Dysgeusia in Patients with Breast Cancer Treated with Chemotherapy—A Narrative Review

Abstract

Breast cancer (BC) is the most common cancer worldwide. Chemotherapy (CT) is essential for the treatment of BC, but is often accompanied by several side effects, including taste alterations, due to different mechanisms. Although dysgeusia is usually underestimated by clinicians, it is considered very worrying and disturbing by cancer patients undergoing CT, because it induces changes in dietary choices and social habits, affecting their physical and psychological health, with a profound impact on their quality of life. Several strategies and therapies have been proposed to prevent or alleviate CT-induced dysgeusia. This review aimed to evaluate the available evidence on prevalence, pathophysiological mechanisms, clinical consequences, and strategies for managing dysgeusia in BC patients receiving CT. We queried the National Library of Medicine, the Cochrane Library, Excerpta Medica dataBASE, and the Cumulative Index to Nursing and Allied Health Literature database, performing a search strategy using database-specific keywords. We found that the literature on this topic is scarce, methodologically limited, and highly heterogeneous in terms of study design and criteria for patient inclusion, making it difficult to obtain definitive results and make recommendations for clinical practice.

Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study

“…However, upon discontinuation of medication, the taste alterations recover. The process of neurotransmission can be impacted in an indirect manner where cranial nerves are destroyed, afferent pathways are modified due to the passage of cytotoxic drugs through the blood-brain barrier, or as a consequence of neuropathy induced by chemotherapy, according to previous research [ 30 ]. In an alternative scenario, taste perception may be modified in an indirect manner as a result of chemotherapy-induced impairment of brain regions that regulate taste perception [ 11 ].…”

“…In previous studies [ 2 , 13 , 46 , 47 ], taxane-based chemotherapy was associated with a higher rate of TAs. Still, no mechanism is documented to explain how taxane induces taste alterations [ 30 ]. Otherwise, cyclophosphamide has two mechanisms for taste disturbance: direct and indirect.…”

“…It was shown that cyclophosphamide directly induces the destruction of the lingual epithelial cells, resulting in the death of sensory cells in taste buds, increasing the taste threshold and decreasing the ability of taste discrimination. Furthermore, when aged gustative cells die, cyclophosphamide indirectly prevents their replacement by suppressing the normal taste cell replacement process [ 30 , 48 ].…”

Suppression of sweet taste-related responses by plant-derived bioactive compounds and eating. Part I: A systematic review in humans

“…Moreover, experimental data involving healthy subjects with decreased perception of sweetness via Gymnema sylvestre extracts have shown that they consumed fewer total and sweet calories compared to individuals with normal perception [ 29 ]. In contrast, other experimental studies conducted with Gymnema sylvestre extracts in healthy subjects and clinical research point out that a blunted sweet taste sensation may also be linked to an increased appetite and body weight gain [ 24 , 30 , 31 ]. In this case, a reduced taste perception might initially cause less satisfaction after a meal, triggering compensatory responses that drive some individuals to increase food intake to satisfy these desires.…”

Effect of Regular Consumption of a Miraculin-Based Food Supplement on Taste Perception and Nutritional Status in Malnourished Cancer Patients: A Triple-Blind, Randomized, Placebo-Controlled Clinical Trial-CLINMIR Pilot Protocol

“…To date, the pharmaceutical and supplement industry has been unable to provide effective treatment or strategy for patients suffering from dysgeusia. Zinc supplementation [7][8][9], amifostine [10][11][12], selenium, lactoferrin, and cannabinoids are among the treatments used today, with limited clinically beneficial effects on taste disorders [13,14]. This scenario necessitates new clinical trials to identify effective strategies for controlling dysgeusia and improving the health and quality of life of patients [13,15].…”