Platinum-Based Chemotherapy: — What to Expect

Hearing loss is a recognised risk with cisplatin, the platinum agent with the greatest effect on the inner ear. It tends to affect high-frequency sounds first. Carboplatin carries a lower risk, and oxaliplatin does not affect hearing in the same way. Your team will arrange hearing tests if you are on cisplatin. Tell them if you notice ringing in your ears or find it harder to follow conversation — these are early signs to report, not wait out.

This is peripheral neuropathy — platinum drugs can affect the nerves that run to the tips of the limbs. It usually begins as a mild tingling or numbness and can build over cycles. On oxaliplatin, there is also a cold-triggered version: touching cold objects or drinking cold water can produce an immediate sharp sensation in the hands, feet or throat. Tell your team at every visit, because how it changes over time affects their decision-making about your treatment.

This is a kidney protection measure and it applies mainly to cisplatin. The drug is processed through the kidneys, and without adequate hydration it can damage kidney cells directly. The large volume of fluid is given intentionally — it flushes the kidneys throughout treatment and reduces the risk of lasting harm. It is part of the treatment plan, not something that has gone wrong.

For some people it improves gradually over months once treatment is complete. For others, some degree of tingling or numbness persists for longer. We do not yet have reliable ways to predict who will recover fully. This is why your team tracks the symptom carefully through treatment — the pattern over cycles informs decisions about continuing, pausing or adjusting what you receive.

This depends on your specific blood results and which agent is being considered — it is a decision for your treating oncologist, not a general rule. Some patients with reduced kidney function receive carboplatin with careful monitoring. Cisplatin is generally avoided when kidney function is significantly reduced. If you are concerned about your kidney results, raise it at your next appointment so your team can review them directly with you.

Ask your team before taking any supplement, herbal preparation or medicine, because some can interact with chemotherapy. If you are on oxaliplatin, cold food and drinks can trigger or worsen neuropathy in the days after treatment, and many patients find it easier to avoid them during that period. If you are on cisplatin, staying well hydrated between sessions supports kidney protection. Your oncology team is the right source for advice specific to your regimen.