Hearing issues common among cancer survivors

More than half of adults who underwent chemotherapy for breast, gastrointestinal, gynecologic or lung cancer had confirmed hearing loss, and more than 35% had tinnitus, according to data published in BMJ Supportive & Palliative Care.

The associations were observed regardless of platinum- or taxane-containing chemotherapy regimens, Christine Miaskowski, RN, PhD, FAAN, professor and vice chair for research and Sharon Lamb Endowed Chair in Symptom Management Research at the University of California, San Francisco, and colleagues reported.

In light of the findings, Miaskowski said that primary care physicians should screen patients with cancer for hearing loss and tinnitus at each visit during the time they are receiving chemotherapy.

“When the treatment is completed, it would be prudent to send the survivor for a hearing test because survivors often do not always perceive the amount of hearing loss that occurs following chemotherapy,” she told Healio.

Most research investigating the link between hearing loss and chemotherapy has been conducted in children, according to the researchers. The limited amount of research in adults has focused on those with head and neck cancer who received platinum-containing chemotherapy regimens.

Only a handful of case reports and small studies have investigated the association between hearing loss and platinum compounds, taxane compounds or both in patients with breast, gastrointestinal, gynecological or lung cancer, according to Miaskowski and colleagues, “and findings from these studies are inconclusive.” Further, the researchers reported that no studies have thoroughly characterized the link between tinnitus and platinum and taxane compounds in patients with these cancers.

“Given that these four cancers represent the most common cancer diagnoses in the United States; that platinum and/or taxane regimens are among the most common treatments for these patients; and that no data are available on ototoxicity and tinnitus in survivors with these cancer diagnoses, the purposes of this study were to evaluate for differences in the occurrence rates and effects of hearing loss and tinnitus in survivors who received a platinum-containing chemotherapy regimen (ie, platinum alone), a taxane-containing chemotherapy regimen (ie, taxane alone), or a platinum- and taxane-containing regimen (ie, both platinum and taxane),” Miaskowski and colleagues wrote.

The study included 273 adults with breast, gastrointestinal, gynecologic or lung cancer. Among them, 12.8% had received a platinum-containing regimen, 56.8% received a taxane-containing regimen and 30.4% received a regimen containing platinum and taxane. On average, participants were aged 61 years and completed cancer treatment approximately 5 years earlier, according to a press release.

The participants self-reported hearing loss and tinnitus and underwent an audiometric assessment. The researchers adjusted the analysis for age- and gender-related changes in hearing by evaluating each participant’s audiogram using National Health and Nutrition Examination Survey-modified Occupational Safety and Health Administration standards.

Miaskowski and colleagues categorized participants with hearing loss as those who scored in the 50th percentile or less for age and gender, and categorized participants with tinnitus as those who reported being consciously aware of the condition for more than 10% of the time they are awake.

Overall, the occurrence rates for hearing loss ranged from 52.3% to 71.4%, and the occurrence rates for tinnitus ranged from 37.1% to 40%, according to the researchers. There were no significant differences among the three chemotherapy groups.

Among participants who self-reported that they did not have hearing loss, Miaskowski and colleagues reported that 31% were later found to have audiogram-confirmed hearing loss.

“While individuals often underestimate hearing problems, our findings point to the need for cancer survivors to have their hearing tested,” Miaskowski said in the release. “Though the type of hearing loss that occurs with platinum and taxane drugs is permanent, patients’ hearing can be improved with the use of a hearing aid. Only 17% of the survivors in our study were using a hearing aid, which suggests that clinicians need to refer survivors for a hearing test on a routine basis.”

References:

• Cheung SW, et al. BMJ Support Palliat Care. 2022;doi:10.1136/spcare-2022-003684.
• Hearing loss and tinnitus are common in cancer survivors. https://www.eurekalert.org/news-releases/959878. Published July 27, 2022. Accessed July 27, 2022.