicos.gov.br ) approval number RBR-9qnm34y, registered on 01/05/2021.
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Özkan İ, Taylan S, Eroğlu N, Kolaç N. The Relationship between Malnutrition and Subjective Taste Change Experienced by Patients with Cancer Receiving Outpatient Chemotherapy Treatment. Nutr Cancer 2021; 74:1670-1679. [PMID: 34328368 DOI: 10.1080/01635581.2021.1957485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Taste changes and malnutrition are two important problems in patients with different types of cancer. This study was conducted to evaluate the relationship between malnutrition and subjective taste changes experienced by cancer patients receiving outpatient chemotherapy. The study used a cross-sectional design and was carried out with 1382 patients with cancer receiving outpatient chemotherapy. Of the patients, 63.1% experienced taste changes. It was determined that 8.8% of patients had malnutrition according to the Mini Nutritional Assessment. The mean scores of patients experiencing malnutrition and being at risk for malnutrition from all sub-dimensions of The Chemotherapy-induced Taste Alteration Scale (CiTAS) were found to be higher than the patient group evaluated to have normal nutrition. It was determined that a unit increase in the scores of the parageusia and phantogeusia subscales of the CiTAS increased the risk of malnutrition by 3.36 times (%95 CI= 2.68-4.02). In line with these results, we recommend that patients with cancer receiving chemotherapy should be routinely evaluated in terms of taste changes in clinical practice and that they should be followed up in terms of malnutrition in the presence of taste changes.
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Affiliation(s)
- İlknur Özkan
- Internal Medicine Nursing Department, Kumluca Faculty of Health Sciences, Akdeniz University, Kumluca-Antalya, Turkey
| | - Seçil Taylan
- Surgical Nursing Department, Kumluca Faculty of Health Sciences, Akdeniz University, Kumluca-Antalya, Turkey
| | - Nermin Eroğlu
- Faculty of Health Sciences, Fenerbahçe University, Istanbul
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Malta CEN, de Lima Martins JO, Carlos ACAM, Freitas MO, Magalhães IA, de Vasconcelos HCA, de Lima Silva-Fernandes IJ, de Barros Silva PG. Risk factors for dysgeusia during chemotherapy for solid tumors: a retrospective cross-sectional study. Support Care Cancer 2021; 30:313-325. [PMID: 34283319 DOI: 10.1007/s00520-021-06219-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 04/09/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This study retrospectively analyzed the risk factors for transchemotherapy dysgeusia. METHODS Before each chemotherapy cycle, patients were routinely evaluated for the presence/severity of dysgeusia based on the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale for adverse effects and graded as follows: 0, no change in taste; 1, altered taste with no impact on eating habits; or 2, altered taste with an impact on eating habits. Information from 2 years of evaluations was collected and patient medical records were reviewed to obtain data on chemotherapy cycle, sex, age, body mass index, body surface area, primary tumor, chemotherapy protocol, and history of head and neck radiotherapy. The X2 test and multinomial logistic regression were used for statistical analysis (SPSS 20.0, p < 0.05). RESULTS Among 7425 total patients, 3047, 2447, and 1931 were evaluated after the first, second, and third chemotherapy cycles, respectively. One-fifth of the patients (19.0%) presented a significant loss of taste, with 1118 (15.0%) showing grade 1 dysgeusia and 442 (6.0%) showing grade 2 dysgeusia. The chemotherapy duration (p < 0.001), female sex (p < 0.001), location of the primary tumor in the uterus (p = 0.008), head and neck (p = 0.012), and testicles (p = 0.011), and use of ifosfamide (p = 0.009), docetaxel (p = 0.001), paclitaxel (p < 0.001), pertuzumab (p = 0.005), bevacizumab (p < 0.001), and dacarbazine (p = 0.002) independently increased the risk of dysgeusia. In head and neck tumors, a previous history of radiotherapy significantly increased the prevalence of dysgeusia (p = 0.017), and the use of cisplatin (p = 0.001) increased this prevalence. CONCLUSION Cycles of chemotherapy, sex, uterine cancer, head and neck tumors, testicular cancer, ifosfamide, docetaxel, paclitaxel, pertuzumab, bevacizumab, and dacarbazine increase the risk of dysgeusia.
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Affiliation(s)
| | - Joyce Ohana de Lima Martins
- Dentistry Graduate Program, Federal University of Ceará, Fortaleza, Brazil. .,Laboratory of Molecular Biology and Oncogenetics, Ceará Cancer Institute, Papi Júnior Street, 1222, Rodolfo Teófilo, Fortaleza, Ceará, 60351-010, Brazil.
| | | | | | | | | | | | - Paulo Goberlânio de Barros Silva
- Dentistry Graduate Program, Federal University of Ceará, Fortaleza, Brazil.,Graduate Program in Dental Sciences, Unichristus, Fortaleza, Brazil.,Post-Graduate Program in Oncology, Rodolfo Teófilo College/Ceará Cancer Institute, Fortaleza, Brazil
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Mogi K, Kamiya I, Makino A, Hirao A, Abe R, Doi Y, Shimizu T, Ando H, Morito K, Takayama K, Ishida T, Nagasawa K. Liposomalization of Oxaliplatin Exacerbates the Non-Liposomal Formulation-Induced Decrease of Sweet Taste Sensitivity in Rats. J Pharm Sci 2021; 110:3937-3945. [PMID: 34246630 DOI: 10.1016/j.xphs.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 11/15/2022]
Abstract
Here, we investigated whether or not the characteristics of the oxaliplatin-induced sweet taste sensitivity were altered by PEGylated liposomalization of oxaliplatin (liposomal oxaliplatin), which enhances its anticancer efficacy. Liposomal oxaliplatin and oxaliplatin were intravenously and intraperitoneally, respectively, administered to male Sprague-Dawley rats at the total dose of 8 mg/kg. A brief-access test for evaluation of sweet taste sensitivity on day 7 revealed that both liposomal oxaliplatin and oxaliplatin decreased the sensitivity of rats, the degree with the former being greater than in the case of the latter. Liposomalization of oxaliplatin increased the accumulation of platinum in lingual non-epithelial tissues, through which taste nerves passed. The lingual platinum accumulation induced by not only liposomal oxaliplatin but also oxaliplatin was decreased on cooling of the tongue during the administration. In the current study, we revealed that liposomalization of oxaliplatin exacerbated the oxaliplatin-induced decrease of sweet taste sensitivity by increasing the accumulation of platinum/oxaliplatin in lingual non-epithelial tissues. These findings may suggest that reduction of liposomal oxaliplatin distribution to the tongue on cooling during the administration prevents exacerbation of the decrease of sweet taste sensitivity, maintaining the quality of life and chemotherapeutic outcome in patients.
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Affiliation(s)
- Keisuke Mogi
- Department of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414, JAPAN
| | - Ikumi Kamiya
- Department of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414, JAPAN
| | - Aimi Makino
- Department of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414, JAPAN
| | - Ayaka Hirao
- Department of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414, JAPAN
| | - Reina Abe
- Department of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414, JAPAN
| | - Yusuke Doi
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-machi, Tokushima 770-8505, JAPAN
| | - Taro Shimizu
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-machi, Tokushima 770-8505, JAPAN
| | - Hidenori Ando
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-machi, Tokushima 770-8505, JAPAN
| | - Katsuya Morito
- Department of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414, JAPAN
| | - Kentaro Takayama
- Department of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414, JAPAN
| | - Tatsuhiro Ishida
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-machi, Tokushima 770-8505, JAPAN
| | - Kazuki Nagasawa
- Department of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414, JAPAN.
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36
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Molecular and Neural Mechanism of Dysphagia Due to Cancer. Int J Mol Sci 2021; 22:ijms22137033. [PMID: 34210012 PMCID: PMC8269194 DOI: 10.3390/ijms22137033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 12/21/2022] Open
Abstract
Cancer is one of the most common causes of death worldwide. Along with the advances in diagnostic technology achieved through industry–academia partnerships, the survival rate of cancer patients has improved dramatically through treatments that include surgery, radiation therapy, and pharmacotherapy. This has increased the population of cancer “survivors” and made cancer survivorship an important part of life for patients. The senses of taste and smell during swallowing and cachexia play important roles in dysphagia associated with nutritional disorders in cancer patients. Cancerous lesions in the brain can cause dysphagia. Taste and smell disorders that contribute to swallowing can worsen or develop because of pharmacotherapy or radiation therapy; metabolic or central nervous system damage due to cachexia, sarcopenia, or inflammation can also cause dysphagia. As the causes of eating disorders in cancer patients are complex and involve multiple factors, cancer patients require a multifaceted and long-term approach by the medical care team.
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Larsen AK, Thomsen C, Sanden M, Skadhauge LB, Anker CB, Mortensen MN, Bredie WLP. Taste alterations and oral discomfort in patients receiving chemotherapy. Support Care Cancer 2021; 29:7431-7439. [PMID: 34080053 DOI: 10.1007/s00520-021-06316-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/25/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Taste alterations (TA) and oral discomfort in cancer patients are neglected side effects of the disease and treatments. They contribute to poor appetite, decrease food intake and affect quality of life, leading to adverse outcomes such as malnutrition and depression. The study aimed to explore TAs in relation to other oral conditions causing discomfort in cancer patients. Additionally, the correlation between patients' acidity of saliva and experienced TAs and oral discomfort was evaluated. METHODS A case study including 100 patients diagnosed with cancer receiving chemotherapy or immunotherapy. Data were collected using two questionnaire forms: the Chemotherapy-induced Taste Alteration Scale (CiTAS) and an additional information questionnaire. Saliva samples were collected for each patient and measured with a pocket pH meter. Data were analysed using descriptive statistics, and comparisons were performed using the Kruskal-Wallis H test, Mann-Whitney U test and Fisher's exact test. RESULTS The prevalence of reported TAs was 93%. Patient age, oral discomfort and swallowing difficulty were found to be significant factors for experienced TAs (p < 0.05). No correlation between patients' acidity of saliva and reported TAs and oral discomfort was found. CONCLUSION CiTAS proved to be a convenient tool to collect information about TAs in cancer patients. Using the CiTAS tool, a high prevalence (93%) of reported TAs in cancer patients receiving chemo- or immunotherapy was found. CiTAS provides a fast and cheap recognition of symptoms and causes of TAs that can be addressed.
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Affiliation(s)
- Anne Kathrine Larsen
- Main Kitchen, Kulinarium, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
| | - Christine Thomsen
- Main Kitchen, Kulinarium, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - Mathilde Sanden
- Main Kitchen, Kulinarium, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - Lotte Boa Skadhauge
- Centre for Nutrition and Bowel Diseases, Department of Clinical Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - Camilla Bundgaard Anker
- Main Kitchen, Kulinarium, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - Marie Nerup Mortensen
- Main Kitchen, Kulinarium, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - Wender L P Bredie
- Department of Food Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
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Kinjo T, Kanda K, Fujimoto K. Effects of a self-monitoring intervention in breast cancer patients suffering from taste alterations induced by chemotherapy: A randomized, parallel-group controlled trial. Eur J Oncol Nurs 2021; 52:101956. [PMID: 33940487 DOI: 10.1016/j.ejon.2021.101956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/11/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study evaluates the effect of a self-monitoring intervention on taste alterations in breast cancer patients undergoing outpatient chemotherapy. METHODS The study was a randomized controlled trial. Thirty-four participants were divided into two groups: a self-monitoring (SMG) group (n = 17) and a control group (CG) (n = 17). A conceptual framework was developed with reference to the components of self-management, cognitive behavioral therapy, and the concepts of self-monitoring. Interventions were based on this framework. SMGs recorded their taste symptoms as homework and worked with the researcher to set goals and provide feedback four times every three weeks. In the feedback, the researcher actively listened to the SMG about their feelings and coping strategies during the taste changes, and gave approval and praise for these. The implementation period was 9 weeks for each participant; the CG was provided with conventional nursing support. The intervention was evaluated by comparing the items of symptom improvement, quality of life (QOL), and self-efficacy between the groups before and after the start of the intervention using a scale score. Scale scores were also compared for recognition of taste changes, concerns during treatment, distress, and impacts on each treatment day. RESULTS SMG had significantly lower scores than CG for perceived change in taste (p = 0.009), and there was an interaction with CG (p = 0.008). SMG had also significantly lower scores than CG in concern during treatment (p = 0.015). CONCLUSION This study showed that a self-monitoring intervention reduced negative cognition of taste alterations and reduced discomfort. The results suggest that the self-monitoring intervention is effective nursing support for chemotherapy-induced taste alterations.
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Affiliation(s)
- Taeko Kinjo
- Gunma University Hospital Division of Nursing, 3-39-15, Showa-machi, Maebashi-shi, Gunma, 371-8511, Japan.
| | - Kiyoko Kanda
- Department of Nursing, Takasaki University of Health and Welfare, 501 Nakaorui-machi, Takasaki-shi, Gunma, 370-0033, Japan.
| | - Keiko Fujimoto
- Department of Nursing, Takasaki University of Health and Welfare, 501 Nakaorui-machi, Takasaki-shi, Gunma, 370-0033, Japan.
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Abstract
Of all the oral sensations that are experienced, "metallic" is one that is rarely reported in healthy participants. So why, then, do chemotherapy patients so frequently report that "metallic" sensations overpower and interfere with their enjoyment of food and drink? This side-effect of chemotherapy-often referred to (e.g., by patients) as "metal mouth"-can adversely affect their appetite, resulting in weight loss, which potentially endangers (or at the very least slows) their recovery. The etiology of "metal mouth" is poorly understood, and current management strategies are largely unevidenced. As a result, patients continue to suffer as a result of this poorly understood phenomenon. Here, we provide our perspective on the issue, outlining the evidence for a range of possible etiologies, and highlighting key research questions. We explore the evidence for "metallic" as a putative taste, and whether "metal mouth" might therefore be a form of phantageusia, perhaps similar to already-described "release-of-inhibition" phenomena. We comment on the possibility that "metal mouth" may simply be a direct effect of chemotherapy drugs. We present the novel theory that "metal mouth" may be linked to chemotherapy-induced sensitization of TRPV1. Finally, we discuss the evidence for retronasal olfaction of lipid oxidation products in the etiology of "metal mouth." This article seeks principally to guide much-needed future research which will hopefully one day provide a basis for the development of novel supportive therapies for future generations of patients undergoing chemotherapy.
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Affiliation(s)
- Alastair J M Reith
- Oxford Medical School, Medical Sciences Division, John Radcliffe Hospital, UK
| | - Charles Spence
- Crossmodal Research Laboratory, Department of Experimental Psychology, Oxford University, UK
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Silva IMV, Donaduzzi LC, Perini CC, Couto SAB, Werneck RI, de Araújo MR, Kurahashi M, Johann ACBR, Azevedo-Alanis LR, Vieira AR, Couto-Souza PH. Association of xerostomia and taste alterations of patients receiving antineoplastic chemotherapy: A cause for nutritional concern. Clin Nutr ESPEN 2021; 43:532-535. [PMID: 34024566 DOI: 10.1016/j.clnesp.2021.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 02/11/2021] [Accepted: 03/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS The symptoms of xerostomia and taste alteration are adverse effects which frequently occur in patients under chemotherapy and once associated they can potentially impair their nutritional status. The aim of this study was to investigate the association of xerostomia and taste alterations in patients being treated by neoplastic chemotherapy. METHODS Fifty patients scheduled to receive neoplastic chemotherapy were followed for their first two chemotherapy cycles for solid tumors and the Chemotherapy-Induced Taste Alteration Scale (CiTAS) was adopted. Xerostomia was defined by the presence of dry mouth complaints reported by the patients and signs of hyposalivation identified during the intraoral examination. RESULTS Of the 50 patients, 33 were women, mean age; 61,48 ± 9,07 years, and 17 were men, mean age; 57,35 ± 11,50 years. The most common tumor was located in the breast affecting 15 patients (30%). The Mann-Whitney test showed that the mean scores of CiTAS were significantly higher for those patients who reported having xerostomia when compared with those without xerostomia after the first two chemotherapy cycles. The cofounding variables such as age, smoking habits and use of antidepressants were not statistically associated with taste alterations (p > 0.05). CONCLUSIONS Taste alterations were worse for patients who complained of xerostomia during the first two cycles of antineoplastic chemotherapy and the association of both symptoms can potentially impair their nutritional status and quality of life.
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Affiliation(s)
- Isabela M V Silva
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Liziane C Donaduzzi
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Carla C Perini
- Department of Nutrition, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Soraya A B Couto
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Renata I Werneck
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Melissa R de Araújo
- School of Dentistry, Universidade Federal do Paraná (UFPR), Av. Prefeito Lothário Meissner, 632 - Jardim Botânico, 80210-170, Curitiba, Brazil
| | - Maikol Kurahashi
- Oncology Service of the Santa Casa Hospital of Curitiba, Praça Rui Barbosa, 694 - Centro, 80010-030, Curitiba, Brazil
| | - Aline C B R Johann
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Luciana R Azevedo-Alanis
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Alexandre R Vieira
- Clinical Research for the School of Dental Medicine, University of Pittsburgh, 335 Sutherland Dr., Pittsburgh, PA, 1526, USA
| | - Paulo H Couto-Souza
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil.
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de Haan JJ, Renken RJ, Moshage Y, Kluifhooft DA, Corbier C, Daly LE, Blanchard H, Reyners AKL. Self-reported taste and smell alterations and the liking of oral nutritional supplements with sensory-adapted flavors in cancer patients receiving systemic antitumor treatment. Support Care Cancer 2021; 29:5691-5699. [PMID: 33629188 PMCID: PMC8410716 DOI: 10.1007/s00520-021-06049-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/04/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Taste and smell alterations (TAs and SAs) are often reported by patients with cancer receiving systemic antitumor therapy and can negatively impact food intake and quality of life. This study aimed to examine the occurrence of TAs and SAs and investigate the impact of TAs on overall liking of oral nutritional supplements (ONS) with warming and cooling sensations. METHODS Patients receiving systemic antitumor therapy completed a questionnaire on sensory alterations and evaluated overall liking of 5 prototype flavors of Nutridrink® Compact Protein (hot tropical ginger (HTG), hot mango (HM), cool red fruits (CRF), cool lemon (CL), and neutral (N)) on a 10-point scale via a sip test. Differences between patients with and without TAs were investigated using permutation analysis. RESULTS Fifty patients with various cancer types and treatments were included. Thirty patients (60%) reported TAs and 13 (26%) experienced SAs. Three flavors were rated highly with a liking score > 6 (CRF 6.8 ± 1.7; N 6.5 ± 1.9; HTG 6.0 ± 2.0). Larger variation in ONS liking scores was observed in patients with TAs with or without SAs (4.5-6.9 and 4.6-7.2, respectively) vs. patients without TAs (5.9-6.5). TAs were associated with increased liking of CRF (Δ = + 0.9) and N (Δ = + 1.0) flavors. CONCLUSIONS TAs and SAs are common in patients with cancer undergoing systemic antitumor therapy. Patients with TAs were more discriminant in liking of ONS flavors compared to patients without TAs, and sensory-adapted flavors appeared to be appreciated. The presence of TAs should be considered when developing or selecting ONS for patients with cancer. TRIAL REGISTRATION Registration at ClinicalTrials.gov (NCT03525236) on 26 April 2018.
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Affiliation(s)
- Jacco J de Haan
- Department of Medical Oncology, University Medical Center Groningen, PO Box 30.001, 9700RB, Groningen, The Netherlands.
| | - Remco J Renken
- Department of Cognitive Neuroscience Center, University Medical Center Groningen, Groningen, The Netherlands
| | - Yvette Moshage
- Department of Medical Oncology, University Medical Center Groningen, PO Box 30.001, 9700RB, Groningen, The Netherlands
| | - Daniëlle A Kluifhooft
- Department of Medical Oncology, University Medical Center Groningen, PO Box 30.001, 9700RB, Groningen, The Netherlands
| | | | | | | | - Anna K L Reyners
- Department of Medical Oncology, University Medical Center Groningen, PO Box 30.001, 9700RB, Groningen, The Netherlands
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Kaizu M, Komatsu H, Yamauchi H, Yamauchi T, Sumitani M, Doorenbos AZ. Characteristics of taste alterations in people receiving taxane-based chemotherapy and their association with appetite, weight, and quality of life. Support Care Cancer 2021; 29:5103-5114. [PMID: 33604787 PMCID: PMC8295069 DOI: 10.1007/s00520-021-06066-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/09/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE There is limited evidence on the effect of chemotherapy-associated taste alteration. This study aimed to evaluate taste alteration characteristics in patients receiving taxane-based chemotherapy and investigate the association of taste alterations with appetite, weight, quality of life (QOL), and adverse events. METHODS This cross-sectional study evaluated 100 patients receiving paclitaxel, docetaxel, or nab-paclitaxel as monotherapy or combination therapy. Taste alterations were evaluated using taste recognition thresholds and severity and symptom scales. Taste recognition thresholds, symptoms, appetite, weight, and adverse events were compared between patients with and without taste alterations, and logistic regression analysis was performed to identify risk factors. RESULTS Of the 100 patients, 59% reported taste alterations. We found significantly elevated taste recognition thresholds (hypogeusia) for sweet, sour, and bitter tastes in the taste alteration group receiving nab-paclitaxel (p = 0.022, 0.020, and 0.039, respectively). The taste alteration group reported general taste alterations, decline in basic taste, and decreased appetite. Neither weight nor QOL was associated with taste alterations. Docetaxel therapy, previous chemotherapy, dry mouth, and peripheral neuropathy were significantly associated with taste alterations. CONCLUSIONS Almost 60% of patients receiving taxane-based regimens, especially docetaxel, reported taste alterations. Taste alteration affected the patient's appetite but did not affect the weight or QOL. Docetaxel therapy, previous chemotherapy, dry mouth, and peripheral neuropathy were independent risk factors for taste alterations.
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Affiliation(s)
- Mikiko Kaizu
- Keio University Graduate School of Health Management Course for Nursing, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan.
| | - Hiroko Komatsu
- Japanese Red Cross Kyushu International College of Nursing, 1-1 Asty Munakata-City, Fukuoka, 811-4157, Japan
| | - Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Teruo Yamauchi
- Division of Medical Oncology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Masahiko Sumitani
- Department of Pain and Palliative Medicine, The University of Tokyo Hospital, 7-3-1 Hongou, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ardith Z Doorenbos
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.,Palliative Care, University of Illinois Cancer Center, 845 S. Damen Ave, Chicago, IL, 60612, USA
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43
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Taste alteration after gastrectomy in patients with gastric cancer. Surg Today 2021; 51:777-784. [PMID: 33387026 DOI: 10.1007/s00595-020-02194-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/05/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate the relationship between changes in taste due to surgical procedures and other clinical factors, we performed a detailed investigation of taste alteration in patients who underwent gastrectomy. METHODS Questionnaires on taste alteration were distributed to patients who visited our outpatient clinic from July 2018 to January 2019 for the postoperative evaluation of gastric cancer. Associations of clinical characteristics with changes in sensitivity to the four major taste types (sweet, sour, salty, and bitter) were examined. RESULTS Of the 243 eligible patients, 42 (17.3%) experienced taste alteration after gastrectomy; taste sensitivity decreased in 21 (8.6%) patients and increased in 31 (12.7%) patients. The frequency of a decreased sensitivity to sweet was significantly higher in patients who underwent total gastrectomy than in those who underwent distal gastrectomy (18.8% vs. 3.3%, P = 0.001). Patients who underwent total gastrectomy were significantly more likely than those who received distal gastrectomy to experience increased sensitivity to sour (12.5% vs. 2.2%, respectively; P = 0.004) and bitter (15.6% vs. 3.8%, respectively; P = 0.007) tastes. A multivariate analysis revealed that total gastrectomy was an independent risk factor for total taste alteration. CONCLUSIONS Patients who underwent total gastrectomy showed a high likelihood of both loss and gain of taste sensitivity.
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Validation of the Chinese version of chemotherapy-induced Taste Alteration Scale among patients with head and neck cancer undergoing radiotherapy. Eur J Oncol Nurs 2020; 48:101818. [PMID: 32937262 DOI: 10.1016/j.ejon.2020.101818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/22/2020] [Accepted: 07/28/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE To validate the Chinese version of the Chemotherapy-induced Taste Alteration Scale (CiTAS) among patients with head and neck cancer (HNC) undergoing radiotherapy (RT). METHODS Patients with HNC undergoing RT were enrolled from a cancer hospital. Data were collected by face-to-face interview. Patients' subjective taste alterations (TAs) were assessed by the CiTAS. The content validity was evaluated by five experts. Confirmatory and exploratory factor analysis were used to assess construct validity. Convergent validity was assessed by the correlation between the CiTAS score and the Quality of Life Questionnaire-Core 30 (QLQ-C30) score. A single-item subjective intensity taste alteration question and quartiles of RT duration were used to assess the discriminant validity. The reliability was assessed by the Cronbach's alpha and test-retest reliability. RESULTS 253 patients participated this investigation and 25 patients completed twice. Confirmatory factor analysis showed that the original CiTAS structure with four dimensions was not applicable to patients with HNC undergoing RT. The Chinese version of modified-CiTAS (m-CiTAS) retained 17 items (the item "bothered by the smell of food" was deleted) loading onto three factors: decline in taste, discomfort, and phantogeusia and parageusia. The m-CiTAS showed acceptable correlations with the QLQ-C30. It could effectively discriminate the intensity of subjective TAs according to the single-item question and quartiles of RT duration. The m-CiTAS showed acceptable internal consistency (Cronbach's alpha = 0.573-0.958) and test-retest reliability (r = 0.726-0.831, P < 0.05). CONCLUSIONS The Chinese version of m-CiTAS is an acceptable and applicable instrument to evaluate TAs among patients with HNC undergoing RT.
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Eglseer D, Seymann C, Lohrmann C, Hoedl M. Nutritional problems and their non-pharmacological treatment in adults undergoing haematopoietic stem cell transplantation-A systematic review. Eur J Cancer Care (Engl) 2020; 29:e13298. [PMID: 32862488 PMCID: PMC7757254 DOI: 10.1111/ecc.13298] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/16/2020] [Accepted: 08/07/2020] [Indexed: 12/16/2022]
Abstract
Objective This systematic review aimed to identify the most relevant problems related to malnutrition in adult patients undergoing haematopoietic stem cell transplantation (HSCT) and to identify non‐pharmacological interventions to treat these problems. Methods A systematic search for each research question was performed in MEDLINE, CINAHL, Embase, the Cochrane Library, Google Scholar and reference lists in the period 2009–2019. Results Six and nine studies were included respectively. Quantitative pooling of data was not possible due to the heterogeneity of the studies. Oral mucositis (OM), nausea/vomiting, diarrhoea and dysgeusia were the most frequently reported nutritional problems. Cryotherapy and laser therapy seem to be effective in the prevention and treatment of OM. Recommendations for or against the use of mouth rinses and light therapy in the treatment of OM cannot be made, as too few studies have been conducted in this area. The evidence for non‐pharmacological treatment options in the case of nausea/vomiting and diarrhoea is rather limited. No study was identified with regard to treatment of dysgeusia. Conclusion Nutrition in HSCT patients has not yet been studied to a satisfactory extent. There is an urgent need for high‐quality studies to be conducted in this area to optimise the care of patients undergoing haematopoietic stem cell transplantation.
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Affiliation(s)
- Doris Eglseer
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Carola Seymann
- Department of Internal Medicine, HaematologyUniversity Hospital of Graz, Graz, Austria
| | - Christa Lohrmann
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Manuela Hoedl
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
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46
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Galaniha LT, McClements DJ, Nolden A. Opportunities to improve oral nutritional supplements for managing malnutrition in cancer patients: A food design approach. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.03.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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47
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Taste and smell disturbances in cancer patients: a scoping review of available treatments. Support Care Cancer 2020; 29:49-66. [PMID: 32734392 DOI: 10.1007/s00520-020-05609-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 06/30/2020] [Indexed: 10/23/2022]
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.
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Kerr C, Hughes G, McKenna L, Bergin C. Prevalence of smell and taste dysfunction in a cohort of CoVID19 outpatients managed through remote consultation from a large urban teaching hospital in Dublin, Ireland. Infect Prev Pract 2020; 2:100076. [PMID: 34316563 PMCID: PMC7362847 DOI: 10.1016/j.infpip.2020.100076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/03/2020] [Indexed: 11/28/2022] Open
Abstract
Background Coronaviruses are known to precipitate disorders of smell and taste function. With the emerging global coronavirus disease (CoVID19) pandemic due to the severe acute respiratory syndrome coronavirus 2, early reports suggested that smell and taste dysfunction were clinical features of CoVID19. Our study aimed to investigate the prevalence of smell and taste disturbances in a cohort of CoVID19 positive patients who were isolated at home and being medically managed through telephone consultation. Methods This was a retrospective cross-sectional study conducted at St. James’s Hospital Dublin, an urban 850 bed tertiary referral centre. 46 out of 50 CoVID19 positive patients, managed through a telephone clinic from the hospital infectious disease department, were assessed for olfactory and gustatory function loss. Results The median age of participants was 36.5 years (interquartile range (IQR) 27 - 48) and 19 (41%) were male. The majority (31; 67%) never smoked and 17 (37%) reported co-morbidities. Approximately half of patients reported some degree of smell (22; 48%) or taste (25; 54%) function loss. 13 patients (28%) reported a complete loss of sense of smell, 8 (17%) reported a complete loss of sense of taste and 7 (15%) reported simultaneous total loss of both. The median age of patients with any degree of smell disturbance was significantly lower than patients without (median 30.5 years (IQR 24 – 43.25) versus 41 years (IQR 28.25 – 52.75), p = 0.025). The median age of patients with any degree of taste disturbance was lower than those without, but did not reach statistical significance (median 34 years (IQR 24 - 45) versus 40 years (IQR 27.5 – 52.5) p = 0.174). Conclusion Smell or taste dysfunction were present in our defined subgroup of patients. Further research is required in different population cohorts to build the evidence base for smell and taste dysfunction as clinical indicators of CoVID19 disease and to assess if these symptoms persist after disease resolution.
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Affiliation(s)
- Colm Kerr
- Department of Infectious Diseases, St. James's Hospital Dublin, Ireland.,School of Medicine, University of Dublin Trinity College, Dublin, Ireland
| | - Gerry Hughes
- Department of Infectious Diseases, St. James's Hospital Dublin, Ireland.,School of Medicine, University of Dublin Trinity College, Dublin, Ireland
| | - Louise McKenna
- Department of Infectious Diseases, St. James's Hospital Dublin, Ireland
| | - Colm Bergin
- Department of Infectious Diseases, St. James's Hospital Dublin, Ireland.,School of Medicine, University of Dublin Trinity College, Dublin, Ireland
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Enriquez-Fernandez BE, Martinez-Michel L, Thorlakson J, Wismer WV. Patient-reported taste change assessment questionnaires used in the oncology setting: A narrative review. Eur J Oncol Nurs 2020; 47:101775. [PMID: 32559713 DOI: 10.1016/j.ejon.2020.101775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Patient-reported questionnaires to assess taste changes (TC) among patients with cancer and the common domains or aspects assessed by those questionnaires are identified in this narrative review. Taste changes are a prevalent symptom experienced by patients with cancer that impact food choice and enjoyment, reduce food intake, and diminish quality of life. Appropriate assessment is essential to detect and manage this symptom. METHOD A systematic search of relevant databases between 1999 and 2018 yielded 1959 articles; 38 articles were included in the review. RESULTS Seventeen questionnaires designed specifically to assess patient-reported taste changes among patients with cancer are described in the review. Seven domains were identified among the questionnaires; the most frequently assessed domain was the description of the taste change in 14 questionnaires). Timeframe, scoring, number of items and domains, and item phrasing varied greatly among questionnaires and the approach to domain and item evaluation was inconsistent. Comprehensive questionnaires (n = 7) assessed five or more domains to characterize the taste change experience. The majority of questionnaires have been cited only once or twice. CONCLUSION Patient-reported taste change assessment in oncology has been achieved by a large number of diverse questionnaires; no standard tool or approach is used. Development of a question bank of validated or standardized taste change modules or items may strengthen the consistency and applicability of research in this area.
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Asano S, Sawatari H, Mentani H, Shimada Y, Takahashi M, Fudano K, Sasaki K, Niitani M, Tanabe K, Kataoka T. Taste Disorders: Effect of Education in Patients With Breast Cancer Receiving Chemotherapy. Clin J Oncol Nurs 2020; 24:265-271. [PMID: 32441675 DOI: 10.1188/20.cjon.265-271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND For patients with breast cancer treated with certain chemotherapy regimens, taste disorders associated with those regimens can negatively affect quality of life. OBJECTIVES This study evaluated the effects of taste disorder-related education on meal satisfaction and sense of taste in Japanese women with breast cancer undergoing chemotherapy. METHODS A sample of 53 newly diagnosed women with breast cancer scheduled for chemotherapy treatment were randomly assigned to the control or intervention (nurse-provided education about chemotherapy-associated taste disorders) group. Meal satisfaction and sense of taste were assessed using a visual analog scale. FINDINGS The proportions of patients with meal dissatisfaction and impaired sense of taste were lower in the intervention group than in the control group. Although meal dissatisfaction and impaired sense of taste recovered in the intervention group two months after protocol completion, they did not recover in the control group. Providing education to women with breast cancer scheduled for chemotherapy treatment can affect patients' experience of treatment-associated taste disorders.
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Affiliation(s)
| | | | | | | | | | - Kazumi Fudano
- Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital
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