Influence of cancer and acute inflammatory disease on taste perception: a clinical pilot study

Abstract

Purpose: Cancer patients are at high risk of malnutrition and tumor cachexia further increasing morbidity and mortality. Reasons for cachexia are not clear yet, but inflammatory processes as well as the occurrence of taste disorders reducing nutrient uptake are discussed to play key roles. The purpose of this study was to gain insight into causative factors of taste disturbance in cancer patients. Does the cancer itself, inflammatory processes or cancer therapy influence taste disorders?

Methods: To capture an underlying taste disorder patients with cancer (n = 42), acutely hospitalized inflammatory disease patients (n = 57) and healthy controls (n = 39) were examined. To assess the influence of chemotherapy, patients with and without chemotherapy were compared. Taste tests were performed according to DIN ISO 3972:2011. Inflammation was recorded using laboratory parameters. Statistical evaluation was conducted using the Software R.

Results: Cancer patients showed significantly increased taste thresholds for sweet, salty, and umami compared to healthy controls. There were no significant differences in taste detection and recognition between patients with former, current, or without chemotherapeutical treatment. Patients with an acute inflammatory disease showed an increased taste threshold for umami compared to healthy controls.

Conclusions: It could be shown that cancer patients suffer from taste disorders irrespective of an existing chemotherapeutical treatment. Cancer-related inflammation appears to have a greater impact on taste perception than an acute inflammatory process. Therefore, an adapted dietary adjustment should be carried out at an early stage for cancer patients in order to avoid nutritional disorders caused by a taste disorder.

Keywords: Cachexia; Cancer; Inflammatory disease; Malnutrition; Taste disturbance.

Fig. 1

Detection threshold—comparison of the three groups. c control group, h hospitalized group, t tumor group. p values (Kruskal-Wallis rank sum test): p _kw. p values (adjusted by Holm-Bonferroni): p _ch = control group vs. hospitalized group, p _ct = control group vs. tumor group, p _ht = hospitalized group vs. tumor group. 1. Sweet: p _kw = 0.00151. c vs. h, c vs. t, h vs. t. p values: p _ch = 0.985, p _ct = 0.004, p _ht = 0.004. Numbers of subjects taken into account / n value: n _c = 63, n _h = 57, n _t = 38. 2. Bitter: p _kw = 0.492. c vs. h, c vs. t, h vs. t. p values: p _ch = 0.846, p _ct = 0.846, p _ht = 0.846. Numbers of subjects taken into account / n value: n _c = 63, n _h = 57, n _t = 38. 3. Sour: p _kw = 0.0249. c vs. h, c vs. t, h vs. t. p values: p _ch = 0.103, p _ct = 0.507, p _ht = 0.039. Numbers of subjects taken into account / n value: n _c = 63, n _h = 57, n _t = 38. 4. Salty: p _kw = 0.02. c vs. h, c vs. t, h vs. t. p values: p _ch = 0.098, p _ct = 0.021, p _ht = 0.243. Numbers of subjects taken into account / n value: n _c = 63, n _h = 57, n _t = 38. 5. Umami: p _kw = 0.000216. c vs. h, c vs. t, h vs. t. p values: p _ch = 0.002, p _ct < 0.001, p _ht = 0.150. Numbers of subjects taken into account / n value: n _c = 63, n _h = 56, n _t = 38

Fig. 2

Recognition threshold—comparison of the three groups. c control group, h hospitalized group, t tumor group. p values (Kruskal-Wallis rank sum test): p _kw. p values (adjusted by Holm-Bonferroni): p _ch = control group vs. hospitalized group, p _ct = control group vs. tumor group, p _ht = hospitalized group vs. tumor group. 1. Sweet: p _kw = 0.0505. c vs. h, c vs. t, h vs. t. p values: p _ch = 0.384, p _ct = 0.024, p _ht = 0.384. Numbers of subjects taken into account / n value: n _c = 39, n _h = 57, n _t = 38. 2. Bitter: p_kw = 0.594. c vs. h, c vs. t, h vs. t. p values: p _ch = 1.0, p _ct = 1.0, p _ht = 1.0. Numbers of subjects taken into account / n value: n _c = 39, n _h = 57, n _t = 38. 3. Sour: p _kw = 0.754. c vs. h, c vs. t, h vs. t. p values: p _ch = 1.0, p _ct = 1.0, p _ht = 1.0. Numbers of subjects taken into account / n value: n _c = 39, n _h = 57, n _t = 38. 4. Salty: p _kw = 0.0432. c vs. h, c vs. t, h vs. t. p values: p _ch = 0.243, p _ct = 0.031, p _ht = 0.278. Numbers of subjects taken into account / n value: n _c = 39, n _h = 57, n _t = 38. 5. Umami: p _kw = 0.000148. c vs. h, c vs. t, h vs. t. p values: p _ch < 0.001, p _ct = 0.007, p _ht = 0.272. Numbers of subjects taken into account / n value: n _c = 39, n _h = 56, n _t = 38

Fig. 3

Detection thresholds. (a) Influence of current chemotherapeutical treatment. Detection thresholds of patients receiving current chemotherapy vs. patients currently not receiving chemotherapy. cc current chemotherapy, ncc no current chemotherapy. n value: n _cc = 24, n _ncc = 14. Wilcoxon-Mann-Whitney test: Significance levels: 1. Sweet: p _cc/ncc = 0.238, W = 129. 2. Bitter: p _cc/ncc = 0.814, W = 160. 3. Sour: p _cc/ncc = 0.643, W = 152.5. 4. Salty: p _cc/ncc = 0.454, W = 193. 5. Umami: p _cc/ncc = 0.701, W = 155. (b) Influence of chemotherapeutical treatment. Detection threshold of chemotherapeutically treated patients vs. chemotherapy-naïve patients. c chemotherapy, nc no chemotherapy (chemotherapy-naïve). n value: n _c = 28, n _nc = 10. Wilcoxon-Mann-Whitney test: Significance levels: 1. Sweet: p _c/nc = 0,151, W = 97. Bitter: p _c/nc = 0.941, W = 137.5. Sour: p _c/nc = 0.81, W = 147.5. Salty: p _c/nc = 0.602, W = 156. Umami: p _c/nc = 0.581, W = 123

Fig. 4

Recognition thresholds. (a) Influence of current chemotherapeutical treatment. Recognition threshold of patients receiving current chemotherapy vs. patients currently not receiving chemotherapy. cc current chemotherapy, ncc no current chemotherapy. n value: n _cc = 24, n _ncc = 14. Wilcoxon-Mann-Whitney test: Significance levels: 1. Sweet: p _cc/ncc = 0.266, W = 131,5. 2. Bitter: p _cc/ncc = 0.958, W = 166. 3. Sour: p _cc/ncc = 0.661, W = 182.5. 4. Salty: p _cc/ncc = 0.687, W = 181.5. 5. Umami: p _cc/ncc = 0.922, W = 164.5. (b) Influence of chemotherapeutical treatment. Recognition threshold of chemotherpeutically treated patients vs. chemotherapy-naïve patients. c chemotherapy, nc no chemotherapy (chemotherapy-naïve). n value: n _c = 28, n _nc = 10. Wilcoxon-Mann-Whitney test: Significance levels: 1. Sweet: p _c/nc = 0.31, W = 109.5. 2. Bitter: p _c/nc = 1, W = 139.5. 3. Sour: p _c/nc = 0.126, W = 185. 4. Salty: p _c/nc = 0.895, W = 144. 5. Umami: p _c/nc = 0.786, W = 148.5