Journal of Cancer Survivorship

, Volume 12, Issue 2, pp 234–245 | Cite as

Impact of chemotherapy-induced neurotoxicities on adult cancer survivors’ symptom burden and quality of life

  • Christine Miaskowski
  • Judy Mastick
  • Steven M. Paul
  • Gary Abrams
  • Steven Cheung
  • Jennifer Henderson Sabes
  • Kord M. Kober
  • Mark Schumacher
  • Yvette P. Conley
  • Kimberly Topp
  • Betty Smoot
  • Grace Mausisa
  • Melissa Mazor
  • Margaret Wallhagen
  • Jon D. Levine



Limited information is available on the impact of chemotherapy (CTX)-induced neurotoxicity on adult survivors’ symptom experience and quality of life (QOL). Purposes were to describe occurrence of hearing loss and tinnitus and evaluate for differences in phenotypic characteristics and measures of sensation, balance, perceived stress, symptom burden, and QOL between survivors who received neurotoxic CTX and did (i.e., neurotoxicity group) and did not (i.e., no neurotoxicity group) develop neurotoxicity. Neurotoxicity was defined as the presence of chemotherapy-induced neuropathy (CIN), hearing loss, and tinnitus. Survivors in the no neurotoxicity group had none of these conditions.


Survivors (n = 609) completed questionnaires that evaluated hearing loss, tinnitus, stress, symptoms, and QOL. Objective measures of sensation and balance were evaluated.


Of the 609 survivors evaluated, 68.6% did and 31.4% did not have CIN. Of the survivors without CIN, 42.4% reported either hearing loss and/or tinnitus and 48.1% of the survivors with CIN reported some form of ototoxicity. Compared to the no neurotoxicity group (n = 110), survivors in the neurotoxicity group (n = 85) were older, were less likely to be employed, had a higher comorbidity burden, and a higher symptom burden, higher levels of perceived stress, and poorer QOL (all p < .05).


Findings suggest that CIN, hearing loss, and tinnitus are relatively common conditions in survivors who received neurotoxic CTX.

Implications for cancer survivors

Survivors need to be evaluated for these neurotoxicities and receive appropriate interventions. Referrals to audiologists and physical therapists are warranted to improve survivors’ hearing ability, functional status, and QOL.


Chemotherapy Peripheral neuropathy Hearing loss Tinnitus Balance Survivor 



This study was funded by the National Cancer Institute (NCI, CA151692). Dr. Miaskowski is supported by a grant from the American Cancer Society and NCI (CA168960). This project was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number UL1 TR000004.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Recruitment was facilitated by Dr. Susan Love Research Foundation’s Army of Women® Program.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Christine Miaskowski
    • 1
  • Judy Mastick
    • 1
  • Steven M. Paul
    • 1
  • Gary Abrams
    • 2
  • Steven Cheung
    • 2
  • Jennifer Henderson Sabes
    • 2
  • Kord M. Kober
    • 1
  • Mark Schumacher
    • 2
  • Yvette P. Conley
    • 3
  • Kimberly Topp
    • 2
  • Betty Smoot
    • 2
  • Grace Mausisa
    • 1
  • Melissa Mazor
    • 1
  • Margaret Wallhagen
    • 1
  • Jon D. Levine
    • 2
  1. 1.School of NursingUniversity of CaliforniaSan FranciscoUSA
  2. 2.Schools of MedicineUniversity of CaliforniaSan FranciscoUSA
  3. 3.School of NursingUniversity of PittsburghPittsburghUSA

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