Hearing & Vision Changes
Cisplatin and carboplatin cause dose-dependent hearing loss (ototoxicity) in 50–70% of patients — often permanent. Radiation to the brain or eye causes cataracts, retinopathy, or optic nerve damage. Certain targeted therapies cause visual disturbances. Tinnitus (ringing in ears) is another common complaint. Early identification and protection strategies are critical.
Herbs & Supplements — Safety Information
Herbal information is for educational purposes. Many herbs interact with chemotherapy and other medications — consult your oncologist before use.
When to Seek Medical Help Immediately
- •Sudden significant hearing loss in one or both ears
- •Sudden vision loss, double vision, or visual field defect — can indicate stroke or brain metastasis
- •Tinnitus that is pulsatile (beats with heartbeat) — vascular cause requires evaluation
- •Eye pain or severe light sensitivity
3 Natural Remedies
Baseline Audiometry Before Cisplatin
Best for: All patients starting cisplatin or high-dose carboplatin
This is a preventive action rather than a remedy: getting a baseline audiogram (hearing test) before starting cisplatin or carboplatin allows early detection of hearing changes at follow-up tests. High frequencies are lost first. Early detection allows dose adjustment or switch to alternative agents before severe hearing loss occurs.
🧪 How to Prepare
Request formal audiological assessment (pure tone audiometry and speech discrimination) before starting platinum-based chemotherapy. Repeat testing after every 2–3 cycles. Report any perceived hearing changes to oncology team immediately.
⏰ When to Take
Before treatment starts. Repeat during treatment cycles.
N-Acetyl Cysteine (NAC) for Ototoxicity
Best for: Ototoxicity and nephrotoxicity prevention during cisplatin chemotherapy
NAC is a glutathione precursor with strong antioxidant activity that may protect cochlear hair cells from cisplatin's oxidative damage. Animal studies show strong protection; human trials are ongoing (NCT results mixed). The benefit-to-risk ratio is strongly favourable given NAC's excellent safety profile. Some oncology centres now routinely recommend it.
🧪 How to Prepare
NAC 600 mg twice daily (1200 mg/day total). Effervescent sachets or capsules. Take with food.
⏰ When to Take
Start before cisplatin infusion cycles and continue throughout treatment. Time the dose: some protocols give NAC 4 hours after cisplatin infusion to avoid potential interference with drug action — discuss timing with oncologist.
Tinnitus Management Techniques
Best for: Cisplatin-induced tinnitus, chronic tinnitus management
Tinnitus (ringing, buzzing, hissing in ears) from cisplatin ototoxicity is often permanent. Management focuses on reducing the distress and auditory prominence of the tinnitus rather than eliminating it. Sound therapy and cognitive-behavioural techniques are the most evidence-supported approaches.
🧪 How to Prepare
Sound therapy: use a white noise machine, nature sound app, or low-volume music to reduce the contrast between tinnitus and silence (especially at night). Tinnitus Retraining Therapy (TRT): specialist programme combining sound therapy with counselling. Avoid silence: silence makes tinnitus seem louder — maintain gentle background sound. Reduce caffeine and alcohol (both worsen tinnitus for many). Relaxation: tinnitus loudness correlates with stress levels.
⏰ When to Take
Ongoing. Audiologist referral recommended if tinnitus significantly impacts quality of life.
Evidence Level Guide