Chemotherapy and Hearing Loss
Chemotherapy is the therapeutic use of chemical agents to treat diseases. It is mostly used to destroy cancer cells.
He success of chemotherapy medications can be explained, among other things, by their strength and high doses.
Unfortunately, this means that the side effects are numerous. You’re probably familiar with several of these: hair loss, nausea and intense fatigue. Other side effects, although less known, also deserve our attention. This is the case for ototoxicity, which is the ability of a substance (drug or chemical) to harm the inner ear.
Ototoxic chemotherapy drugs include cisplatin, vincristine, nitrogen mustards, vinblastine, carboplatin and bleomycin. Cisplatin is one of the most toxic substances for the ear. The resulting hearing loss is often permanent and may be accompanied by tinnitus.
Many factors may influence the appearance of auditory symptoms, such as age, other medical conditions (e.g. renal failure) or hereditary factors. If you already have hearing loss or tinnitus, mention it before starting cancer treatments, as the treatments may increase hearing loss. The dosage, mode of administration, duration of treatment and interactions with other drugs may also influence the ototoxicity of the treatments.
Watch for Signs
Ototoxic effects may be numerous and variable. Symptoms may appear during treatment or in the following years. They can be temporary or permanent.
Auditory disorders caused by ototoxic treatments may have an impact on communication and quality of life, with possible effects on a person’s work, learning and social lives. Hearing loss can lead to isolation and stress during social interactions.
Some ototoxic substances, such as chemotherapy with cisplatin, make the ear more sensitive to noise exposure. It is therefore important to use hearing protection (earmuffs, noise breakers) when you’re exposed to noise (work in noisy environments, concerts) to avoid damaging your ears.
Various health professionals (audiologist, audioprosthetist, oncologist, pharmacist, nurse, etc.) work to prevent, limit and manage ototoxicity. Audiological monitoring involves a basic assessment (before the start of chemotherapy) and a follow-up during and after treatment. Early detection of hearing loss during treatment can give the oncologist an opportunity to adjust the treatment if possible, in order to minimize its impact on everyday life or prevent permanent hearing loss. If this is not possible, the audiologist can suggest other solutions, like hearing aids or communication strategies, to the patient, depending on their specific needs.
If you notice any of the following symptoms during or after a chemotherapy treatment, make an appointment with an audiologist.
- Feeling of not hearing as well as you used to: asking people to repeat themselves more often, increasing the TV volume, having trouble understanding in noisy environments, etc. A child may confuse words or appear to be daydreaming.
- Tinnitus (whistling or buzzing only you can hear).
- Feeling of fullness in the ear.
- Loss of balance, vertigo, dizziness.
Don’t hesitate to talk to an audiologist to learn more about ototoxicity.