The effects of chemo on hearing

With World Hearing Day observed on 3rd March, Janine Hansrajh explains the importance of undergoing a hearing screening prior to commencing chemotherapy treatment.


Unfortunately, certain chemotherapy drugs are potentially ototoxic (toxic to the ear). Ototoxicity refers to medication that causes the auditory and/or vestibular system to dysfunction, resulting in hearing loss, tinnitus (ringing in the ear) and imbalance.

These drugs and other chemicals destroy hair cells in the inner ear, specifically the cochlear which is the organ of hearing.

Hearing loss resulting from ototoxicity usually affects the high frequencies initially, thereafter progressing to the mid to low speech frequencies.

It is important to discuss ototoxicity with your oncologist prior to commencing chemotherapy to try and preserve hearing post treatment.

It is of utmost importance that one has a hearing assessment prior to starting chemotherapy. Based on the hearing test results, the audiologist will inform your oncologist as soon as hearing loss is detected, so that the dosage and frequency of the chemotherapy can be altered and replaced with less ototoxic medication, where possible.

Process of monitoring for ototoxicity:
  • An initial hearing assessment on day 0 or within 24 hours of commencing chemotherapy.
  • Weekly hearing assessments while on treatment.
  • An exit evaluation upon completion of treatment.
  • Further monthly testing, for a period of six months, post completion of treatment.

Hearing loss resulting from ototoxicity is usually permanent sensorineural hearing loss and is irreversible. Based on the degree of hearing loss, your audiologist may recommend the fitment of a hearing aid device.

Depending on your individual medical aid plan,  with motivation from your oncologist, these hearing assessments are likely to be covered under the oncology benefit.

Janine Hansrajh qualified as a speech pathologist and audiologist at the University of the Witwatersrand in 2008. She is in private practice at both Lenmed Ahmed Kathrada and Randfontein Private Hospitals. Her areas of interest include adult neuro-rehabilitation, paediatric dysphagia and hearing loss associated with ototoxicity. She is also a member of the multi-disciplinary team at the Ahmed Kathrada Cancer Institute.

MEET OUR EXPERT – Janine Hansrajh

Janine Hansrajh qualified as a speech pathologist and audiologist at the University of the Witwatersrand in 2008. She is in private practice at both Lenmed Ahmed Kathrada and Randfontein Private Hospitals. Her areas of interest include adult neuro-rehabilitation, paediatric dysphagia and hearing loss associated with ototoxicity. She is also a member of the multi-disciplinary team at the Ahmed Kathrada Cancer Institute.


2 Replies to “The effects of chemo on hearing”

  1. Hi, had 16 Chemos and 30 radiations between.May 2019 and Dec 2019. Had singing/ringing in ears from early on with chemo treatment and informed Oncologist. Finished radiation 13 Dec and still have ringing in left ear on and off. Is it going to get worse?

    1. Hi Tessa, unfortunately we can’t answer that. I would suggest speaking to your oncologist and ask him/her to refer you to a hearing specialist. Was any treatment given for the ringing in your ears?

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