• Hearing Loss and Cancer Treatments

    Physicians are well aware of the many side effects of chemotherapy and radiation treatment. However, only in recent years has research address the risk of hearing loss and related conditions (e.g. tinnitus) as reported by numerous post-cancer treatment patients. These studies have related a strong link between hearing loss and cancer treatments, especially among certain chemotherapy medications.

    It is important for both physicians and patients to understand the risk of ototoxicity when treating cancer, and its long-term implications, which may include permanent hearing loss.

     

    Ototoxicity and its relationship to cancer treatments.

    Certain chemotherapy medications or radiation therapy can cause ototoxicity (hearing loss due to medication), which may be manifested as temporary or permanent hearing loss, depending on the type of treatment and the extent of hearing damage.

    Ototoxicity resulting in sensorineural hearing loss refers to drug or chemical damage within the inner ear where cochlear hair cells vibrate in response to sound waves.   This damage may affect vital hearing and balance information to the brain, resulting in hearing loss, tinnitus, and/or loss of balance.

    Platinum-based chemotherapy medications, particularly cisplatin and carboplatin, are considered the primary “culprits” when it comes to ototoxicity. Other potentially ototoxic chemotherapy drugs include Bleomycin, Vincristine, Vinblastin, Bromocriptine, and Methothrexate Nitrogen mustard.[1]

     

    Effects of ototoxicity in adults:

    • Physical effects of hearing loss including balance issues and a greater likelihood of falls[2] over time, especially in older adults. Hearing loss has also been linked to the development of certain forms of dementia[3] and cognitive decline.
    • Psychological fallout, including depression, isolation, anxiety, anger, and poor self-image.[4]
    • Economic impact, which includes higher rate of unemployment, difficulty retaining a job or advancing a career.[5]

    Because of the long-term effects of hearing loss in adult survivors, and the debilitating effects associated with the condition, oncologists will likely do their utmost to mitigate ototoxic exposure during treatment. When aggressive treatment is necessitated, and the patient experiences hearing loss, it is important to consider treatment options such as hearing aids, which can help 95% of patients with hearing loss. As cancer treatments have more successful, and the cancer patient live longer, hearing loss treatment, could improve the patient’s quality of life after cancer treatment.

    “20 year ago, many patients considered themselves lucky to survive – now medical advance mean the quality of life after treatment is crucial.”[6]

     

    [1] American Tinnitus Association. Ototoxic Brochure by League for Hard of Hearing. 2012.
    [2] USNews.com. Hearing Loss Triples Risk of Falling: Study. 2012
    [3] Johns Hopkins Medicine. Hearing Loss Accelerates Brain Function Decline in Older Adults. 2013
    [4] Mary Kaland, Kate Salvatore. The Psychology of Hearing Loss. The ASHA Leader, 2002
    [5] David Jung, Neil Bhattacharyya. Association of Hearing Loss with Decreased Employment and Income Among Adults in the United States. Annals of Otology, Rhinology & Laryngology. 2014
    [6] Mark Downs, Executive Director of Technology and Enterprise of the British RNID