Taste changes during radiotherapy for head and neck cancer.

INTRODUCTION

Taste changes (dysgeusia) during radiotherapy for head and neck cancer are associated with malnutrition, tube feeding and reduced toleration of treatment.

METHOD

The MD Anderson symptom inventory - head and neck (MDASI-HN) questionnaire was completed by patients in a single department receiving radical radiotherapy or chemo-radiotherapy for head and neck cancer during weeks 1 and 4 of radiotherapy. Participants who developed dysgeusia in week 4 completed supplementary questions exploring what foods they could taste and how they managed taste changes.

RESULTS

At week 4, 97% of 61 participants reported taste changes, 77% reporting moderate or severe changes. 30% of participants reported taste changes during week 1. Patients with oropharyngeal, oral cavity and parotid gland tumours were most likely to develop dysgeusia. Females were more likely than males to report taste changes. A soft, semi-liquid diet was reportedly easier to tolerate as the more food was chewed the worse the taste became.

CONCLUSIONS

Patients having radiotherapy for all head and neck cancers should be warned of the very high risk of developing taste changes and the time scale for this. Patients with taste changes should be advised a softer diet requiring less chewing will be better tolerated. The finding that females are more at risk than males of dysgeusia needs further investigation.

IMPLICATIONS FOR PRACTICE

Patients with head and neck cancer should expect taste changes from the start of radiotherapy. Patients with dysgeusia should be advised that soft, semi-liquid foods that require less chewing before swallowing are easier to tolerate and that taste changes day-to-day.