Cancer Treatment and Hearing Loss

By Stacey Samuels-Cole, AuD

My mother was diagnosed in November 2002 with Stage IV breast cancer. She underwent a mastectomy followed by six months of chemotherapy and six months of radiation treatment. Subsequent to her treatment, she (as well as her family) noticed a significant decrement in her hearing acuity. The loss of hearing was a big blow, however, after being fit with hearing aids in both ears, she progressed very well over the past nine years following her treatment. However, in June 2011 she was again diagnosed with breast cancer and has undergone a second mastectomy and chemotherapy treatments, which have resulted in stays in ICU, the loss of her hair, her appetite, lots of weight, and most of her hearing.

Chemotherapy and radiation use powerful ototoxic (poisonous to the ears) drugs to destroy cancer cells in an attempt to alleviate any further spread of cancerous cells. The main class (not a complete list) of cancer treatment drugs, which may be damaging to the auditory system are Cisplatin, Carboplatin and Oxaliplatin. Carboplatin is the least ototoxic but is nonetheless damaging to the inner ear and can cause hearing loss, which in many cases is permanent. Cytotoxic drugs are often combined with other drugs, which will affect the degree of hearing loss experienced and it can affect some patients even years after treatment.

Other more common ototoxic drugs include radiation, aspirin, antibiotics and diuretics all of which can affect the inner ear in a variety of ways. The drugs are thought to damage fine hair cells within the cochlea and/or the auditory nerve, which are the major passageways for the conversion of sound waves into electrical signals, which are then interpreted by the brain as sound. Ototoxic drugs can also affect the balance mechanism in the inner ear, which causes dizziness and unsteadiness as well as, trigger the development of tinnitus (ringing or sounds in the ear), which can also be distressing conditions.

If you or a loved one has noticed issues with your hearing or balance, discuss these side effects with your oncologist or physician. Sudden or progressive loss of your hearing and intermittent disequilibrium/vertigo, or tinnitus may be devastating. Please know audiologists are trained to test the auditory and balance system and provide a personalized rehabilitation plan. Although hearing loss caused by ototoxic drugs is often not reversible, there are treatments and devices that can give back the sounds you've been missing and help to improve your overall quality of life.