Clinical hearing sciences
Treatment for cancer has improved significantly in recent years, with two-thirds of people now surviving to 5 years or more after diagnosis. As part of the variety of available treatments, platinum-based chemotherapy drugs are in widespread use for the treatment of a number of common cancers. Whilst their effectiveness has contributed to improvements in survival rates, these drugs are ototoxic (cause damage to the inner ear) and thus associated with a significant risk of cochlear hearing loss and tinnitus. For example, a recent study of the ototoxic impact of cisplatin in the treatment of testicular cancer found that one in five of the adult survivors experienced permanent severe/profound hearing loss, and troublesome tinnitus was reported in two in five. Similar figures are seen in other cancer diagnoses, and these hearing symptoms can have significant adverse implications for quality of life. The research data regarding the development of hearing loss and tinnitus consist in the main of observational studies, with testing before and after treatment which is usually limited to standard audiometric frequencies (250Hz-8kHz), rather than the higher frequencies (10-16kHz) which are potentially more sensitive to ototoxic change. There is sparse information available about the ongoing and long term effects and impact of tinnitus and hearing loss associated with platinum-based chemotherapy, though there are indications that the Oncology clinical community are becoming interested in these occurrences.
By Chittka L, Brockmann [CC BY 2.5 (http://creativecommons.org/licenses/by/2.5)], via Wikimedia Commons.
Within the Clinical hearing sciences theme we will be researching tinnitus and hearing loss associated with platinum-based chemotherapy, looking at:
- How often this occurs
- How severe and burdensome the symptoms are
- Whether it is possible to predict who will develop these symptoms
- How people can best be treated and supported
It is hoped that increased knowledge in this area will support early identification of those survivors of cancer who are likely to develop ongoing functional limitation, handicap, and reduced health-related quality of life as a result of auditory symptoms, and will help to shape optimised and timely interventions.
The research work is being developed in conjunction with Oncology doctors, nurses and pharmacists, and the early review stage of what is presently known has been supported by a grant from the British Tinnitus Association.
Projects we are working on currently include:
- Scoping reviews of ototoxicity associated with platinum-based chemotherapies in adult survivors of cancer
- Long term impact of hearing loss and tinnitus associated with platinum-based chemotherapy in adult survivors of cancer
- Systematic review of genetic susceptibility to ototoxicity associated with platinum-based chemotherapy
- Feasibility study of the testing for and detection of ototoxicity with self-administered hearing tests in adults with cancer treated with platinum-based chemotherapy
- Systematic review of diplacusis