Tinnitus and Hearing Loss Associated With Neurotoxic Chemotherapy

By Emily Menendez - January 3, 2023

Hearing loss and tinnitus often present at the same time, with tinnitus typically caused by age-related hearing loss, frequent exposure to loud noise, ear injury, or issues with the circulatory system. Hearing loss and tinnitus can also be caused by the use of neurotoxic chemotherapy, but little is known about the association. 

Increasing evidence shows that some chemotherapy drugs, including methotrexate, cisplatin, and ifosfamide can cause other neurological side effects besides hearing loss and tinnitus such as cognitive dysfunctions, mood disorders, and seizures. 

Studying Cancer Survivors With Hearing Loss

A study conducted by Cheung S, Henderson-Sabes J, Mastick J, et al evaluated 273 cancer survivors who received a platinum alone, a taxane alone, or a platinum and taxane containing regimen to determine the effect of neurotoxic chemotherapies on hearing loss and tinnitus. 

The patients who took part in the study were survivors of breast, gastrointestinal, gynecological, or lung cancer, and completed self-report measures of hearing loss and tinnitus. An audiometric assessment was also performed on the patients to measure their ability to hear frequencies between 0.25 kHz and 16.0 kHz. Each patient’s audiogram was measured using the National Health and Nutrition Examination Survey-modified Occupational Safety and Health Administration standards to account for age- and gender-related changes in hearing over time. 

Patients were determined to have hearing loss if at any frequency they scored lower than the 50th percentile for their age and gender. Patients were determined to have tinnitus if they reported conscious awareness of their tinnitus for over 10% of their time spent awake. Differences among the chemotherapy groups were evaluated using parametric and non-parametric tests. 

Results of the Study

Among the 3 chemotherapy groups that were studied, no differences were found in the occurrence rates or effects of hearing loss and tinnitus. The occurrence rates of audiogram-confirmed hearing loss ranged from 52.3% to 71.4%, and the occurrence rates for tinnitus ranged from 37.1% to 40.0%. Overall, common mechanistic pathways may underlie these two neurotoxicities regardless of the chemotherapy regimen taken by patients. 

Caring for Cancer Survivors With Hearing Loss or Tinnitus

As hearing loss and tinnitus is a common issue among cancer survivors who had taken platinum- or taxane-based treatments, several methods exist to aid their hearing. Performing regular hearing tests should be considered for cancer survivors to determine if they have hearing loss or tinnitus, and courses of treatment should be recommended. Hearing aids can help patients with confirmed hearing loss, and while there is no cure for tinnitus, several methods exist to make it less noticeable, such as using white noise machines or a similar device such as a fan or humidifier at night to help cover up the sound. 

As the confirmed presence of hearing loss and tinnitus in many cancer survivors is common, health care professionals should aid their patients in confirming their potential hearing issues early on to provide solutions that can improve the quality of life of cancer survivors. 


Cancer Survivors and Neurotoxic Chemotherapy: Hearing Loss and Tinnitus 

Neurotoxicity of Cancer Chemotherapy