Subjective taste and smell changes in treatment-naïve people with solid tumours

Purpose: Taste and smell changes (TSCs) have been studied in cancer post-chemotherapy (CT) or radiotherapy (RT), and in head and neck (H&N) tumours. They may present as part of a symptom cluster with anorexia, early satiety and weight loss, which can negatively impact nutritional status. This study aimed to examine the prevalence, severity and characteristics of TSCs and their relationship with co-occurring symptoms in non-H&N solid tumours before CT or RT. Methods: A prospective observational study was conducted. Forty consecutive pre-treatment cancer patients who attended oncology outpatients over six weeks were recruited. Data on TSCs, symptoms and nutritional status were obtained using the ‘Taste and Smell Survey’ and the ‘abridged Patient-Generated Subjective Global Assessment’ (abPG-SGA). Weight and height were measured, and BMI calculated. SPSS® was used for statistical analysis. Two-sided P values <0.05 were considered statistically significant. Results: Most patients were newly diagnosed (70%; n=28). Nineteen (48%) reported TSCs; 9 noted stronger sweet taste and 7 stronger salt taste. Of these, 4 reported stronger and 4 weaker odour sensation. Those deemed at nutritional risk by the abPG-SGA tended to have more TSCs. TSCs were significantly associated with dry mouth (P<0.01), early satiety (P<0.05) and fatigue (P<0.05). Conclusions: TSCs preceded CT or RT in almost half of treatment-naive patients with solid tumours, notably stronger sweet and salt tastes. Most of those at nutritional risk reported TSCs. TSCs were significantly associated with other symptoms. Future research and clinical guidelines with a common terminology for assessment, diagnosis and management of cancer TSCs are needed.