Treatment-Related Dysgeusia in Oral and Oropharyngeal Cancer: A Comprehensive Review

Abstract

Oral cancer is the most common tumor of the head and neck region. Its management is based on surgical and systemic therapies. Taste disorders represent the most common side effect of these treatments; indeed, dysgeusia is noted by 70% of oral cancer patients. Despite survival remaining the primary endpoint of cancer patients, taste impairments can cause psychological distress. This comprehensive review describes the last decade’s knowledge from the literature regarding taste alterations in patients with oral and oropharyngeal squamous cell carcinoma. A total of 26 articles in English, including prospective, cross-sectional, and case–control studies, and clinical trials were evaluated. Literature analysis shows that anti-cancer treatments can destroy taste cells, decrease and alter their receptors, and interrupt nerve transmission. Furthermore, the tumour itself can destroy the oral mucosal lining, which encloses the taste buds. Dysgeusia typically occurs in 3–4 weeks of treatments, and usually taste sensation is recovered within 3–12 months. However, some patients exhibit incomplete or no recovery, even several years later. Thus, dysgeusia can become a chronic issue and negatively influence patients’ quality of life, worsening their dysphagia and their nutritional status. Physicians should be focused on preventing oncological treatment-related symptoms, offering the most suitable personalized support during therapy.

Skeletal Muscle Depletion and Major Postoperative Complications in Locally-Advanced Head and Neck Cancer: A Comparison between Ultrasound of Rectus Femoris Muscle and Neck Cross-Sectional Imaging

“…HNSCC patients are among the individuals at highest risk for the development of malnutrition and sarcopenia, especially those with locally-advanced diseases. Indeed, LA-HNSCC and its treatment modalities can seriously compromise patients’ nutritional status: approximately 35% to 60% of all patients with head and neck cancer are malnourished at the time of their diagnosis [ 5 , 23 ], with each of the potential treatment strategy encompassing eventual side effects that may synergistically contribute to the disease-related malnutrition [ 6 , 24 ]. In fact, severity of malnutrition correlates with the tumor burden, affecting the chances of survival [ 7 ].…”

“…These indeed affect the capability of patients to undergo heavy multimodal therapies, which are the gold standard of treatment for such extended disorders, jeopardizing their chances to be healed [ 4 ]. Moreover, approximately 35% to 60% of all patients with HNSCC are malnourished at the time of their diagnosis because of cancer itself and its treatment modalities [ 5 , 6 ]. Friedlander et al found that the degree of malnutrition correlates with the tumor burden and affects outcome; furthermore, the immune suppression observed in malnourished patients is associated with unimpeded tumor growth [ 7 , 8 ].…”

Can Videofluoroscopic Swallowing Kinematic Analysis Predict Recovery of Oral Intake in Postoperative Oral Cancer Patients Requiring Nasogastric Tube Feeding?

“…CR-caused dysphagia has been frequently documented [2,3]. In addition to the other aforementioned risk factors, CR can cause mucositis, pain, nausea, dysgeusia, and impaired swallowing kinematics [27]. It is very common for patients who have received CR to require more time to remove the NGT and recover oral intake than those who do not receive CR.…”

It's not only swallowing: a clinician primer to adult food refusal beyond dysphagia

“…Treatments for head and neck cancer pose both acute and chronic alterations to taste. Seventy-six percent of patients undergoing such treatment have been estimated to experience dysgeusia [5]. Chemo-therapeutic agents and radiotherapies cause cyto-toxic and neurotoxic damage to taste receptor cells; due to damage to progenitor cells, these effects can unfortunately be long-lasting in some individuals [5].…”