Not only the oncological disease, with the series of problems that can affect the organ affected by the tumor and drag on over time. The resulting treatments can have various side effects, which can also be detected in other parts of the body. Among these, there are hearing problems: from its progressive loss to the onset of tinnitus. Consequences have so far been adequately examined especially among those who fell ill in childhood. But actually they are also frequent among adults, with a far from negligible impact on the quality of life. To be able to determine them, the toxicity of chemotherapy.
Hearing loss a consequence of chemotherapy
The information comes from a study published in the journal “BMJ Supportive & Palliative Care” by a group of US otolaryngologists and oncologists. Their work consisted of assessing the prevalence of these disorders – hearing loss and tinnitus – in a group of 273 adult and elderly patients with some of the most common forms of cancer. That is: breast, lung, stomach and colorectal cancers. Plus those of the gynecological sphere: body and cervix, ovary, vulva and vagina. In fact, well over half of those recorded each year in our country. After excluding those who had already suffered from these problems before discovering they had cancer and reconstructing the anamnesis of their disease, from the diagnosis to the therapies performed, the specialists subjected men and women to a series of tests aimed at ascertaining the health of the ear and eardrum (with video otoscope and tympanometry) and a complete audiological evaluation. The results highlighted a high prevalence of ear problems among these patients, who had completed the course of cancer treatment approximately five years earlier. In fact, over 1 in 2 recorded significant hearing loss. Over 1 in 3 had reported episodes of tinnitus.
Risks related to the toxicity of platinum and taxanes
A sign that “these problems are not common only among those who had cancer as a child”, to quote Steven Cheung, neurotologist at the University of California San Francisco and first signing the publication. While such consequences are not in fact a novelty for those who have had testicular or head and neck cancer, little was known of their spread among adults called to deal with some of the most frequent cancers: such as those in the breast, to the colorectal and lung. The cause is to be found in the toxicity of the chemotherapeutic agents used against these diseases: such as those based on platinum and taxanes. The study shows that there would seem to be no differences related to the type of drugs used for chemo. The risk would be almost identical, compared to those that are among the most used active ingredients in these cases.
Hearing loss (in adults) is a risk factor for cognitive impairment
The negative impact that tinnitus and hearing loss have on many daily activities – from rest at night to listening to radio and TV, to the difficulty of conversing with family and friends – is significant. This is why their detection is an aspect that should not be overlooked, to ensure a good quality of life for cancer patients. “Hearing loss in adulthood and old age is considered a risk factor for cognitive impairment – says Eleonora Trecca, medical director of the complex operating unit of otolaryngology and maxillofacial surgery of the Irccs hospital Casa Sollievo della Suffering of San Giovanni Rotondo (Foggia) – This is why it is important to recognize and treat it, even more so in already fragile patients “. If not for those who have passed a pediatric tumor (more at risk due to early exposure to chemotherapy), are struggling or have passed a head and neck cancer (already entrusted to the treatment of the otorine), at the moment there are no standardized protocols that provide for hearing screening in cancer patients. “The ideal would be to monitor hearing conditions before, during and after a course of chemotherapy. Unfortunately, this does not happen automatically”.
Hearing loss in cancer patients: how to treat it?
To determine the hearing problems is the toxicity of drugs – which changes according to the dose and duration of exposure – at the level of the hair cells of the basal gyrus of the cochlea. The consequence is a progressive and bilateral hearing loss, which mainly affects the high frequencies. “This is an irreversible process: this is why early diagnosis is essential – concludes the expert -. Mild forms are usually not treated, but controlled with an annual follow-up. In more complex cases, however, it is uses hearing aids “.