What is Chemotherapy?
From the American Cancer Society: “Chemotherapy (chemo) is the use of strong drugs to treat cancer. Chemo was first used to treat cancer in the 1950s. It has helped may people live full lives. The chemo drugs your doctor or nurse gives you have been tested many times. Research shows they work to help kill cancer cells. There are more than 100 chemo drugs used today. Doctors choose certain drugs based on the kind of cancer you have and its stage.”
Undoubtedly, chemo has saved many people from the devastating effects of cancer. As with all medication, chemo is accompanied by certain side-effects. One lesser known side effect of chemo is the loss of hearing.
Ototoxicity – or “Ear Poisoning”
Certain drugs used in chemo are ototoxic, or poisonous to the ear. Ototoxicity may cause permanent sensorineural hearing loss, due to the effects of the drugs on our inner ear hair cells. These hair cells are responsible for translating the vibrations of sound waves into neural signals that are sent to our brains to be processed and recognized as sound.
Chemo is targeted at killing cancer cells, but in the process, they may kill off healthy cells as well, such as the inner ear hair cells. Because these cells do not regenerate, the damage caused to them by ototoxic medication often results in sensorineural hearing loss.
Ototoxic drugs may also cause tinnitus, a ringing of the ear, as well as dizziness and issues related to balance such as vertigo.
In some cases, patients receive both chemo and radiation. Studies have found that radiation may cause conductive hearing loss, which relates to the outer or middle ear. Radiation near the head, neck, and ear area has been found to cause inflammation or fluid buildup in the inner ear, which leads to conductive hearing loss.
Recommended Actions
According to the University of Arizona’s Department of Surgery – Division of Otolaryngology, patients who are recommended chemotherapy as a part of their medical plan must take several actions prior to treatment. Obtaining a baseline audiogram (hearing test) that includes ultrahigh frequencies and distortion product otoacoustic emissions (inner ear hair cell function) is the first step. A hearing test consists of a series of simple, painless, and noninvasive activities that allow audiologists to record our hearing ability by ear.
After this initial hearing test, it is recommended that people receiving chemo continue to monitor their hearing regularly, according to a schedule recommended by an audiologist. There are some steroid injections that may prevent hearing loss or recover hearing function.
Treating Hearing Loss
For cancer survivors, hearing loss may not appear right away but rather occur as a late effect of chemotherapy. With decades of the use of chemo to save lives, it is only rather recently that hearing loss has become more widely known as a side-effect. Even now, there are no concrete numbers on the cases of hearing loss caused by chemotherapy.
Regardless, seeking treatment for hearing loss is crucial to one’s health. Untreated hearing loss has numerous consequences, affecting one’s emotional health (increased risk of depression, stress, anxiety, etc.), physical well-being (higher rates of falls and hospitalizations), and even economic viability (people with untreated hearing loss earn less than their counterparts with normal hearing or treated hearing).
The first step to treating hearing loss is to schedule an appointment with an audiologist for a hearing test. Whether you are about to begin your chemo treatment or you are beginning to experience late effects of your completed chemo, it is never too late to begin saving your hearing.