Dr. Pam Swartz - Dealing With Hearing Loss After Cisplatin

Episode 130

Cisplatin is one of the most powerful, life-saving drugs in testicular cancer treatment — but it comes with a lasting side effect that too few patients are warned about. In this episode of It Takes Balls, audiologist Dr. Pam Swartz unpacks how cisplatin damages hearing, why it's permanent, and what young survivors can do to protect their quality of life for the decades ahead.

Dr. Swartz starts with the basics of how we hear — from the eardrum and the body's three smallest bones to the roughly 30,000 hair cells in the cochlea — and explains a key truth: we hear with our brain, not our ears. She then breaks down why cisplatin is classified as highly ototoxic (a "class five" medication affecting hearing, balance, and tinnitus), how it accumulates around and kills the outer hair cells, and why that damage can't be reversed. Roughly 40% of patients on high doses experience some hearing loss, often in the high frequencies first — which is why voices can start to sound mumbled, women and children become harder to understand, and the TV keeps creeping louder.

This conversation is packed with practical, actionable guidance. Dr. Swartz explains why every patient should get a baseline audiogram before starting treatment (tested out to 20,000 Hz, not the standard 8,000) and a follow-up 6–8 weeks after finishing, how to protect the hearing you have from added noise damage, and how far modern hearing aids have come — now rechargeable, Bluetooth-enabled, and self-adjusting thousands of times per second. She also covers cochlear implants, listening strategies (sound bars, closed captioning, choosing the restaurant booth), and how partners and family can become better communicators.

A large part of the episode focuses on tinnitus — the ringing so many survivors live with. Dr. Swartz, who has tinnitus herself, explains what it is, why the emotion you attach to it makes it louder, and why sound therapy is the most effective tool we have. She shares how a simple air purifier changed her own experience, common triggers to watch (salt, caffeine, alcohol, stress), and why CBT, deep breathing, and mindfulness genuinely help. She also recommends the ReSound Tinnitus Relief app — the same sound-therapy tool used by the VA — which runs all night and layers multiple sounds to help mask the ringing.

Whether you're about to start chemotherapy, already noticing changes in your hearing, or supporting a survivor, this episode is an essential guide to advocating for your ears — because surviving testicular cancer means living well for the long haul.

Resources mentioned: ReSound Tinnitus Relief app | American Tinnitus Association | Find an audiologist through ASHA (American Speech-Language-Hearing Association) or the American Academy of Audiology

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