19 Jun 2015
Cancer and hearing loss. These are words that don’t have a strong association in our vernacular. When you or a loved one is battling cancer, there are other concerns that take centre stage. Working in an oncology and palliative floor at the hospital, I’m acutely aware of the physical and emotional distress that the cancer survivor and their loved ones go through.
One area that’s often overlooked due to the medical urgency of cancer is discussions around quality of life. Chemotherapy drugs are often effective at treating some cancers, but they can have a lot of negative side-effects on the person. One of them is it being harmful to the ears, in other words, ototoxic. Specifically, some platinum drugs such as cisplatin is highly ototoxic and this is well documented in research.
As a healthcare provider, I’m an advocate for improving one’s health but I feel one’s quality of life is just as important. Especially when someone has survived cancer and there may be a risk or recurrence or new disease, you want to optimize their social and emotional well-being by ensuring they have the tools to communicate well.
A well-known researcher in the field of ototoxicity and Audiology, Dr Kathleen Campbell, has experienced this first hand with her family member and reinforces the importance of monitoring someone’s hearing throughout their cancer journey when treated with these ototoxic drugs (read her interview here). Not only is regular monitoring important, but also providing these individuals with digital hearing aids that can accommodate the changing hearing loss through their cancer journey. It’s just as important for them to be able to stay connected with their loved ones as it is for them to continue fighting.
So what would be considered an ototoxic event? The American Speech-Language Hearing Association (ASHA) defines a significant ototoxic event as meeting one of the three criteria:
a) more than 20 dB decrease at any one test frequency
b) more than 10 dB decrease at any two adjacent frequencies, or
c) loss of response at three consecutive frequencies where responses were previously obtained.
If this is duplicated after 24 hours, then it’s considered an ototoxic change.
Who can determine these side-effects? A licensed Audiologist would be able to test your hearing and monitor these changes and have frank discussions about the status of you or your loved one’s hearing ability.
Dr Campbell suggests regular monitoring before each round of chemo and after the full course of treatment. That way, a baseline can be established and any changes because of each chemo treatment session can be documented.
This is particularly important for children, since they are at greater risk of ototoxicity than adults. These children should have long-term audiologic follow-up when a hearing loss is detected during and after chemotherapy.
June is National Cancer Survivor Month. Focusing on the fight against cancer is very important, but let’s not lose focus on the person and their need for connectedness throughout their journey.
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