Loss of smell in lung cancer patients undergoing chemotherapy: Prevalence and relationship with food habit changes.

BACKGROUND AND OBJECTIVES: Cancer patients undergoing cytotoxic chemotherapies exhibit a series of adverse side effects including smell and taste alterations, which can have a significant impact on their food behavior and quality of life. Particularly, olfactory alterations are often underestimated, although declared as frequent by cancer patients. In the present study, we set out to examine loss of smell in lung cancer patients undergoing chemotherapy and its relationship to food habits. MATERIAL AND METHODS: Forty-four bronchial cancer patients receiving cisplatin and 44 controls age and gender matched participants were tested for olfactory and gustatory functions using the European Test of Olfactory Capabilities and the Taste Strips test. Participants reported their food and dietary habits by filling a self-administered questionnaire. Patients were tested under two different sessions: i) before the beginning of the treatment, and ii) 6 weeks later, after 2 cycles of chemotherapy. Controls were tested under the same protocol with two sessions separated by 6 weeks. RESULTS AND CONCLUSIONS: The results highlighted decreased smell and taste abilities in almost half of the lung patients' group even before the exposition to Cisplatin. On a perceptual level, patients rated typical food odors as less edible compared to controls. Moreover, within the patients' group, hyposmics reported using more condiments, possibly as a compensatory mechanism to their decreased sensory abilities. Taken together, these findings showed that loss of smell is prevalent in lung cancer patients and is related to changes in dietary practices including seasoning. Future studies will provide a better understanding of these sensory compensation mechanisms associated with olfactory loss and their effects on food pleasure in this patient population.

Chemotherapy-induced taste and smell changes influence food perception in cancer patients.

PURPOSE: Chemotherapy-induced taste and smell alterations may have a negative impact on the quality of life and nutritional status. A prominent issue when dealing with taste and smell alterations and their consequences on food behavior and well-being lies in the variation arising from individual differences in chemosensory perceptions. The main aim of this study was to examine the effect of individuals' variation in the severity of taste and smell alterations relative to the stage of chemotherapy on self-reported food behavior and food perception. METHODS: Eighty-nine cancer patients completed a questionnaire subdivided into two parts: a chemosensory part that allowed classification of patients in three groups ("no alterations," "moderate alterations," and "severe alterations") and a food behavior part. RESULTS: The results highlighted a negative impact of chemosensory alterations on food perception. Compared with patients without taste and smell alterations, patients with severe chemosensory alterations reported significantly more frequent food perception problems, including modification of the perceived taste of food, finding bad taste in all food, and being unable to perceive food taste. Whereas 72% of patients with severe alterations were in late stage, only 37% of patients were in late stage in the no alterations group, indicating an effect of the treatment stage on taste and smell alterations. CONCLUSION: Our results underlie the importance of providing specific attention to the severity of chemotherapy-induced taste and smell alterations and considering the individual differences among patients for a better nutritional management.

Cisplatin chemotherapy induces odor perception changes in bronchial cancer patients.

A study of olfactory function was performed in 15 bronchial cancer patients receiving cisplatin and 15 control subjects. Whereas odor detection and odor identification abilities were not influenced by the administration of cisplatin, a decrease in pleasantness was observed only for food odors, and not for non-food odors. Taken as a whole, these findings suggest that cisplatin therapy in bronchial cancer patients impairs the pleasure of perceived food odors, which may account for disturbances in food intake and quality of life in this population.

Does olfactory specific satiety take place in a natural setting?

Olfactory-specific satiety (OSS) is characterized by a specific decrease in the odor pleasantness of a food eaten to satiety or smelled without ingestion. The usual protocol for studying OSS takes place in laboratory, a setting rather removed from the real world. Here, we set out to examine OSS in a natural setting: during a meal in a restaurant. We hypothesized that an aroma contained in a food that is eaten at the beginning of a meal decreases the pleasantness of the flavor of a food with the same aroma eaten at the end of the meal. In the first experiment (Experiment 1), a test group received an appetizer flavored with a test aroma (anise) at the beginning of the meal. After the main dish, they received a dessert flavored with the same aroma. A control group received the same aromatized dessert, but after a non-aromatized appetizer. This experiment was replicated (Experiment 2) using verbena as the test aroma. For both experiments, results revealed that aroma pleasantness, but not intensity or familiarity, significantly decreased in the test groups vs. the control groups. These findings extend the concept of OSS to a realistic eating context.