title: Characterization of chemosensory alterations in advanced cancer reveals specific chemosensory phenotypes impacting dietary intake and quality of life.
abstract: BACKGROUND
  Taste and smell (chemosensory) alterations are common and distressing among advanced cancer patients, but their specific nature is poorly described and seldom linked to dietary intake. Details of altered chemosensory perception may help to explain food intake behaviors.
  
  
  OBJECTIVE
  Our goal was to characterize chemosensory alterations and their relationship with dietary intake and quality of life (QOL).
  
  
  METHODS
  Adult advanced cancer patients (n=192) completed a chemosensory self-assessment questionnaire to characterize changes in their sense of smell and four basic tastes (sweet, sour, salty, and bitter) since the onset of cancer, three-day food record, and QOL questionnaire.
  
  
  RESULTS
  Patients experienced either no alteration in any basic tastes and sense of smell sensations (26% of patients) or one of three altered chemosensory phenotypes: 1) stronger sensations overall (42%), 2) weaker sensations overall (18%), or 3) mixed (some sensations stronger and others weaker, 14%). For individual sensations (sweet, sour, salty, bitter, and smell), stronger sensation was twice more prevalent than weaker sensation (P=0.035). Patients reporting chemosensory alteration consumed 20%-25% fewer calories per day (P=0.0018), experienced greater weight loss (P=0.0036), and had poorer QOL scores (P=0.0176) compared with patients with no alterations, but results did not vary by chemosensory phenotype. Chemosensory alterations were not related to tumor type (P=0.884), gender (P=0.286), or nausea (P=0.278).
  
  
  CONCLUSIONS
  Chemosensory alterations predict dietary intake and QOL; the identification of chemosensory phenotypes provides a rationale to adjust the properties of foods and dietary recommendations in function of the specific nature of these changes.
authors.affiliation: Department of Agricultural, Food and Nutritional Science, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Tristin Dawne
authors.initials: TD
authors.lastname: Brisbois
authors.forename: Ingrid Heila
authors.initials: IH
authors.lastname: de Kock
authors.forename: Sharon Mariko
authors.initials: SM
authors.lastname: Watanabe
authors.forename: Vickie Elaine
authors.initials: VE
authors.lastname: Baracos
authors.forename: Wendy Victoria
authors.initials: WV
authors.lastname: Wismer
mesh_terms: D000368:Aged; D004435:Eating / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000150:complications; D009369:Neoplasms / Q000150:complications* / Q000523:psychology*; D000857:Olfaction Disorders / Q000503:physiopathology; D010641:Phenotype; D011788:Quality of Life; D018401:Sample Size; D012678:Sensation Disorders / Q000209:etiology* / Q000523:psychology*; D012903:Smell / Q000502:physiology*; D011795:Surveys and Questionnaires; D013649:Taste / Q000502:physiology*; D013651:Taste Disorders / Q000503:physiopathology