Abstract
Taste and smell abnormalities (TSA) are common in patients receiving chemotherapy and may lead to altered nutritional intake, treatment withdrawal, and impaired quality of life. Lipid peroxidation in the oral cavity is one cause of TSA. Lactoferrin (LFN), an iron-binding salivary protein, reduces production of lipid oxidation byproducts and has been shown to reduce perception of unpleasant flavors. To assess the feasibility of LFN as a treatment for TSA, we conducted pilot investigations among patients with cancer who self-reported TSA following onset of chemotherapy. The primary objective was to assess change in subjective taste and smell perception from baseline to completion of 30days of LFN supplementation. Patients were treated with 750mg LFN daily for 30days and followed for an additional 30days without LFN. TSA was measured via the taste and smell questionnaire (TSQ) including taste (score 0-10), smell (score 0-6), and composite scores (0-16) (0 = no TSA) at baseline, day 30, and day 60. A total of 26 patients enrolled; 19 remained on study at day 30 and 17 at day 60. Baseline mean TSQ scores were 6.5 (taste), 3.1 (smell), and 9.6 (composite). By day 30, mean composite TSQ score improved by 1.7 (p = 0.018); taste and smell improved by 0.6 (p = 0.062) and 1.1 (p = 0.042), respectively. From baseline to day 60, mean composite TSQ score improved by 3.8 (p < 0.0001); taste and smell improved by 1.9 (p = 0.001) and 1.8 (p = 0.003). Further evaluation of LFN is warranted to determine its value for improving self-reported TSA among patients receiving chemotherapy.
Highlights
Cancer-related taste and smell abnormalities (TSA) are poorly understood despite their considerable impact on patients [1,2]
Further evaluation of LFN is warranted to determine its value for improving self-reported TSA among patients receiving chemotherapy
Twenty-six adult patients presenting for chemotherapy for various malignancies were enrolled and completed baseline assessments
Summary
Cancer-related taste and smell abnormalities (TSA) are poorly understood despite their considerable impact on patients [1,2]. Though TSA may be acute following a variety of cancer treatments, patients commonly report chronic TSA that can persist for years following treatment completion [4]. These disruptions diminish hedonic pleasure of eating and may profoundly impact quality of life, social relationships, psychological and emotional function, and nutrition (e.g., food aversion, malnutrition) [1,2]. Disinterest in eating as a function of TSA stands to impair physical and emotional well-being and may be distressing within the context of cancer. Additional research is warranted to understand cancer-related TSA and identify prevention and treatment strategies
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