Taste and smell abnormalities in advanced cancer: Negative impact on subjective food intake

Abstract

AbstractBackgroundTaste 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.MethodsConsecutive 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.ResultsAll 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.ConclusionTSAs 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.