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Hearing Loss and Mesothelioma Treatment

Hearing loss, dizziness, and ringing in the ears are not symptoms typically associated with mesothelioma, but they can be caused by the cancer’s most common treatment. Chemotherapy drugs that contain platinum, including some of the most effective drugs for treating mesothelioma, can cause inner ear and nerve damage.

This damage may lead to hearing loss or tinnitus that is not reversible. Radiation therapy, although it is less common may also cause ear damage. Talk to your oncologist before beginning treatments to find out what the risks are and if you can do anything to minimize hearing loss and related damage.

Mesothelioma Therapies

Malignant mesothelioma is a type of aggressive cancer that originates in tissue lining organs in the body, known as the mesothelium. It is almost exclusively caused by exposure to asbestos, and while rare has a big impact on those affected. Mesothelioma in its most common form impacts the tissue around the lungs. This is known as pleural mesothelioma. Peritoneal mesothelioma is cancer of the tissue around the abdominal organs.

A diagnosis of mesothelioma often comes with a poor prognosis; a cure, or even remission, is rarely possible. Treatments, however, can help remove some cancerous tissue, slow the progression of the disease, extend a patient’s life, and provide symptom relief. The most common types of treatment for mesothelioma are combinations of surgery, chemotherapy, and radiation therapy.

Chemotherapy is one of the most commonly used treatment types for mesothelioma patients. Patients receive intravenous drugs that attack and kill cancer cells. These drugs also destroy healthy cells because they are only specific to cells that grow rapidly. The damage to healthy cells can lead to a number of side effects, commonly nausea and hair loss but also rarer effects like hearing loss.

Radiation therapy can also be used to destroy cancer cells and is more targeted than chemotherapy. A beam of high-energy particles is directed at the site of a tumor to kill the cells. Although directed, this kind of therapy can also cause damage to healthy tissue. The radiation has to pass through skin, other tissue, and organs to get to cancerous cells. Skin damage and fatigue are common side effects, but depending on the tumor location, hearing loss can also be an issue.

Chemotherapy and Ototoxicity

Ototoxicity is a term used to describe damage drugs cause to the parts of the inner ear related to hearing and balance or damage to nerves related to hearing. This kind of damage can cause hearing loss, from mild to severe. Ototoxicity can also cause issues with balance, which is regulated by the inner ear, and tinnitus, a ringing sound in the ears.

There are many drugs that are considered ototoxic, that is they can cause this kind of ear and nerve damage that impacts hearing. For patients with mesothelioma undergoing chemotherapy, cisplatin and carboplatin are among the drugs most likely to cause ototoxicity. These are also two of the most common chemotherapy drugs used for mesothelioma, often in combination with other drugs. Symptoms of ototoxicity include:

  • Dizziness
  • Loss of balance
  • Diminished hearing or loss of hearing
  • Ringing or buzzing sound in the ears

Cisplatin and carboplatin cause damage and symptoms of ototoxicity because of the platinum they contain. This heavy metal can damage the protective sheath of the protein known as myelin that surrounds nerve endings. Platinum also damages any exposed parts of nerves, including the fine endings. Approximately 20 percent of patients being treated with a platinum-based chemotherapy drug will suffer some degree of hearing loss and damage.

Radiation and Hearing Loss

Damage to the ear and nerves that results in hearing loss is much less commonly caused by radiation for mesothelioma patients. It is a serious issue for anyone receiving radiation for head and neck cancers. The proximity of the radiation to the ear in these cases can lead to damage. In addition to inner ear damage, radiation may cause inflammation, stiffness in ear bones, or fluid accumulation.

This damage from radiation therapy can be a concern for anyone with metastatic mesothelioma that has spread to the head or neck. If you will be receiving radiation therapy in this area, you may experience hearing loss as a side effect.

Preventing Damage and Hearing Problems

The damage to the ear and nerves and resulting hearing loss and tinnitus caused by chemotherapy drugs usually does not resolve. The damage is cumulative and can progress slowly making it difficult to notice until it transitions from mild to moderate or severe. While it may not be possible to prevent all damage in every case, patients may be able to switch drugs and minimize hearing loss and other symptoms by catching it early.

If you are being treated with platinum-based drugs, be aware of your hearing and any ringing sounds. Let your doctor or oncologist know right away if you notice anything unusual, such as not hearing things as well as you used to. You can also request that your doctors give you a baseline hearing test before treatment and then follow up with periodic tests to determine if there is any damage.

Another way to minimize or try to prevent hearing loss with chemotherapy is to take an additional drug. Researchers are developing drugs that stop platinum drugs from damaging the small nerves that affect hearing. These are new drugs, and they may cause additional side effects.

Coping with Hearing Loss or Tinnitus

It is important to balance the risks and the benefits of any medical treatment. If you are being treated for mesothelioma you may choose to go with aggressive treatment and live with any side effects like hearing loss and ringing in the ears. If you do experience this permanent type of damage, you can learn to cope with it.

Poor health can worsen tinnitus, for instance, so eating a good diet and being as active as possible, getting enough sleep, and finding ways to manage stress can help reduce it and allow you to better cope. For hearing loss, a hearing aid may help. It is also important to let loved ones know about your limitations so that they will speak more loudly and take steps to include you in conversations.

Support groups for patients with cancer, especially mesothelioma can also be a powerful way to cope with all the troubling aspects of living with this disease. The cancer itself and all the treatments trigger a number of uncomfortable symptoms and side effects that you now have to live with, but you are not alone. Join an online or in-person support group to share your feelings and learn from others.

Page edited by Dave Foster

Dave has been a mesothelioma Patient Advocate for over 10 years. He consistently attends all major national and international mesothelioma meetings. In doing so, he is able to stay on top of the latest treatments, clinical trials, and research results. He also personally meets with mesothelioma patients and their families and connects them with the best medical specialists and legal representatives available.

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