My husband had the 1st of 3 "big bag" cisplatin doses last week, on Tuesday. Beginning on Friday, he's been experiencing very short (like, 1-3 seconds) bursts of ringing in his ears, mostly in the left ear but sometimes in both. It happens about 5-6x/day.

Before he started chemo we talked to his ENT about the cisplatin/hearing loss issue, and he had a hearing test performed. The test showed some very, very slight conductive loss (not neural) in the lower ranges only so the ENT and MO conferred and decided my husband was still a good candidate for cisplatin. The ENT told us that if ringing became a problem, my husband would likely be put on a super high course of steroids and something else (I don�t have my notes with me so I can�t remember what else�possibly an antibiotic?) and that should reverse it before it became permanent loss/tinnitus. Oh, and I think he�ll have to have weekly hearing tests now but I could be making that up; as I said, I don�t have my notes with me.

We have an appointment with the ENT and audiologist tomorrow, and the after that the ENT will confer with the MO and we�ll address the possibility of switching to carbo rather than cisplatin. The preference is definitely to keep him on cisplatin if possible but obviously we don�t want him to have any kind of significant hearing impairment. Right now I�m looking for experience with short bursts of tinnitus rather than the long, continuous ringing. Anyone had this on cisplatin, and: Did it go away? When did it go away? Did you do the steroid/antibiotic course and if so, how did you handle that?

That's how I noticed my now permanent high frequency hearing loss. No it never got better and yes it finally went away but left in it's path the permanent part. I didn't experience any "ringing" until after my 2nd bag (of 3) and really didn't recognize what I was experiencing as "ringing". To me it was more like a very very faith buzz. That was in 2006 and no one mentioned anything that could be done to reverse the damage. Hopefully that has changed.

Hi Heather

Alex's tinnitus eventually went away but he didn't get it until the last of his treatments (or maybe second last). Also, he was having the smaller weekly doses of cisplatin by the time he got to radiation treatment.

Cisplatin caused ototoxicity is dose dependent and cumulative which means that if your husband is getting the tinnitus now with 2 bags to go, there is a risk of permanent hearing loss. I also wonder if the intermittent ringing you mention, is early stages that we all get, although most of us don't recognise it at that point. I have tinnitus myself, and it sort of snuck up on me. I know that I have had bouts for many years, but one day I realised it was there all the time.

Have never heard of high dose steroids to combat this. It doesn't make sense to me. Maybe ask if the doctor is able to explain simply in English, then share with the rest of us for future reference?

I had a quick look around my (now enormous) library and could only find information on transience (reversible)cisplatin induced tinnitus relating to testicular cancer. In that group, there was a small component of the group who had reversible tinnitus (10%). Be careful applying this information to your husband though - the subjects were very young (av 31 years) and may have had different doses compared with your husband. I guess my point is to suggest that it is possible but the odds aren't great???

It can be many things that can cause this condition...ototoxicity, mostly from medications, and tinnitus, including radiation, and it could be referred pain from other structures on the face that share the same ear nerves, from the surgery, an infection, TMJ, growth of the existing tumor or new one, so these will probably be ruled out. If it is chemo related, other than switching to Carboplatin, which has less hearing toxicities, they may slow the rate of the cisplation infusion and give a lesser doses, maybe even weekly. It's good your husbad is going to see the ENTwho can best deal with this.

Good luck tomorrow.

I will defintely update after we see the ENT and audiologist. We're also following up with the MO on Wednesday, but that was a regularly-scheduled follow-up. His recommendation re: the ringing was to increase water intake and see the ENT.

Hi Heather,

Wife had the same issue with Cisplatin, and the ringing of ears.

If it is consistent throughout the day - tell your Medical oncologist and they will probably move you to Carboplatin which will hopefully prevent any long term damage occurring to your husbands high frequency hearing.

Hope that helps.

Hi Heather. My husband had the weekly Cisplatin versus the 3 doses. He didn't have the ringing until his last treatment and unfortunately has permanent hearing loss.

Ok, so we had the hearing test and follow-up with the ENT this afternoon. His hearing is completely normal; in fact, it was improved over the test he had 3 weeks ago. His ENT is comfortable leaving everything as is right now, unless my husband has a full day of ringing. In that case, we're to get another hearing test done and then the ENT will treat it with high-dose steroids and an antiviral (not antibiotics), probably Valtrex. He said that he's seen lots of folks going through the same dose of cisplatin and that in all likelihood this is a transient problem that will resolve.

We'll talk to the MO tomorrow and see what he says, but I suspect he'll agree with the ENT and we'll proceed with the next dose of cisplatin. It's not scheduled until January 2 so we have some time to see if the ringing stays intermittent or if he has an all-day episode.

Thanks for the input, everyone.

Heather,

I just went through this. I too had short boots of ringing during the treatment. The lasted 3 min or so and then went away. Now 4 weeks out and I don't have any problems. My MO told me ~5% have a hearing issue that ranges from minimal to extreme loss of hearing. With cisplatin its a number game. I don't think anyone can tell who will, or how much you will be effected. It's a tough call.

In the autumn of 2011, I had 4 weeks of Cisplatin, before I was switched to 2 weeks of Carboplatin. The low level ringing in my ears began even before I stated my treatment, but it certainly became more discernable as my treatment progressed.
It has never actually tailed off, but then again it has never got any worse, even after 18 weeks of Cisplatin this summer - and this was triple the strength of my dose in 2011.
As I sit here now, in a quiet house before my wife and daughter come home, I can detect the faint fuzzy ringing in my ears. However, on a day to day basis I don't really notice it. I may miss the odd word and my wife occasionally points out that I have the volume on the TV too high, but it's not something that bothers me too much.
Hope your tinnitus if it does surface again is similarly manageable - my Consultants gave me the impression that it was just one of those things I had to accept.