Oral -Somatosensory Alterations in Head & Neck Cancer Patients and Food Intake

Abstract

ObjectivesPrevalence of malnutrition in cancer ranges between 25–70% with increased risk in sites related to food ingestion, namely head and neck cancer (HNC). This is attributable to oral manifestations observed during treatments such as sensory alterations (SA). SA have been well documented and are associated with altered food perception and reduced food intake. In addition to taste and smell, food perception is also influenced by somatosensation comprising of tactile/texture, thermal, and trigeminal perception. The current review aims to investigate SA, specifically oral somatosensory alteration, among HNC patients and its potential consequences on food intake. MethodsA literature search was conducted using PubMed, Scopus, and Web of Science. Related works were also identified by snowballing. Keywords searched were, but not limited to: head and neck cancer; malnutrition; taste; smell; oral somatosensation; texture; oral tactile; trigeminal; thermal; chemotherapy; radiotherapy. ResultsMalnutrition in HNC patients ranged between 9–100% depending on tumor site, treatment, and time point (before, during, or after treatment). Between 56–100% of HNC patients experienced taste and/or smell alterations. Patients with these alterations showed altered food behavior including food aversion, modified food preference, reduced appetite, and lower food enjoyment. SA were also linked to lower food intake and higher weight loss. Regarding somatosensation, psychophysical studies (n = 7) showed reduced oral tactile function among HNC patients but its correlation with texture perception remains elusive. These studies (n = 2) also indicated reduced thermal sensitivity, whereas psychophysical studies investigating trigeminal perception have not been identified. Qualitative studies reported alterations such as altered sensitivity to spices, certain food textures, and temperature. ConclusionsSA are directly linked to food perception which contributes to changes in food behavior. However, evidence is still limited on oral somatosensory alteration and overall, results are inconclusive on the relationship between altered food behavior and intake. Such insights should support optimization of personalized meal for patients. Funding SourcesDanone Nutricia Research, French Industrial Training through Research Agreements, French League against Cancer.