Hearing Loss After Childhood Cancer

Some treatments for childhood cancer can damage hearing. Hearing loss can interfere with daily living, so it is important to have your hearing checked and treated if hearing loss is found. How severe hearing loss is varies by each person. Some people can’t hear high-pitched sounds and others have total hearing loss. Likewise, some types of hearing loss can improve over time while other types cannot.

Am I at Risk?

Certain cancer treatments can affect the ears and increase risk for hearing loss in one or both of them. They include:

  • Chemotherapy from the “platinum” group, such as cisplatin or high doses of carboplatin
  • High doses of radiation to the head or brain, especially if the beam was directed to the brainstem or ear
  • Surgery involving the brain, ear, or auditory nerve
  • Certain antibiotics and diuretics

What Are the Symptoms of Hearing Loss?

Some people don’t have any symptoms; others might have symptoms such as:

  • Ringing or tingling sounds in the ear
  • Trouble hearing when background noises are present
  • Not paying attention to sounds, such as voices
  • Problems in school (see related Health Link: “Educational Issues after Childhood Cancer“)

Should I Have My Hearing Checked?

If you had cancer treatment that can affect the ears, have your hearing tested by a hearing disorder specialist (audiologist) at least once after you finish treatment. You might need additional testing based on the type and dosage of your treatment. Testing should be repeated if hearing loss is found or if you begin to have trouble hearing.

What If I Have Hearing Loss?

If you have hearing loss, many services and tools can help you communicate. They can be used together or separately.

Hearing aids.

These devices make sounds louder. Several types are available to best suit the age and size of the person, as well as the extent of hearing loss.

Auditory trainers.

Also called “FM trainers,” these devices are very helpful in the school setting. The teacher wears a microphone that transmits sound over FM radio waves to the receiver worn by the person with hearing loss.

Other assistive devices.

Some other devices that help people with hearing loss communicate are telephone amplifiers, teletypewriters, and specialized appliances such as alarm clocks that vibrate and smoke detectors with flashing lights.

Telecommunication relay services.

In web-based video relay, an interpreter translates your signed language into voice or text. In voice/text relay, an operator speaks messages you send via teletypewriter.

Cochlear implants.

This device is surgically placed and enables sound perception by the brain in people with profound hearing loss.

Alternate or supplementary communication methods.

These methods include speechreading, signed language, cued speech, and spoken language.

Community and educational resources.

Services such as speech therapy and auditory trainers for the classroom are provided through local public school districts or referral agencies. To receive services parents must usually request an Individualized Education Plan (IEP) for the child (see related Health Link: “Educational Issues after Childhood Cancer“). Many hospitals have a teacher or school liaison that can assist with getting an IEP and other specialized services.

The American with Disabilities Act (ADA, PL 101-136) guarantees people with hearing loss equal access to public events, spaces, and opportunities. This includes text telephones and telephone amplifiers in public places, and assistive listening devices in theaters.

How Can I Protect My Hearing?

If you have or are at risk for hearing loss, be sure to seek treatment right away if you have an ear infection, swimmer’s ear, or earwax blockage. Also, take care to protect your ears from loud noises, which can damage your ears.

Examples of items, activities, and jobs that can increase risk for hearing loss include:

Appliances

Recreation

Occupations

power saws

hunting

firefighters

vacuum cleaners

boating or water skiing

construction workers

lawn mowers, yard trimmers, or leaf blowers

motorcycling or four-wheeling

farmers

headphones

airport workers

amplifiers

cab, truck, and bus drivers

hair stylists

If you can’t avoid exposure to loud noise, you should:

  • Wear hearing protectors, such as earplugs or earmuffs.
  • Limit periods of exposure to the noise by taking breaks and going quieter areas when you can.
  • Be aware of the noise around you and make efforts to limit it.

What Should I Talk With My Doctor About?

Talk with your primary care doctor if you have hearing loss or are at risk for it. If you need medicine at any point, ask your doctor to use alternatives to those that have the potential to cause further hearing loss. Medicine that has this potential include certain antibiotics, diuretics, salicylates (such as aspirin), and medicine used to treat high iron levels.

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