Hearing loss and ringing ears after cancer treatment

Usually, yes. Some cancer treatments can damage the delicate hair cells in the inner ear that turn sound into signals for the brain. These cells do not grow back, so hearing loss caused by treatment is generally permanent. The medicine most strongly linked with this is cisplatin, and to a lesser extent carboplatin, especially at high amounts or before stem cell transplant. Radiotherapy to the head and neck, particularly near the ears or brain, can also affect hearing, sometimes years later. Some antibiotics used to treat infections during cancer care, and certain water tablets, can add to the risk. Hearing loss typically begins with high-pitched sounds, which can make speech harder to follow, especially in noisy places, and may be accompanied by ringing or buzzing in the ears.

Children are particularly affected, both because they are more vulnerable and because hearing is essential for learning speech, language and reading. Even mild high-pitched hearing loss can affect a child's understanding in a noisy classroom and their progress at school. Hearing loss after cisplatin usually develops during or soon after treatment and then stays stable, but in some people it can worsen over the following years, especially after radiotherapy or with further noise exposure and ageing. This is why hearing checks are part of long-term follow-up for survivors at risk.

Although the damage cannot usually be reversed, a lot can be done to help. Hearing tests by an audiologist show the pattern and degree of loss. Hearing aids are effective for many people, including children. Classroom support, such as sitting near the teacher, using sound systems and speech therapy, helps children learn. Protecting remaining hearing from loud noise, managing ringing ears with sound therapy and support, and telling doctors about hearing loss before any treatment with ear-affecting medicines are all important. This page explains the general picture; an audiologist can assess your hearing.

Damage is usually permanent

Inner ear hair cells do not grow back.

High-pitched sounds go first

Speech in noisy places becomes harder to follow.

Help is effective

Hearing aids, classroom support and noise protection make a big difference.

It cannot tell you whether your hearing has been affected or how much. A hearing test by an audiologist can answer that.

It also cannot recommend a specific hearing aid. An audiologist can advise on the right device for you.

Signs of hearing loss in adults

Adults may notice difficulty following conversations in groups or noisy places, turning up the television, asking people to repeat themselves, missing high-pitched sounds such as birds or alarms, or ringing in the ears. Family members often notice before the person does.

Signs of hearing loss in children

Children may not respond when called, seem inattentive, have delayed speech, struggle at school or turn up devices. Hearing tests are especially important after cisplatin in childhood.

Hearing aids and cost

Hearing aids vary in price. Ask about government schemes, hospital programmes and charities that support hearing aids, particularly for children.

Noise protection

Protect remaining hearing by avoiding loud music, using ear protection at noisy events or workplaces, and keeping headphone volume moderate.

Before future treatment

If you ever need treatment with medicines that affect hearing, tell your doctors about existing hearing loss so they can monitor or choose alternatives.

Emotional impact

Hearing loss can cause isolation and frustration. Support groups, counselling and communication strategies help.

Communication tips for families

Face the person when speaking, reduce background noise, speak clearly without shouting, and rephrase rather than repeat.

How hearing is tested

Adults and older children usually have a hearing test listening through headphones and signalling when they hear sounds of different pitches and volumes. High-frequency testing may pick up early damage. Very young children may have tests that measure ear responses without needing them to respond.

Monitoring during treatment

For people receiving cisplatin, especially children, hearing may be tested before and during treatment so changes can be discussed early with the oncologist.

Hearing aids for high-pitched loss

Modern hearing aids can be adjusted to boost high-pitched sounds specifically, improving speech clarity. Regular follow-up with an audiologist keeps the settings right.

Other listening devices

Devices that connect phones or televisions directly to hearing aids, captioning, and apps that convert speech to text can make daily life easier.

Cochlear implants

For severe hearing loss that hearing aids cannot help, cochlear implants may be considered. An ear, nose and throat specialist can advise.

Hearing and work

At work, sitting where you can see speakers, using captioned video calls and asking colleagues to face you help. Employers can make reasonable adjustments.

Children at school

Teachers may not know about treatment-related hearing loss. Share hearing test reports, request front-row seating, ask teachers to face the class while speaking, and consider speech therapy.

Ringing ears and sleep

Ringing is often more noticeable in quiet rooms at night. Background sounds, such as a fan or soft music, can make it less intrusive.

Balance problems

Some treatments affect the balance part of the inner ear, causing unsteadiness. Report dizziness, as balance exercises can help.

Ear infections and wax

Blocked wax or infections can worsen hearing further. See a doctor for ear pain or discharge, and avoid inserting objects into ears.

Protecting children's ears

Keep headphone volumes low for children who had cisplatin, and use ear protection during loud events or festivals with firecrackers.

Emotional support for families

Parents may feel guilt or worry about hearing loss caused by treatment that was needed. Talking with the team and other families can help.

Keeping hearing reports

Keep hearing test reports with treatment records so changes can be compared over time.

Hearing checks as adults

Adults treated as children should continue hearing checks if advised, especially if they notice changes.

What to do next

Ask whether your treatment affects hearing, arrange hearing tests if at risk, see an audiologist about hearing aids, arrange school support for children, protect hearing from noise, and seek urgent care for sudden hearing loss.