There is one word that everyone fears hearing from their doctor – “cancer.” According to the CDC, over 1.5 million people in the United States were diagnosed with cancer in 2020. Depending on age, stage, and type of cancer, the average 5-year survival rate is around 66%, with some cancers having 97% survival and others as low as 11-12%. National Cancer Survivors Day is the beginning of June every year. It is a day to celebrate the lives of those who have survived. For those who have survived and, particularly those who are now cancer free, life typically becomes much more meaningful and everyday becomes a day in which living to the fullest is a priority. However, even with survival, there are often many things about life which become different and need to be dealt with even when the cancer finally becomes a memory from the past.
According to CancerWorld.net, currently about 53% of new cancers globally require the use of chemotherapy as part of the treatment plan. Some of the most common types of side effects of chemotherapy include fatigue, hair loss, pain, sores, intestinal issues, nausea and vomiting, nervous system effects, and cognitive changes (Cancer.net). Damage from chemotherapy to the heart, lungs, liver, kidneys, and the reproductive system are often long-standing and/or permanent. One of these possible permanent changes which is typically not discussed is hearing loss.
Chemotherapy can cause a slow decline in hearing over. These drugs often contain heavy metals which are known to be toxic to the ear. They can damage the ears hair cells (sensory cells for hearing) and damage the myelin sheath (protective coating) around nerves. Often, the effect is a slow gradual change which begins in the high pitches and is cumulative with each additional treatment cycle. Because of the slow, gradual nature of the loss, hearing loss is typically not noticed for some time – often not even being detected for months. Sometimes, the changes in hearing will continue for up to 12 months after the discontinuation of the medication.
When a hearing loss occurs from chemotherapy, it is common for a person to feel like others are mumbling more often, or to notice a need for others to repeat themselves frequently. Understanding speech in noisy environments also becomes more difficult as hearing decreases. Sometimes, the first sign of hearing loss is tinnitus, which is hearing a persistent ringing or buzzing in the ears. Due to the nature of hearing loss and how it affects daily quality of life, it is important to monitor hearing when chemotherapy (or any ototoxic drug) is needed.
The first step of monitoring for ototoxic hearing loss is to get a baseline hearing test. This should be completed prior to the first treatment with chemotherapy or any ototoxic drug. If you have already begun treatment, completing an assessment as soon as possible will still help provide some indication of any changes in hearing following treatment. During your treatment, your audiologist and physician may recommend a regular testing interval to monitor your hearing sensitivity. It is common to continue monitoring at 3 months, 6 months, and 12 months post treatment as hearing loss may occur many months after treatment has stopped.
At Oro Valley Audiology, we are committed to ensuring optimal hearing health care for all patients. If you or someone you love is going through treatment with ototoxic medications, please contact our office to schedule a baseline hearing test. We will work with you to monitor your hearing over time and, if needed, provide the hearing treatment necessary to help you continue to have the fullest quality of life possible even if a hearing loss were to occur.
Resources:
“USCS Data Visualizations.” CDC, gis.cdc.gov/Cancer/USCS/#/Survival.
“More Than 50 Percent Rise in Chemotherapy Demand by 2040 | Cancer World Archive.” Cancer World | Magazine Article Archive 2004-2019, 3 June 2019, archive.cancerworld.net/news/more-than-50-percent-rise-in-chemotherapy-demand-by-2040.
“Chemotherapy Side Effects.” American Cancer Society, www.cancer.net/navigating-cancer-care/how-cancer-treated/chemotherapy/side-effects-chemotherapy.
