{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"Episode 397: Cancer Symptom Management Basics: Ototoxicity","description":" \u201cReferring patients to audiology early on has shown dramatic reduction in hearing loss or complications because the audiologist can really see where were they at before they started chemotherapy, where were they at during, if they get an audiogram during their treatment. And then after treatment, it\u2019s really important for them to see an audiologist because this is really a survivorship journey for them. And as nurses, the \u2018so what\u2019: We are the first line of defense,\u201d ONS member Jennessa Rooker, PhD, RN, OCN\u00ae, director of nursing excellence at the Tampa General Hospital Cancer Institute in Florida, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS\u00ae, manager of oncology nursing practice at ONS, during a conversation about ototoxicity in cancer care. Music Credit: \u201cFireflies and Stardust\u201d by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 9, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center\u2019s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the management of ototoxicity after chemotherapy treatment. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast\u2122 Cancer Symptom Management Basics series ONS Voice articles: Oncology Drug Reference Sheet: Cisplatin Oncology Drug Reference Sheet: Carboplatin Oncology Drug Reference Sheet: Oxaliplatin FDA Approves Sodium Thiosulfate for Cisplatin-Associated Ototoxicity in Pediatric Patients ONS book: Clinical Manual for the Oncology Advanced Practice Nurse (fourth edition) American Cancer Society resources: 4 Causes of Hearing Problems for Cancer Survivors Cancer Survivors Network American Speech-Language-Hearing Association (ASHA) Hearing Loss: An Under-Recognized Side Effect of Cancer Treatment Embedded Ear Care: Audiology on the Cancer Treatment Team American Society of Clinical Oncology (ASCO) Annual Meeting abstract: Innovative Infusion Center Assessments of Chemotherapy-Induced Neurotoxicities: A Pilot Study Supporting Early and Routine Screenings as Part of Survivorship Programs Children\u2019s Oncology Group supportive care endorsed guideline: Prevention of Cisplatin-Induced Ototoxicity in Children and Adolescents With Cancer: A Clinical Practice Guideline Ear and Hearing article: Roadmap to a Global Template for Implementation of Ototoxicity Management for Cancer Treatment International Ototoxicity Management Group (IOMG) IOMG Wikiversity page Shoebox hearing assessments World Health Organization initiative: Make Listening Safe To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode \u201cAt different pitches, the eardrums move faster or slower, signaling the inner ear, or the cochlea\u2014the thing that looks like a snail in the pictures. The cochlea has fluid and hair cells inside of it that receive movements from the eardrum. The hair cells change the movement into electrical signals that actually go to the auditory nerves or the cranial nerve VIII.\u201d TS 2:15 \u201cOtotoxicity is an umbrella term for some sort of exposure to a toxin that causes damage to the inner ear. These toxins can be in the environment, such as loud or different noises, or they can be from medications, including antibiotics or commonly cancer treatments, such as radiation chemotherapy. Some common chemotherapies can be platinum-based chemotherapies like cisplatin or carboplatin. And then what patients are experiencing if they have ototoxicity can be hearing loss.\u201d TS 3:15 \u201cThe hypothesized mechanism of action is that the chemicals like the platinum compound in cisplatin \u2026 that platinum compound travels through our bloodstream. Since chemotherapy is systemic, it\u2019ll go to the inner ear, and it gets stuck there by binding to the cellular DNA in that cochlea, or that snail-looking image. That initiates the release of the reactive oxygen species, which are really trying to help clean it out, but releases such high levels that it ends up causing damage to those inner ear hairs. These inner ear hairs cannot regenerate themselves, so then they\u2019re permanently damaged. And remember we said that those hairs send electrical signals to the brain that recognize sound. So that function is permanently gone once those hair cells are damaged.\u201d TS 7:10 \u201cI definitely think this is a huge interdisciplinary collaborative effort. As nurses and advanced providers, we\u2019re assessing and providing education. Our medical oncologists are doing those dose modifications and submitting those audiology referrals. The radiation oncologists are very important to know about this\u2014maybe dose localization awareness. Maybe they do some changes with the doses. And then our audiologists and [ear, nose, and throat physicians], they can do that diagnostic confirmation and any rehabilitation measurements and really monitor them throughout their journey as well. And nurse navigators play a huge part in making sure those patients get those referrals, because a lot of the time the audiologists aren\u2019t in the cancer clinic, so they may have to go to another location or may need help coordinating with all their appointments that they have.\u201d TS 22:28 \u201cWe had a really innovative way of monitoring the hearing that a couple other studies have also tested. It\u2019s a remote point-of-care hearing screen. It was on [a tablet] with calibrated headphones. And then it\u2019s a paid-for subscription to an audiology testing platform. \u2026 Myself, along with a couple of other nurses, were trained how to use this testing device with the tablet and the headphones and the software program. And it was a quick down-and-dirty portable hearing assessment for patients. So anyone who was new to cisplatin, never gotten cisplatin treatment before, was enrolled into the study, and they received a hearing test every time that they came for chemo, and we gave it to them during their hydration.\u201d TS 28:59   ","author_name":"The ONS Podcast","author_url":"http:\/\/onsvoice.libsyn.com\/website","html":"