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Olfactory changes among patients receiving chemotherapy.

Britt-Marie Bernhardson1, Carol Tishelman, Lars Erik Rutqvist

  • 1Department NVS, Division of Nursing, Karolinska Institutet, Stockholm, Sweden. britt-marie.bernhardson@ki.se

European Journal of Oncology Nursing : the Official Journal of European Oncology Nursing Society
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Chemotherapy can cause smell changes (SCs) without taste changes. Patients reported heightened smell sensitivity, leading to emotional distress and weight gain, impacting daily life.

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Area of Science:

  • Oncology
  • Neuroscience
  • Sensory Science

Background:

  • Taste and smell changes (TSCs) are recognized chemotherapy side effects.
  • Smell changes (SCs) in isolation during chemotherapy remain understudied.
  • Understanding isolated SCs is crucial for patient care and quality of life.

Observation:

  • Focus on patients experiencing SCs without concurrent taste alterations.
  • Qualitative interviews and a survey of 518 out-patients receiving chemotherapy in Sweden.
  • Analysis of 43 participants with exclusively SCs and three detailed case studies.

Findings:

  • All patients with isolated SCs reported increased olfactory sensitivity.
  • No patients reported decreased smell sensitivity; weight gain was more frequent.
  • Nausea was more common in the SC-only group compared to those without TSCs.

Implications:

  • Isolated SCs during chemotherapy are unpredictable and cause emotional distress.
  • Current explanatory models (anticipatory nausea, pseudohallucinations, chemical sensitivity) do not fully account for heightened olfactory sensitivity.
  • Further research is needed to elucidate the mechanisms and management of chemotherapy-induced isolated smell changes.