For many people with cancer, chemotherapy is a life-saving treatment, and that is incredibly important. As medical professionals, we’re grateful to live in this era of modern medicine when this kind of treatment is available to our patients. At the same time, we should have a discussion about how this essential treatment may have lasting effects on other aspects of our health, specifically our hearing.
How Chemotherapy Can Lead to Hearing Loss
Different types of chemotherapy will affect hearing health in different ways. Moreover, the effects may vary depending on the patient’s age, overall health and the extent of their exposure.
Ototoxic Drugs
Ototoxicity is the main driver for hearing loss in cancer patients. As a quick review of how we hear, sound waves enter the ear and travel to the cochlea, an organ in the inner ear. The vibrations from the sound wave are converted into electrical impulses that are then sent to the brain via the auditory nerve. There, they are interpreted as sound, and the hearing process is complete.
Most chemotherapy drugs, specifically platinum-based drugs such as cisplatin or carboplatin, are known to be ototoxic, meaning they cause direct damage to the structures in the ear. They target the cells and membranes that make up the cochlea, meaning its ability to convert sound into electrical impulses and its ability to transmit them to the brain is damaged. Damage to these structures is permanent, so any damage to hearing ability is irreversible.
Radiation
Chemotherapy is often used in conjunction with radiation therapy for cancer patients, and this treatment can also cause damage to the structures of the ear. Radiation is powerful and is aimed within the body, so it should only affect the area of treatment. However, if the area of treatment is the brain, head or neck, the auditory system may be affected.
What To Do About It
We’re giving you this information because we want you to be informed about side effects and encourage you to monitor them. We are not advocating that you decline necessary medications and treatments.
To that end, the best thing to do about hearing loss in the wake of chemotherapy is to keep an eye on your hearing health. We strongly recommend you discuss any and all potential side effects—such as hearing loss—with your healthcare team so you can stay on top of other aspects of your health while battling cancer.
It may be beneficial to get your hearing checked before beginning chemotherapy to establish a baseline, and to continue getting it checked throughout treatment. This will help you notice any changes and enable swift intervention and hearing loss treatment without interrupting your cancer treatment.
Symptoms of Hearing Damage to Watch For
If you notice any changes to your hearing after beginning chemotherapy, speak to your doctor right away. Just like with cancer itself, early intervention with hearing loss can slow its progression and improve your chances of treatment being effective. Some signs include:
- Feeling like everyone is mumbling
- Difficulty hearing high-pitched sounds and voices
- Difficulty following a conversation, especially in noisy environments
- Tinnitus
If your healthcare team has recommended a hearing screening or ototoxicity monitoring for you during your cancer treatment, or if you’ve noticed changes in your hearing that you want to investigate, contact us at SH Audiology to schedule an appointment.