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Hearing Blog

Breast cancer treatments and hearing loss

October 26, 2021

October brings Breast Cancer to the forefront of medical care this month.  I think we all know someone who has battled cancer.  Some people will win the fight, some will lose the fight, and others will continuously battle.  Different chemotherapy drugs produce different side effects.  There is weight loss, hair loss, and nausea, pain, headaches, just a multitude of events that the patient must endure.  Cancer treatments have improved over the years thus improving patient survival rates.  The treatments also are increasing patients’ risk of ototoxicity.  

Ototoxicity is a hidden side effect of chemotherapy.  Ototoxicity is defined as a property that is toxic to the ear. (oto-); specifically, to the cochlea or the auditory nerve and possibly the vestibular system., (Wikipedia).   So, often, patients who undergo chemotherapy may endure longer-term side effects.  If you are going to be taking chemotherapy you should contact your hearing health care provider and get a complete hearing evaluation before starting treatment.   According to the University of Arizona Cancer Center, “Hearing loss has become one of modern cancer therapy's most prevalent side effects.  In fact, hearing loss is among the most underreported, yet potentially devastating, side effects endured by many chemotherapy patients". 

The reasons for hearing loss while taking chemotherapy are because of the use of chemotherapy agents like cisplatin and carboplatin, these treatments are very successful in attacking cancer, but they can cause ototoxicity.  Chemotherapy weakens the body’s immune system and often patients are prescribed high doses of antibiotics which are also known to contribute to hearing loss.  Ototoxicity or damage to the inner ear begins in the extreme upper hearing frequencies.  These upper ranges are above where normal speech usually occurs; thus, chemotherapy patients usually are not aware at the time that a hearing loss is setting in.  Usually, as the chemotherapy treatment continues the hearing loss will become more noticeable.  Often this hearing loss will also be accompanied by tinnitus.  (Ringing, buzzing, chirping).  Dizziness may also be present.  During your treatments, you should schedule regular hearing exams to monitor your hearing.  The hearing may continue to degrade even after chemotherapy treatments have stopped.

Hearing loss can occur from many things.  It may come on gradually as we age, maybe hereditary, or possibly there was noise exposure in your life.  Hearing loss that is caused by ototoxicity is different.   It can come on suddenly and can range from mild hearing loss, or tinnitus to near deafness.  There is no cure for ototoxicity.  However, there are ways to cope with the symptoms.  Contact your hearing health care provider for your hearing test before starting chemo.  If you experience a hearing loss due to ototoxicity, then your hearing provider will have the necessary background to help you.   You may need hearing instruments.  You may need hearing instruments with tinnitus multiflex management capabilities, or perhaps another form of tinnitus sound therapy that can help to control ringing and buzzing in your ears.  

One of my colleagues at Starkey Hearing Technologies; Mary Leisses (Mary is Starkey's Director of Network Education & Training), had emotional and physical scars from her ordeal.   If there was a treatment that existed, then she tried it.  She was given much advice from people as to what to do and not to do.  However, she was a very type "A" personality and she realized very quickly that what works for one person or what one could handle is very different among individuals.  So, along with her physical and emotional scars she ended up with tinnitus.  According to Mary; "good old-fashioned tinnitus.  On bad days it gets worse.  When I have too much coffee, it gets worse.  It's always there and it’s not going to get any better."   During her second round of chemo, doctors took an aggressive approach with antibiotics aimed at minimizing her risk of infection.   Mary ended up reacting to the medicine and wound up with tinnitus upon the completion of her treatment.   She believes it was the antibiotics and not the chemo drugs that damaged her inner ear.  "You put poison in your body and then you take more poison to counteract the poison that is being used to fight cancer" she said.   While Mary lost her battle with Brest cancer, she continued to her need to help others learn by sharing her journey with her cancer.  Rest in Peace Mary.

According to Kelly Macauley Frost, AU.D., CCC-A, there is active research in ototoxicity.  Cancer researchers are looking at agents that might prevent hearing loss but won’t inhibit the anti-tumor effects of the cancer treatments.   Antibiotics that might reverse the effects of ototoxicity are being studied as well as the development of chemo drugs that will not cause hearing loss.

Everyone should have a baseline hearing evaluation for their medical profile.  If you are undergoing Chemo, then you should be monitoring your hearing with periodic tests.  To Hear Better Is To Live Better!


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