Abstract
BackgroundTreatment of cancer with cisplatin can result in hearing loss. Given the increasing burden of cancer in Africa, appropriate and timely identification, intervention and management of hearing loss in affected patients is of paramount importance.ObjectivesThis study describes the perspectives and practices of healthcare professionals in relation to cisplatin-associated ototoxicity at an institution treating patients diagnosed with cancer.MethodA concurrent triangulation study design was used to collect quantitative data from seven oncologists, nine nurses and 13 pharmacists using self-administered questionnaires, and qualitative data from four audiologists through semi-structured interviews for this hospital-based study, conducted in South Africa.ResultsLevels of awareness of cisplatin-associated ototoxicity varied with only 33% of the nursing personnel being aware in comparison to the oncologists and pharmacists. Oncologists were identified as the main custodians for providing information to patients. Whilst 82% of the participants considered the audiologist to be part of the oncology team, there was no provision for ototoxicity monitoring in the chemotherapy protocols, nor any ototoxicity-monitoring programme in place. There was no evidence that knowledge of cisplatin-associated ototoxicity translated into an appropriate management strategy for such patients.ConclusionHealthcare personnel overseeing the care and management of cancer patients need to improve their awareness of ototoxicity and refer timeously for audiological evaluation. Audiologists require greater awareness of monitoring programmes to appropriately implement and manage such programmes within a cancer platform and be part of a multidisciplinary team.Keywordsawareness; cisplatin; South Africa; ototoxicity; cervical cancer; healthcare personnel.
Highlights
South Africa is experiencing an increase in the overall burden of disease attributable to cancer, with the number of new cancer cases predicted to increase by 46% by 2030 (Ferlay et al, 2013)
In light of the country’s quadruple burden of disease, this poses a challenge to the medical fraternity, as many human immunodeficiency virus (HIV), tuberculosis (TB) and cancer therapeutics are ototoxic, causing hearing loss from temporary or permanent inner ear dysfunction owing to treatment with such agents (Yorgason, Fayad, & Kalinec, 2006)
Thirty-three healthcare personnel, including seven oncologists, nine nurses and 13 pharmacists, all of whom are involved in the management and care of cancer patients, as well as four audiologists (A, B, C and D), participated in the study
Summary
South Africa is experiencing an increase in the overall burden of disease attributable to cancer, with the number of new cancer cases predicted to increase by 46% by 2030 (Ferlay et al, 2013). In light of the country’s quadruple burden of disease, this poses a challenge to the medical fraternity, as many human immunodeficiency virus (HIV), tuberculosis (TB) and cancer therapeutics are ototoxic, causing hearing loss from temporary or permanent inner ear dysfunction owing to treatment with such agents (Yorgason, Fayad, & Kalinec, 2006). The public health importance of ototoxicity is often unheeded, to the detriment of affected patients. This negatively affects their communication ability, often resulting in educational and economic shortcomings, and social isolation (Paken, Govender, Pillay, & Sewram, 2016). Given the increasing burden of cancer in Africa, appropriate and timely identification, intervention and management of hearing loss in affected patients is of paramount importance
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