Fatigue, Stress, and Functional Status are Associated With Taste Changes in Oncology Patients Receiving Chemotherapy

Paule V. Joseph, Alissa Nolden, Kord M. Kober, Steven M. Paul, Bruce A. Cooper, Yvette P. Conley, Marilyn J. Hammer, Fay Wright, Jon D. Levine, Christine Miaskowski

Research output: Contribution to journalArticlepeer-review


Context: A common complaint among oncology patients receiving chemotherapy is altered taste perception. Objective: The purpose of this study was to evaluate for differences in common symptoms and stress levels in patients who reported taste changes. Methods: Patients were receiving chemotherapy for breast, gastrointestinal, gynecological, or lung cancer. Change in the way food tastes (CFT) was assessed using the Memorial Symptom Assessment Scale before the patients’ second or third cycle of chemotherapy. Valid and reliable instruments were used to assess for depressive symptoms, state and trait of anxiety, cognitive impairment, diurnal variations in fatigue and energy, sleep disturbance, and pain. Stress was assessed using the Perceived Stress Scale and the Impact of Events Scale-Revised. Multiple logistic regression was used to evaluate for risk factors associated with CFT. Results: Of the 1329 patients, 49.4% reported CFT. Patients in the CFT group reported higher levels of depression, anxiety, fatigue, and sleep disturbance as well as higher levels of general and disease specific stress. Factors associated with CFT group included being non-White; receiving an antiemetic regimen that contained a neurokinin-1 receptor antagonist with two other antiemetics; having a lower functional status; higher levels of morning fatigue; and reporting higher scores on the hyperarousal subscale of the Impact of Event Scale-Revised. Conclusions: This study provides new evidence on associations between taste changes and common co-occurring symptoms and stress in oncology patients receiving chemotherapy. Clinicians need to evaluate for taste changes in these patients because this symptom can effect patients’ nutritional intake and quality of life.

Original languageEnglish (US)
Pages (from-to)373-382.e2
JournalJournal of Pain and Symptom Management
Issue number2
StatePublished - Aug 2021


  • Taste changes
  • anxiety
  • chemotherapy
  • depression
  • fatigue
  • sleep disturbance
  • stress

ASJC Scopus subject areas

  • General Nursing
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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