Ringing in your ears on chemotherapy: what cisplatin can do to hearing

If you have noticed a ring, hiss or buzz in your ears since starting treatment, the first thing to find out is whether cisplatin is in your regimen.

MedlinePlus is unambiguous about cisplatin: it may cause serious hearing problems, especially in children. That is not a footnote buried in a list of rare effects. It sits in the special-precautions section, which is where the important warnings live.

Look at your treatment plan or ask your nurse for the drug names. Knowing which drug you are on changes what you should be asking for.

MedlinePlus says your doctor will order tests to monitor your hearing before and during your treatment.

That before is the useful word. A hearing test done after you have already noticed a problem tells your team what your hearing is now. A test done before treatment tells them what has changed. Small shifts that you would never notice yourself can show up on a chart, and that is often the point at which decisions get made.

If nobody has mentioned a hearing test and you are being scheduled for cisplatin, ask. It is a fair question and a routine one.

A baseline you never needed costs nothing. A baseline you needed and do not have cannot be recreated.

This is the question everyone wants answered, and the answer is genuinely uncertain.

MedlinePlus states that hearing loss may be permanent in some cases. Read that carefully. Not always permanent. Not never. Some cases.

We cannot tell you which group you are in, and neither can a website. That depends on your dose, your cumulative exposure, your age and what your tests show. Your oncologist and audiologist are the people with the data.

What we can say is that "may be permanent" is a good reason not to sit quietly on new symptoms for another three weeks until your next appointment.

MedlinePlus lists hearing loss, ringing in the ears and dizziness together among the symptoms to tell your doctor about.

The same page lists other serious effects to report immediately, including pain, burning or tingling in the hands or feet, sudden changes in vision including colour vision, and swelling, pain, redness or burning at the injection site.

None of these are things to save up for later. The reason they are grouped as report-immediately items is that early action is sometimes possible and late action often is not.

MedlinePlus advises, in the same hearing warning, that you tell your doctor and pharmacist if you have ever had radiation therapy to your head. It does not say by how much that changes your risk, only that your team should know.

If your treatment history includes head or neck radiation, even years ago, make sure it is written in the notes the team is actually reading. Old records do not always follow you as reliably as everyone assumes.

The ringing itself can be maddening, particularly at night when there is nothing else to listen to. Many people find some background sound helps, though MedlinePlus does not make recommendations on that.

What it does make clear is the medical path: get tested, keep getting tested, and report changes as they happen rather than after they settle. That is the part within your control.

If your hearing has changed enough to affect conversations at appointments, tell the clinic. Being able to hear what your team is telling you matters as much as any other part of your care.

• Call your care team the same day if a new ringing, hissing or buzzing starts in your ears, if sounds become muffled or speech becomes harder to follow, or if you feel dizzy or unsteady — MedlinePlus lists hearing loss, ringing in the ears and dizziness as cisplatin effects to report immediately.
• Call your care team within a day or two if an existing ringing is clearly louder or more constant than it was, or if a hearing test that was promised before your next cisplatin dose has not been booked.