Some people with leukemia experience changes in their hearing, including hearing loss. Research has found that between 15 percent and 40 percent of people living with leukemia experience ear symptoms, including hearing loss. In some cases, this complication arises after a person has started treatment for leukemia. In other cases, it’s their hearing loss that initially leads them to seek medical treatment, whereupon their health care provider diagnoses them with leukemia as well.
If you notice changes in your hearing while living with leukemia, talk to your health care team about how to address this complication. While your doctors manage treatment for the cancer itself, they can also advise you of ways to manage your hearing loss — and monitor its progress.
People living with both chronic and acute forms of leukemia are at risk of developing hearing loss. Some people experience gradual changes in hearing in one or both ears. Less commonly, a person with leukemia may experience sudden hearing loss. Problems like tinnitus (ringing in the ears), vertigo (dizziness), and balance issues may also occur.
Hearing loss with leukemia can be caused by a number of conditions related to the disease. In most cases, ear-related (or otologic) problems result from hemorrhage or bleeding, infections, or tumoral infiltration, though other factors can contribute, as well.
Hearing loss can be caused by certain chemotherapy medications or radiation therapy used to treat various types of cancer in children or adults. Medications known to cause hearing loss are referred to as ototoxic medications, and some of these drugs are used to treat leukemia.
Before starting any ototoxic chemotherapy drugs, a baseline record of your hearing, including an audiologic hearing test or audiogram, may be requested by your doctor. This can help your health care team monitor any side effects.
Other medical and surgical cancer treatments considered to be risk factors for hearing loss include:
One of the most important things you can do if you experience hearing loss is to undergo regular hearing tests. This is also crucial for children, as they also have an increased risk of experiencing hearing loss after certain chemotherapy treatments.
Hearing tests can be performed by your usual health care provider, though they may refer you for a follow-up visit with a specialist. An audiologist is a health care professional who specializes in the diagnosis and treatment of hearing loss, as well as balance disorders related to the ears. Another specialist you might be referred to is an otolaryngologist — also known as an ear, nose, and throat doctor or ENT. ENTs are medical doctors who are trained in medicine and surgery. Thanks to this training, they can handle more complex issues relating to hearing loss, tinnitus, and balance issues.
Your doctor may recommend you undergo auditory testing before some types of leukemia treatment as a baseline measure of your hearing pretreatment, and later as a regular part of continued treatment. This is especially true if you are being treated with any ototoxic medications. These tests can help determine what kind of hearing-specific treatments may be necessary. Additionally, people who have had chemotherapy or radiation treatment of the head and neck should have audiologic monitoring every five years (or more, depending on individual needs and disease progression).
Magnetic resonance imaging (MRI) and computed tomography (CT) scans may also be recommended to check the bony parts of the inner ear, as well as the other temporal bones that surround the ear canal and protect the brain’s temporal lobe.
There are many options for treating and managing hearing loss. Some involve attempting to reverse hearing damage, while others aim to help those with existing hearing loss better manage daily activities.
For some people with leukemia-associated hearing loss, a treatment called leukapheresis may reverse the damage done by cancer treatments (if performed early on). Leukapheresis is prescribed for people with excess white blood cells and involves passing your blood through a special machine. This machine removes white blood cells, including leukemia cells, from the blood before returning the rest of your blood and plasma back into your body.
Special medical devices are available to help people hear better. The most common are hearing aids. Hearing aids are small devices that can be worn in or around the ear to help amplify sounds and make it easier to hear. They can also help with tinnitus.
Hearing-assisted technology systems (HATS), sometimes called assistive listening devices, can work in several different ways. Some amplify the sounds around you to help you hear better, while others work by changing sounds to text, allowing you to read what is being said. Certain kinds of HATS communicate through a hearing aid.
Different types of HATS include:
Cochlear implants are a surgical option recommended for some people dealing with severe hearing loss. The cochlea is the part of the ear that transmits sound waves received from the middle ear into nerve impulses, which are then interpreted by the brain as sounds. Cochlear implants work by stimulating the auditory nerve and the cochlea. They will not help hearing loss caused by damage to the nerve that carries hearing signals to the brain.
Cochlear implants have two parts: electrodes that are surgically implanted in the inner ear and an external part that is worn behind the ear. Though they can’t restore normal hearing, the combination of a cochlear device and auditory therapy following the surgery helps improve hearing and quality of life for many people.
If you or a loved one is experiencing hearing loss associated with leukemia, get support from people who understand. On MyLeukemiaTeam, the social network for people diagnosed with leukemia and their loved ones, more than 9,000 members ask questions, share stories, enjoy conversations, and get support from people around the world who know what you’re going through.
Have you developed hearing loss with leukemia? How did you and your health care team manage it? Share your experience in the comments below or by posting on MyLeukemiaTeam.