Simple solutions to gastro-intestinal symptoms in chemotherapy patients

INTERVENTION: At base line before chemotherapy commmenced genetic test strips will be used to screen for taste sensitivities Genetic taste test strips will be used to screen for genetically inherited taste recognition thresholds using taste testing strips which are impregnated with either 30mg thiourea, 30mg phenylthiocarbamide (PTC), or 30mg sodium benzoate. Participants were asked to trial each taste test strip in a random order by applying a strip to their moistened tongue and reporting whether it had no taste or tasted bitter, salty, sour, sweet, or any other taste. Patients will be classified as non‐tasters with no taste reported, tasters when a recognisable taste is identified, and hyper‐tasters if a strong taste was elicited. Number of taste buds counted by placing a drop of blue food colouring on tip of dry tongue A 6mm round hole in filter paper placed over the area dyed and the number of papillae counted within this space. Patients will be asked about their symptoms during cycle 2. Those reporting symptoms will be asked to trial mouth rinses during cycle 3 when symptoms are reported to be greatest. Mouth washes of various common oral fluids will be trialled for 12 hours in random order as often as patient requires but at least twice for six consecutive days with overnight wasout periods. They will complete a questionaire daily to see which mouth washes improve taste and symptoms in chemotherapy. a)Distilled cold water 500ml b)Salt 5 g in 500ml cold water c)Sodium bicarbonate 5 g in 500ml cold water d)Sugar 25g in 500ml cold water e)Ginger 2 gram in 500ml cold water f) Peppermint oil 0.2 ml in 500ml coldwater Monitoring for adherence is by questionaire completion and container return. CONDITION: Cancer Patients receiving intravenous chemotherapy of cyclophosphamide or 5 fluorouracil PRIMARY OUTCOME: To determine if the genetics of taste can predict development of upper gastric symptoms in patients receiving chemotherapy.The composite outcomes use genetic taste testing and counting number of taste buds. SECONDARY OUTCOME: Number of participants with any improvements in taste and symptoms (composite), assessed using questionnaire designed for this study for each of the mouthwashes over 6 days during cycle3 of chemotherapy. INCLUSION CRITERIA: Competent patients aged 18‐85 to receive intravenous chemotherapy of cyclophosphamide on regimens AC, TC, AC‐T or FEC‐D or 5‐FU on regimens Modified FOLFOX6 or modified de gramont