4. Discussion
xerostomia, bad taste, oxaliplatin-induced neuropathy, hypogeusia, decline in taste sensation, malnutrition, cancer, chemotherapy-induced taste alterations, taste alterations, cacogausia, Chemotherapy-induced taste alterations, phantageusia, taste hallucinations, epileptic, parageusia, hypergeusia
XEROSTOMIA, ORAL ULCERS, XEROSTOMIA (DRY MOUTH), CANCER, DISEASE, SECONDARY, CAVITY, EFFECTS OF CHEMOTHERAPY, MALNUTRITION, EPILEPTIC
No effective treatment is available for the prevention of chemotherapy-induced taste alterations, which may affect up to 86% of patients [The development of sensory alterations, including taste alterations, during chemotherapy is related to the type of chemotherapeutic agents administered. It is well known that patients treated with paclitaxel have a high frequency of developing a metallic taste, a generally bad taste, and/or xerostomia (dry mouth) [Taste receptor cells have a turn-over of approximately 10 days [Chemotherapy-induced taste alterations could be caused by intravenous chemotherapy entering the oral cavity via tears and saliva, but this should decrease with the clearance of the drug [At baseline, the control group had the ability to distinguish between strong and weak salty taste (The intervention groups’ ability to differentiate between strong and weak saltiness after several courses of chemotherapy indicates that CBD has a protective effect on nerve cells and potentially protects the patients from the abnormal sensory transmission observed during chemotherapy, where patients report difficulty tasting salt [Cannabinoids have been implied to increase taste receptor cells responding to sweet taste [CBD’s efficacy on symptoms and disease is primarily explored in studies with epileptic patients or animal studies [This study has several limitations. The number of patients recruited for the intervention group and the control group did not fulfill calculations on sample sizes. Only 22 patients were included in the intervention group and 10 in the control group. According to the calculations, 25 patients were needed in each group for the primary endpoint of change in LBM. The study enrolment took place during the COVID-19 restrictions, and we believe more patients would have participated without these restrictions. We hope that future studies with CBD will monitor patients’ LBM to elucidate a possible effect of CBD on LBM. The sample size calculation was not made on the secondary endpoint of taste alterations.Another potential limitation is the partly heterogeneous patient characteristics between the two groups. The control group included one man only (10%), as compared with six men in the intervention group (27%). The sex difference is not considered to affect the results of taste perception. Although some studies report taste perception to be affected by sex, other studies do not find this difference [The control group is a little younger than the intervention group (on average, 6.87 years younger) and younger than the target population [Development of paclitaxel- or oxaliplatin-induced neuropathy is more likely to increase with increasing age [In the sensory test, more patients in the intervention group than in the control group did not answer all sample questions (21% and 2.4% missing answers, respectively; details are in Despite the small sample size, the findings in this study showed a noticeable tendency in the effect of CBD on taste alterations in cancer patients receiving chemotherapy. Since the taste detection threshold increases with age (higher concentrations are needed to detect the taste) [In this study, we investigated the short-term effect of CBD on the gustatory effect in patients receiving chemotherapy. Future studies should include larger patient samples, use a randomized design, and also investigate the long-term effect of CBD to explore the delayed regeneration of taste buds. Including more tastants, such as sour and bitter tastes, would also be relevant.We have solely focused on the ability to differentiate taste, not on the differences of hypogeusia (decline in taste sensation), hypergeusia (increase in taste sensation), augusia (complete lack of taste functions in the tongue), parageusia (perversion of the sense of taste), cacogausia (unpleasant taste that does not originate from food or beverage), phantageusia (taste hallucinations), xerostomia, oral ulcers, or oral hygiene in general or their potential effect on the results [In summary, this study indicates that CBD might have an effect on patients’ ability to differentiate between weak and strong sweet and salty tastes during chemotherapy. Before the fourth course of chemotherapy, the intervention group had gained the ability to differentiate between weak and strong salty and sweet tastes, whereas the control group lost this ability during chemotherapy.If CBD helps diminish adverse effects of chemotherapy such as taste alterations, it would be relevant to also investigate the prevalence of malnutrition and the effect on patients’ perceived quality of life during and after chemotherapy. Data from this study will assist in the future design of studies to explore the effect of CBD on the preservation of taste during chemotherapy.