Alterations in emotional responses (pleasantness/unpleasantness) induced by sniffing food odors during chemotherapy in patients with lung cancer.

BACKGROUND: Patients receiving chemotherapy experience anorexia and food aversion in their daily lives, and one of the causes is the smell of food. However, it is not clear why the aversion to these smells occurs. This study aimed to determine the emotional responses of patients when they sniff representative food odors during chemotherapy and to investigate factors influencing smell-induced food aversion. METHODS: The subjects were 26 patients with lung cancer undergoing chemotherapy with carboplatin. A visual analog scale (VAS) was used to evaluate whether they felt unpleasantness, with a focus on nizakana (simmered fish) and citrus fruits odors. This evaluation was performed both before and 2 days after the patients were administered carboplatin. RESULTS: The results revealed that the VAS scores of emotional responses due to the sniffing of each food sample did not differ significantly (P = 0.942) before and during chemotherapy. However, the smell of nizakana with added ammonia altered VAS scores of the emotional responses significantly during chemotherapy (P = 0.015). Moreover, patients with lung cancer who had a heightened level of odor awareness in their daily lives felt more unpleasantness by sniffing nizakana with added ammonia (correlation coefficient [rs] = -0.437, P = 0.026). However, patients with a lower odor awareness level felt no unpleasantness. CONCLUSIONS: The present findings suggest that patients with food aversion during chemotherapy are those with heightened odor awareness level; furthermore, this happens when they sense smells characteristic of substances harmful to the body.

Multidisciplinary nutritional support for autologous hematopoietic stem cell transplantation: a cost-benefit analysis.

OBJECTIVE: The objective of the present study was to evaluate the economic and clinical efficacy of a multidisciplinary nutritional support team (NST) for autologous stem cell transplantation. METHODS: We performed a retrospective cost-benefit analysis of autologous stem cell transplantation (ASCT) in patients with and without NST intervention at a single institute. Patients (n = 120) had undergone 169 ASCTs, 67 before the commencement of NST intervention in September 2005 and 102 after September 2005. The conditioning regimens, prophylactic antibiotics, and supportive care were unchanged from 2001 through 2008. The duration of hospitalization, cost, and laboratory data were analyzed. RESULTS: With NST intervention, the duration of total parenteral nutrition, absence of oral food intake, hospitalization, and therapeutic antibiotic usage were significantly shortened by 11.4, 9.7, 8.1, and 4.5 d, respectively. With NST intervention, the incidence of hepatic adverse events and hyperglycemia was low, and the total cost of hospitalization was significantly decreased by 403 600 yen (US $4484.40). Two cases of therapy-related death were recorded before September 2005. No therapy-related mortality was observed after commencement of NST intervention; however, the difference was not significant. CONCLUSION: Multidisciplinary NST intervention has a positive effect on cost decrease, and it may decrease the incidence of adverse events associated with ASCT and total parenteral nutrition.