Originally published as JCO Early Release 10.1200/JCO.2008.19.2690 on March 16 2009

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Qualitative and Quantitative Assessment of Taste and Smell Changes in Patients Undergoing Chemotherapy for Breast Cancer or Gynecologic Malignancies

From the Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University, Dresden; Frauenklinik (Department of Obstetrics and Gynecology) and Department of Medical Statistics, Klinikum rechts der Isar, Technische Universitaet Muenchen; Departments of Clinical Radiology, Obstetrics and Gynecology Maistrasse, and Obstetrics and Gynecology Grosshadern, Ludwig-Maximilians-University; Department of Obstetrics and Gynecology, Rot-Kreuz-Krankenhaus; Gynecology Arabella; and Haemato-Oncology Pasing, Munich, Germany.

Corresponding author: Silke Steinbach, MD, Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University, Dresden, Fetscherstr. 74, 01307 Dresden, Germany; e-mail: silkesteinbach{at}hotmail.com.

Purpose Smell and taste changes during chemotherapy are significant complaints of cancer patients. Loss of olfactory/gustatory function can lead to malnutrition, weight loss, and possibly a prolonged morbidity of chemotherapy-induced adverse effects, decreased quality of life, poor compliance, and even decreased therapy response. This prospective study comprehensively investigated, to our knowledge for the first time, smell and taste changes in a cohort of 87 patients undergoing chemotherapy for breast cancer or gynecologic malignancies.

Patients and Methods Olfactory function was tested using Sniffin' Sticks (Burghart; Wedel, Germany) and gustatory function was tested using taste strips before, during, and immediately and 3 months after chemotherapy.

Results Olfactory and gustatory function significantly decreased during chemotherapy and recovered almost completely 3 months after chemotherapy. Scores of odor thresholds were affected more than those of discrimination or identification. The olfactory function of older patients was affected more than that of younger patients. There was no difference in the olfactory function during chemotherapy with respect to the chemotherapeutic agent or initial diagnosis (breast or ovarian cancer). Regarding taste, scores of salty taste were affected more than scores of sweet, sour, or bitter taste. The gustatory function did not differ significantly during chemotherapy with respect to age or diagnosis but did differ with respect to the chemotherapeutic agent. Taxane-based chemotherapy caused the most severe disorders.

Conclusion Chemotherapy has a significant but transient effect on olfactory and gustatory function, possibly causing reduced appetite, a low energy intake, and weight loss. Additional spices and flavoring may compensate for this diminished chemosensory function, enhancing patient compliance and quality of life.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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