Heart, Kidney and Hearing Tests — Before Chemotherapy

The echo is not checking whether your heart is healthy — it is recording exactly how well it pumps today, before any treatment. That measurement becomes your reference point. Some chemotherapy drugs can reduce heart pumping function over time, and the change may be subtle at first. Without a measurement taken before treatment began, a result taken months later has nothing reliable to compare against. The test is about creating a baseline, not about suspecting a problem.

Creatinine clearance measures how efficiently your kidneys are filtering waste from your blood. Some chemotherapy drugs are removed from your body through the kidneys, and if kidney function is reduced, those drugs can accumulate rather than clear. Your oncologist uses this result to understand your kidney function before treatment begins, so they can plan your care appropriately. This is not about excluding you from treatment — it is about ensuring the treatment given is appropriate for your body at that moment.

The hearing test is most commonly ordered before drugs that are known to carry a risk to the inner ear. Your oncologist decides whether a hearing test applies to your specific planned treatment — it is not ordered for every chemotherapy regimen. The test captures your baseline hearing across a range of frequencies, including high pitches that ordinary conversation does not reach. Damage from certain drugs often begins in that high range, which is why a starting measurement matters even when your hearing currently seems completely normal.

If your echo shows that your heart's pumping function is below what your oncologist considers appropriate for the planned treatment, they will discuss the options with you. This might mean a review with a cardiologist before chemotherapy begins, a different approach, or monitoring with more frequent echo tests during treatment. It does not automatically mean you cannot have any treatment. The value of the test is exactly this — it gives your team the information to act before a problem arises, not after.

Many oncology teams repeat the echocardiogram at intervals during treatment, particularly if you are on a drug that affects the heart over time. Kidney markers are often checked regularly as part of routine blood tests throughout chemotherapy. Whether and how often your tests are repeated depends on the drugs you are receiving and your baseline results. Ask your oncologist at your pre-treatment appointment so you know what monitoring to expect during your treatment course.

That depends on the chemotherapy you are about to start and how your health has been since the last test. Some oncology teams will accept a recent echo done within a set window; others require one taken closer to the start of treatment. Do not assume a recent result will be accepted, and do not assume you need a repeat without asking. Your oncologist's team can tell you in one conversation whether the existing result is sufficient for your planned regimen.

Mention it to your oncologist. Not every regimen requires all three tests, and your team may have had a reason for the order they chose. What matters now is that your team has the information they need going forward. Some tests can still be done during treatment and used as a reference for monitoring from that point. Raising it is about better care from here on, not about revisiting past decisions.

In most cases they do not cause a significant delay. The echocardiogram and hearing test are outpatient procedures. The creatinine test is a blood or urine test with a quick turnaround. If all results are normal, your team moves forward. If a result raises a question, the short pause to investigate is protecting you — it is a clinical reason to wait, not a bureaucratic one. Ask your team's coordinator whether the tests can be booked alongside other pre-treatment appointments so they run in parallel rather than in sequence.