Management of Dysgeusia related to Cancer

Abstract

a ----------------------------------------------- ABSTRACT:Introduction: Taste change due to cancer is a notorious side effect, adversely affecting appetite and weight. Even though taste change or dysgeusia is one of the major causes of poor nutritional status in cancer survivors, it is not addressed as a significant problem and is often left untreated. The main purpose of this review is to explore current knowledge of pharmacological and behavioral interventions for the treatment of cancer related taste change. Methods: This systematic review was conducted in accordance with PRISMA guidelines to identify original articles on taste change. Multiple databases including; Scopus, Medline, EMBASE, CINAHL, and all databases via Pro quest were searched for original articles or studies related to taste change caused by cancer or its treatment. Relevant articles were subjected to a full text evaluation and assessed by Critical appraisal skills program (CASP) guidelines and the Effective public health practice project (EPHPP) instrument. Results: The search revealed 12 eligible studies, six of which were randomized controlled trials. Most of the studies used a standardized validated tool to measure taste change. Dysgeusia is common in cancer, 14 to 100% cancer patient report it. Pharmacological management with zinc remains inconclusive as one study reports it as beneficial and two other studies reported null effect. Few studies suggested dietary modifications such as use of sugary, salty foods that are helpful to reduce the effect of dysgeusia. Conclusion: Dietary counseling and informing the patient well about self-care strategies before treatment has consistently shown positive results on taste change, with strong statistical power. Other potential treatments for dysgeusia such as zinc, amifostine, and megestrol acetate gave inconsistent results.

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“…Loss of flavor perception, distressing to the cancer patient for the loss of appetite and the enjoyment of food, presents a serious problem leading to the development of malnutrition, wasting and malignant cachexia. It contributes to morbidity, is associated with diminished treatment outcomes [12,13] and compounds with psychological and psychosociological problems [14,15].…”

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“…Management of this symptom requires dietary counseling and parents and the child must be alerted to the importance of good oral hygiene before the treatments [ 38 ].…”

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“…Zinc supplementation is one of the most common interventions studied for preventing and/or treating dysgeusia related to various causes, including cancer-related therapies. 40 It is the cofactor for alkaline phosphatase, the most abundant enzyme in the taste bud membrane. Zinc and other metals control the conformation of the protein (‘gatekeeper’) that regulates the passage of tastants through the taste bud pore.…”