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The good news: far more people are surviving cancer now than at any other point in history. However, this increase in survivorship has created a new set of medical problems that researchers such as Abraham Jacob, MD, are attempting to resolve.
Hearing loss has become one of modern cancer therapy’s most prevalent side effects. In fact, hearing loss is among the most underreported, yet potentially devastating, side effects endured by many chemotherapy patients. Often, these patients don’t realize that their hearing has been compromised until it is too late to receive treatment.
Dr. Jacob started the Hearing Conservation Program to educate chemotherapy patients about their risks for hearing loss, while suggesting possible interventions to prevent hearing loss or to recover a patient’s hearing. Dr. Jacob is an associate professor with the University of Arizona Cancer Center, the UA Department of Surgery — Division of Otolaryngology and the Bio5 Institute.
“It doesn’t even occur to most cancer patients that their treatment could impact their hearing,” said Dr. Jacob, who, in addition to his role with the UA Cancer Center, is the director of the University of Arizona Ear Institute, which is dedicated to the prevention, detection, treatment and rehabilitation of ear disease through clinical care, research and education.
There have been many incredible innovations in the field of cancer treatment in the last few decades. Patients are now recovering from diseases that were once considered untreatable.
As chemotherapy agents such as cisplatin and carboplatin become more successful and patients live longer, healthier lives, oncologists are discovering side effects that can seriously impact a patient’s quality of life. One such impact is ototoxicity — damage to the inner ear by a toxin.
The hearing loss begins in the upper frequencies; often well above the range for speech recognition. The patient doesn’t realize that the damage has begun until ototoxicity has irrevocably impacted the cochlear hair cells and other critical parts of the inner ear.
This field of study is relatively new, as many cancer patients simply didn’t survive long enough to experience significant hearing loss. But as life expectancy grows, the need for patient education grows along with it.
“Of course, treating the cancer is of primary importance,” Dr. Jacob said. “However, we now have the tools to maintain patients’ quality of life after they have been cured of cancer — monitoring and potentially treating their hearing loss.”
Prior to starting chemotherapy, patients are asked to obtain a baseline audiogram from Stephanie Adamovich, PhD, an audiologist recruited to the UA Ear Institute. This includes ultrahigh frequency testing — something that is only available in Tucson at the University of Arizona Medical Center. Otoacoustic emissions, as well as other specialized measures, are also performed. Then, follow-up hearing tests to monitor changes in hearing are planned at regular intervals according to a schedule recommended by the audiologist.
If sudden chemo-related ear damage is detected, the patient may be a candidate for intratympanic steroid injections to prevent further hearing loss or perhaps even recover function.
“We have the only university-based Otology/Neurotology program in the state of Arizona,” Dr. Jacob said. “Our active laboratory and clinical research program ensures that patients are offered only the most up-to-date treatment options. We hope to work together with the oncologists to ensure that the patient’s hearing remains unaffected as they receive treatment.”
To schedule an appointment with Dr. Jacob, please call (520) 694-1000. Oncologists interested in having their patients enroll directly in this innovative University of Arizona Cancer Center program should contact Dr. Adamovich with the University of Arizona Medical Center Audiology Clinic at (520) 694-5008.
-Nick Prevenas, updated Feb. 26, 2013