Platinum-based
chemotherapy is known to cause taste and smell changes (TSCs) via a host of mechanisms, including altered receptor activity, saliva/mucus production, and induction of receptor destruction via mitotic inhibition. In the literature to date, these changes have primarily resulted in worsening of taste and smell. In this case report, we document the first instance of an individual regaining their sense of olfactory detection following treatment with
oxaliplatin for colorectal
adenocarcinoma. We theorize that the improvement in his sense of smell may have resulted from
oxaliplatin-induced destruction of his
nasal polyps through the
caspase-9/
procaspase-9 apoptotic pathway, a pathway shared with other mechanisms of
nasal polyp destruction. These findings were supported by nasal endoscopy and sphenoid sinusoscopy, which demonstrated no clinical persistence of
nasal polyps, in contrast to nasal endoscopy prior to
chemotherapy which demonstrated persistent nasal polyposis. Objective smell testing post-treatment revealed a diminished ability to discriminate odors.
Chemotherapy-induced TSCs play a key role in poor
weight gain, food aversion, emotional distress, and an overall decrease in quality of life, and patients should be informed of these potential consequences prior to starting treatment. However, in patients with
anosmia secondary to nasal polyposis, treatment with
platinum-based
chemotherapy may provide an additional therapeutic benefit. Further studies may help elucidate the potential therapeutic benefits of these agents in managing
steroid-resistant polyposis for patients suffering from olfactory dysfunction.