Cancer Clinical Trial
Official title:
Long-term Ototoxicity in Cancer Survivors Treated With Chemotherapy and the Impact on Quality of Life
This project aims to explore, in depth, the burden of hearing loss and tinnitus on cancer
survivors. Using semi-structured interviews, audiograms and a variety of validated
questionnaires, the specific impact ototoxicity has on quality of life will be investigated.
From this, we can identify the specific needs of patients experiencing hearing loss and
tinnitus following chemotherapy and develop a tailored and personalised support system.
The medical and technological advances in cancer research have caused a decline in cancer
deaths in recent decades. For example, the 5-year survival rate now is above 80% for many
adult cancers, including breast and testicular cancers. In breast cancer alone, the mortality
rate has reduced 39% since 1989 and currently has a 5 year survival rate over 90%. Due to
this increase in survival rates and the intensity of treatment, many face long-term physical
and psychological challenges in survivorship. Cancer survivors may experience altered body
image and changes in sexual health and energy levels in addition to distress, anxiety, the
fear of recurrence and the chronic side effects of their treatment. The need to research the
long-term effects of chemotherapy and the impact they have on quality of life is crucial.
There is a need to broaden research beyond the survival rates and address the need for
support for those who are adapting to a life after cancer. Survivors are left with often
permanent and possible life-debilitating effects from treatment. To date, there has been
little research on the specific late effects of chemotherapy and the associated impact on
quality of life.
Platinum-based chemotherapy, although highly effective, is known to cause ototoxicity,
presenting often as permanent high frequency hearing loss and tinnitus. Hearing loss and
tinnitus are associated with a higher risk of depression, social isolation and anxiety. The
quality of social interactions for a person with hearing loss and tinnitus is diminished as
taking part in conversations becomes challenging. This is particularly problematic as it
means that the quality of life of these cancer survivors is reduced.
The impact hearing loss and tinnitus has on quality of life in cancer survivors remains
unclear and under-studied. Because cancer therapies can potentially cause life-threatening
side effects such as cardiotoxicity and nephrotoxicity, these become the priority. However,
once these side acute effects subside, other long-term side effects remain and can
permanently reduce quality of life. Cancer survivors may have already experienced a difficult
journey from the diagnosis itself, the physical challenges of treatment and finally,
remission. Re-adapting back to their previous life whilst in remission, but with added
permanent side effects, both physically and psychologically, can be extremely difficult for
some survivors.
Currently, there is little information and support offered to these patients who suffer from
ototoxicity, potentially leading to many being undiagnosed and untreated. These patients can
be affected by this toxicity for the rest of their lives, which can have a detrimental impact
on their quality of life. It is essential that a deeper understanding and increased awareness
of how hearing loss and tinnitus affects the quality of life of cancer survivors is sought to
improve long-term symptoms management and support offered. This study aims to develop this
and improve the support given to cancer survivors.
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