Did you know that chemotherapy and radiation can affect hearing? These treatments can often be ototoxic –meaning poisonous to the inner ear. Hearing problems caused by ototoxic medications can be temporary or permanent.
You may be wondering, “If a medication is known to cause permanent hearing loss, why is it used?” The realization is, sometimes there is little to no other choice. If a patient has a life threatening disease, a certain chemotherapy/radiation regimen may be the only option available to cure it.
There are many medications known to cause hearing loss. The following chemotherapy drugs have been reported to cause hearing loss in 10-35% of patients:
- cisplatin and carboplatin
- nitrogen mustard
- dactinomycin and bleomycin
Other drugs that cancer patients may be taking may also cause hearing loss. These medicines include:
- high doses of aspirin
- aminoglycoside antibiotics (gentamycin, streptomycin, tobramycin, and erythromycin)
- diuretics ( lasix and diamox)
- some heart and blood pressure medications (Lopressor)
- non-steroidal anti inflammatory drugs (Advil or Aleve)
Radiation may also cause hearing loss if the ear is included in the radiation field.
Symptoms of hearing loss often include:
- a feeling of fullness in the ear
- difficulty understanding speech
- changes in hearing sensitivity
- ringing in the ears
- episodes of dizziness or vertigo.
Why is it important to monitor hearing in cancer patients taking these medications?
Hearing loss caused by chemotherapy agents can occur rapidly or gradually. It is important to monitor patients before, during, and after treatment in order to detect hearing loss.
Hearing tests are usually performed before the administration of the drug to obtain a baseline and may include pure tone testing, speech testing, OAE monitoring, and tympanometry. Monitoring is then done at scheduled intervals to detect any changes in hearing as soon as possible. Information obtained from the hearing test can help the physician to know how the medication is affecting hearing. This information also helps the audiologist to identify ototoxic hearing loss and to plan and begin rehabilitation measures. Rehabilitation may include hearing aid fitting or the use of communication strategies.
Being aware of hearing loss can improve a patient’s hearing outcomes and quality of life. And with the advent of new technology, audiologists are now able to re-program hearing aids based on changes in hearing which is essential when dealing with a progressive hearing loss.
How to schedule an appointment for cancer hearing evaluation and monitoring?