Yes. Some cancer treatments can cause tinnitus, which means hearing ringing, buzzing, or other sounds that are not coming from outside the body. Certain chemotherapy medicines, especially platinum-based drugs, and radiation aimed at the head or neck can affect hearing. Tinnitus may begin during treatment or appear later, and it can be temporary or lasting. Tell your cancer care team promptly about new ringing or hearing changes.
Tinnitus can be an unexpected side effect of cancer treatment. It may sound like a high-pitched ring, a steady hum, a hiss, or a buzzing noise in one or both ears. Sometimes it occurs alongside hearing changes, while in other cases the main problem is the sound itself. Recognizing this possible side effect helps patients report changes early so their healthcare team can assess their hearing and discuss appropriate support without unnecessarily interrupting cancer treatment.
Which cancer treatments can cause tinnitus?
Some cancer treatments can affect the inner ear or the hearing pathways. This is sometimes described as ototoxicity, meaning damage to structures involved in hearing or balance. According to the American Cancer Society, certain chemotherapy drugs, radiation directed at the head or neck, and some antibiotics used during cancer care can cause hearing problems. These effects may include tinnitus, changes in hearing, or balance difficulties.
Platinum-based chemotherapy
Platinum-based chemotherapy medicines are an important example of cancer drugs that can affect hearing. These medicines are used to treat several types of cancer, and the specific drug and treatment plan influence the potential side effects.
- Cisplatin: This chemotherapy medicine is associated with hearing damage and may cause tinnitus or hearing loss.
- Carboplatin: This is another platinum-based medicine that can affect hearing, although the hearing-related risks are not identical for every drug or treatment regimen.
- Oxaliplatin: This platinum-based medicine is also associated with hearing changes, although its effects depend on the treatment context.
The risk is not the same for everyone receiving chemotherapy. The medicine being used, its dose, the overall treatment plan, and a person's existing hearing health can influence the likelihood of hearing-related side effects. Tinnitus alone does not establish that chemotherapy has damaged the ears, so new symptoms should be assessed in the context of the person's care.
Radiation therapy involving the head or neck
Radiation therapy may contribute to tinnitus when the treatment area includes structures involved in hearing. The inner ear contains the cochlea, which helps convert sound into signals that the brain can understand. Radiation involving the head, brain, or neck may affect hearing structures, depending on the treatment plan and the tissues exposed.
This is particularly relevant for some people receiving treatment for head and neck cancers. The American Speech-Language-Hearing Association (ASHA) describes tinnitus and hearing loss among the possible effects of chemotherapy and radiation used in head and neck cancer care. The likelihood and extent of these effects vary with individual treatment circumstances.
Other medicines used during cancer care
Not every medicine associated with tinnitus is an anticancer drug. Some patients receive antibiotics or other medicines to manage infections and treatment-related problems. Certain medicines can also affect hearing. For this reason, healthcare professionals need to know about all medicines a patient is taking, including nonprescription products and supplements.
If ringing starts after a new medicine is introduced, tell the prescribing clinician. The timing may offer useful information, but it does not prove that the medicine caused the symptom. Do not stop, skip, or change a prescribed cancer medicine or another treatment without discussing it with the healthcare team.
When can tinnitus start during or after cancer treatment?
Tinnitus can begin during a course of chemotherapy or radiation therapy, but hearing-related effects may also appear after treatment has ended. The timing depends on the treatment and the person. A new symptom may occur alongside other changes in hearing, or it may be noticed without an obvious reduction in hearing ability.
Some people find that tinnitus improves as they recover from treatment. For others, it continues for months or longer and may become a lasting problem. Macmillan Cancer Support explains that tinnitus associated with some head and neck cancer treatments may improve but can sometimes persist. It is therefore helpful to report symptoms even when cancer treatment has already finished.
New ringing does not automatically mean that permanent hearing damage has occurred. Tinnitus has several possible causes, including hearing loss unrelated to cancer treatment, earwax blockage, ear infections, noise exposure, and other medicines. The National Institute on Deafness and Other Communication Disorders (NIDCD) explains that tinnitus can be associated with different conditions and medications, so evaluating the circumstances around its onset is important.
What other hearing changes can happen with tinnitus?
Tinnitus may occur on its own or alongside other changes involving hearing or balance. Patients sometimes notice that ordinary sounds seem different or that conversations become harder to follow. These experiences are useful to describe to the cancer care team, but they are not a checklist for diagnosing treatment-related hearing damage.
- Ringing, buzzing, humming, hissing, or whistling sounds without an outside source.
- Difficulty hearing certain sounds or following conversations, particularly in noisy surroundings.
- A feeling that hearing has changed in one ear or both ears.
- Dizziness or a feeling of being unsteady.
- Difficulty sleeping or concentrating when tinnitus is persistent or noticeable.
The combination of symptoms, their timing, and any changes from a person's usual hearing can help clinicians decide what evaluation is appropriate. Tinnitus may be present even when a person has not noticed obvious hearing loss. Conversely, hearing changes can occur without tinnitus.
How do doctors evaluate tinnitus during cancer treatment?
The first step is usually to inform the oncology team about the symptom and when it began. The clinician may ask whether the sound affects one or both ears, whether it is constant or intermittent, whether hearing has changed, and whether dizziness or other symptoms are present. Information about the cancer treatment plan, other medicines, previous hearing problems, and exposure to loud noise may also help guide the assessment.
Hearing tests and specialist assessment
An examination may include checking the ears for problems such as wax buildup or infection. Depending on the circumstances, the clinician may arrange a hearing test or refer the patient to an audiologist or an ear, nose, and throat specialist. Hearing tests measure how well different sounds can be heard and can help identify changes that may not be obvious in everyday conversation.
For treatments known to affect hearing, the care team may recommend a baseline hearing assessment before treatment begins, followed by additional testing during or after treatment. Comparing results over time can help identify changes and inform decisions about further monitoring or supportive care. The timing and frequency of these assessments depend on the treatment regimen and the patient's clinical needs.
When tinnitus begins unexpectedly, the clinician may also consider causes unrelated to cancer treatment. There is no single evaluation that is appropriate for every patient. The assessment should reflect the symptoms, medical history, examination findings, and the specific treatment being received.
What should you do if your ears start ringing during cancer treatment?
Contact your cancer care team promptly when tinnitus appears for the first time, becomes more noticeable, or occurs alongside changes in hearing or balance. Reporting it early gives the team an opportunity to assess the problem and consider whether further testing or a specialist referral is needed. Mention when the sound started, whether it affects one or both ears, and any recent changes in medicines or treatment.
Do not delay reporting the symptom until your next routine appointment if it is new or worsening. Most importantly, do not stop chemotherapy or radiation therapy on your own. The oncology team can weigh the benefits of cancer treatment against possible side effects and determine whether monitoring, additional evaluation, or a change in the plan should be considered.
Seek emergency medical care immediately if tinnitus occurs with sudden hearing loss, facial weakness, severe spinning dizziness, or after a significant head injury. These symptoms can require urgent evaluation rather than waiting for a routine oncology visit. The UK National Health Service (NHS) identifies these combinations as reasons to seek immediate help. Tinnitus that beats in time with your pulse should also be assessed urgently.
Can tinnitus from cancer treatment be managed?
Management depends on the likely cause, whether hearing has changed, and how much tinnitus affects daily life. When an identifiable problem such as an ear infection or wax buildup is found, treating that problem may help. If the tinnitus is associated with hearing loss caused by treatment, the care team may focus on supporting hearing and reducing the effect of the sound on everyday activities.
Depending on the evaluation, supportive options may include:
- Hearing aids: When hearing loss is present, hearing aids may improve access to everyday sounds and communication. Some devices can also help make tinnitus less noticeable.
- Sound therapy: Soft background sounds or suitable sound devices may make tinnitus less intrusive, particularly in quiet environments.
- Counselling or cognitive behavioral therapy: These approaches may help people manage distress, sleep difficulties, or problems concentrating when tinnitus becomes disruptive.
- Audiology and hearing rehabilitation: A hearing specialist can discuss communication strategies and available support based on the person's hearing needs.
There is no single treatment that reliably eliminates tinnitus for everyone. The NIDCD describes several approaches that may reduce its impact, including sound-based approaches and behavioral therapies. A suitable plan should be chosen with the healthcare team, particularly when tinnitus develops during active cancer treatment.
Does the risk differ between children and adults?
Children receiving certain cancer treatments need particular attention to hearing changes because hearing is important for speech, language, learning, and communication development. When treatment may affect hearing, the care team may recommend monitoring and follow-up suited to the child's needs. Parents and caregivers should report concerns about hearing, communication, or balance to the child's oncology team.
Older adults may already have hearing changes related to age or previous noise exposure, which can make it harder to identify the contribution of cancer treatment. Adults of any age can develop treatment-related hearing effects, so decisions about monitoring should be based on the specific treatment plan and clinical circumstances rather than age alone.
What is the key takeaway about cancer treatment and tinnitus?
Cancer treatment can cause tinnitus, especially when certain chemotherapy medicines or radiation affect structures involved in hearing. The symptom may improve over time or persist, and it can occur with or without noticeable hearing loss. New ringing or other hearing changes deserve prompt discussion with the cancer care team, while sudden hearing loss or associated neurological or severe balance symptoms require emergency evaluation. Appropriate hearing assessments and supportive care can help guide next steps without the patient having to change cancer treatment independently.