Ringing in the ears during chemotherapy

Ringing, buzzing, whistling or hissing in the ears is called tinnitus. During chemotherapy it matters because, with some medicines, it can be the first warning that the inner ear is being affected. The main medicine linked with this is cisplatin, and less often carboplatin. These medicines can damage the tiny hair cells in the inner ear that turn sound into signals for the brain, and ringing often appears before any noticeable hearing loss.

People often ignore it, thinking it is minor or will pass. But reporting it before your next dose gives your team the chance to test your hearing and, if needed, adjust the treatment plan while hearing can still be protected. Once hearing loss from these medicines has developed, it usually does not recover. Ringing can also come from other causes, such as ear wax, loud noise, high blood pressure, some antibiotics, anxiety or poor sleep, which is another reason to get it checked.

It can come and go

Ringing may be worse after a dose, at night or in quiet rooms. Even intermittent ringing should be reported.

It may affect one or both ears

Medicine-related ringing usually affects both ears. Ringing in one ear only, or with sudden hearing loss, needs prompt checking for other causes.

Your report can change the plan

Your oncologist may arrange a hearing test and consider changes to protect your hearing.

It cannot tell you whether your ringing is caused by chemotherapy or something else, or whether it will lead to hearing loss. That needs a history, an ear examination and often a hearing test.

It also cannot tell you whether your treatment should change. Your oncologist balances the importance of each medicine for your cancer against the risk to your hearing. That decision should be made together, with full information.

Coping with ringing day to day

Soft background sound, such as a fan, quiet music or nature sounds, can make ringing less noticeable, especially at night.

Avoid loud noise

Firecrackers, loudspeakers at weddings and festivals, and loud headphones can worsen ear damage. Keep your distance and use ear protection.

Stress and sleep affect ringing

Ringing often feels louder when you are anxious or tired. Relaxation and good sleep habits can help you cope.

Children may not describe it

Children may not mention ringing. Ask them gently whether they hear noises in their ears, and watch for changes in hearing or behaviour.

Blood pressure is worth checking

High blood pressure can cause or worsen ringing, and some treatments raise it. Ask for it to be measured.

Ringing can persist after treatment

For some people it continues. An audiologist can offer strategies, sound therapy and hearing aids that reduce its impact.

Keep your hearing test results

Store copies with your treatment summary. Future doctors can compare them if ringing or hearing changes later.

Do not try ear drops without advice

Oils or drops will not help inner ear ringing and can cause problems if the eardrum is damaged. Ask first.

Your concern is valid

You are not being fussy by reporting a ringing ear. It is exactly the kind of early information your team needs.

Keep a simple ringing diary

Note each day whether ringing was present, how loud it felt and whether it followed a dose. A short diary helps your team see whether it is getting worse over cycles.

What to do next

If your ears ring, note the details and tell your team before your next dose. Ask whether a hearing test is needed, share all your medicines, avoid loud noise, and seek same-day help for sudden hearing loss, one-sided ringing with dizziness, or severe symptoms.