Ototoxicity Monitoring Navigator
Some cancer treatments, powerful IV antibiotics, and other medicines can affect hearing and balance. This navigator helps you understand what basic hearing care to expect during treatment, and gives you clear language to use with your care team when you ask about baseline tests, monitoring, and follow-up.
This tool is for education, not diagnosis or treatment decisions. It cannot see your full medical picture. Do not stop or change any medicine on your own. If something feels like an emergency, or you notice sudden big changes in hearing, balance, or neurologic symptoms, treat it as urgent and seek care right away—even if this tool suggests a non-urgent path.
For urgent symptoms, use the UCSF EARS safety guide: /en/emergency.
Answer a few questions
This tool can’t tell how serious things are, but it can help you organize your thoughts about hearing tests during treatment. Choose the option that feels closest—even if it’s not perfect.
Who are you filling this out for?
This only changes wording—it doesn’t change the medical message.
Where are you in treatment or medicine use?
Think about the treatment your team has said could affect hearing—such as certain chemotherapy, IV antibiotics, or other long-term medicines.
What hearing testing or plan do you already have?
If you’re not sure, pick the closest match. This helps us talk about “bare minimum” hearing care for your situation.
For many chemo and IV antibiotic regimens, a baseline hearing test near the start, at least one check during treatment, and a follow-up a few months after are common building blocks of monitoring.
Have you noticed any new hearing or balance changes?
Check any that apply in roughly the last few weeks or months. “No clear changes” is exclusive: choosing it will clear other options, and choosing any symptom will clear “No clear changes.”
Sudden big changes (especially one-sided) or new neurologic symptoms can signal emergencies. This tool will always recommend urgent evaluation in that situation.
Your suggested starting place
In progressAs you answer, we’ll suggest a starting point for hearing care around your treatment: urgent evaluation, treatment-phase monitoring, post-treatment follow-up, or long-term preventive care. When you click See my plan, your summary will appear here and you can screenshot it for your clinicians.
This looks emergent: seek urgent medical care now
Based on your answers, you reported sudden big changes in hearing (especially in one ear) and/or new neurologic warning signs such as facial weakness, trouble speaking, severe headache, vision changes, confusion, or serious difficulty walking.
These patterns may be time-sensitive for hearing and brain health. This navigator cannot tell how serious things are, so it leans strongly toward safety.
- In many places, this combination of symptoms is treated as a medical emergency.
- If you are in the U.S. and can do so safely, consider calling emergency services (for example, 911) or going to the nearest emergency department.
- Use direct language such as: “Sudden hearing loss,” “sudden one-sided hearing loss,” or “new severe dizziness plus neurologic symptoms.”
- Tell them which treatment or medicine you’re on (for example, “cisplatin” chemotherapy or “strong IV antibiotics”).
Even when a medicine can affect hearing, stopping it suddenly may be unsafe. The safest path is urgent medical help so clinicians can weigh risks and benefits with you.
Use the UCSF EARS safety guide: Emergency: Hearing, Tinnitus, and Balance Safety Guide.
Ask for a baseline hearing test before or near the start
You haven’t started treatment yet (or you’re right at the beginning), and there hasn’t been a hearing test connected to this treatment so far.
Many programs aim for a baseline hearing test before the first dose or as close as possible to the start, so any later change can be compared to where you started.
“Bare minimum” to ask for:
- A baseline hearing evaluation with audiology before treatment begins, or as early as feasible.
- Clarify: “If my hearing changes, who should I contact first—oncology/ID, primary care, or audiology?”
- Ask whether your program typically does at least one check during treatment and one follow-up a few months after treatment.
“I’ve read that some chemo and IV antibiotics can affect hearing. Could we add a baseline hearing test before or early in treatment so we have something to compare against later?”
You’ve done the first step—now confirm the follow-up plan
You’ve already had a baseline hearing test tied to this treatment. Next: make sure there’s a clear plan for checks during and after treatment.
“Bare minimum” to ask for now:
- When is the next planned check during treatment?
- What symptoms should trigger an earlier check (new tinnitus, muffled hearing, imbalance)?
- Will there be a follow-up a few months after treatment ends?
“I’m glad we did a baseline hearing test. Can we map out when we’ll re-check my hearing during treatment and once things are done, so changes don’t sneak up on us?”
It’s not too late to ask for hearing monitoring
You’re already in treatment that may affect hearing, and no one has checked your hearing for this course yet. Even if the ideal baseline didn’t happen, it can still help to get a first hearing test now and track changes from here.
“Bare minimum” to ask for now:
- A hearing evaluation with audiology as soon as reasonably possible.
- A plan for at least one check during treatment and one follow-up a few months after treatment.
- Clear instructions on who to call if symptoms appear between visits.
“I’m in the middle of treatment with medicine that can affect hearing. I haven’t had a hearing test yet. Could we add one now, and set up at least one follow-up while or after I’m on this medicine?”
Use your baseline to guide at least one check during treatment
You’ve had at least one hearing test connected to this course. Next: confirm when your next check is planned, and what should trigger an earlier check.
Questions you can bring to your team:
- “When is my next planned hearing check during treatment?”
- “If I notice new symptoms, can I be seen sooner than the routine schedule?”
- “Will we also check hearing a few months after treatment ends?”
Some changes show up first in very high frequencies. Your audiology team may still track them closely as early warning signs.
Consider a post-treatment hearing check
Treatment ended within about the last year, and there hasn’t been a formal hearing test linked to that care. Some people notice changes after treatment is done. A “new baseline” can help.
“Bare minimum” to ask for:
- A hearing evaluation sometime in the first year after treatment—sooner if symptoms are present.
- A plan for what to do if symptoms appear later.
“I had treatment that can affect hearing last year. I never had a hearing test for it. Could we schedule one now so we know where things stand?”
You have data—now turn it into a long-term plan
You’ve had at least one hearing test connected to your past treatment. Next: ask whether follow-up should be symptom-based only or periodic.
Questions to bring to your next visit:
- “Does my hearing test suggest I should have regular follow-up?”
- “If I notice new symptoms, how quickly should I try to be seen?”
- “Are there things I can do now to protect or support hearing?”
Start with a medication review and baseline hearing test
You’re on long-term medicines, or you’re not sure whether any affect hearing. Over time, medicine combinations and health conditions can influence risk.
Reasonable starting steps:
- Ask your clinician for a medication review that includes hearing risk.
- Consider a baseline hearing test so you have a reference going forward.
“I take a few medicines and I’ve read some can affect hearing over time. Could we review whether any of mine are in that category, and whether a baseline hearing test would be helpful?”
Fine-tune how often you’re checked and what is tracked
You’re already getting periodic hearing tests. Next: confirm whether your monitoring plan should change if medicines change, and how to reach your team if sudden symptoms occur.
Questions to refine your plan:
- “Given my medicines and health conditions, how often do you recommend hearing checks?”
- “If my medicines change, should my hearing monitoring change too?”
- “If I notice sudden changes between routine visits, what’s the fastest safe way to reach you?”
Keeping copies of your hearing tests (audiograms) over time makes it easier for new clinicians to see trends.
Use this as patient education scaffolding, not a protocol
This navigator is designed to give patients and families language and expectations around ototoxicity monitoring (baseline near start, targeted monitoring during treatment, and post-treatment follow-up).
Local protocols vary by site and resources. Use this tool to support consistent counseling, safety routing, and symptom-triggered escalation.
Your plan will appear here
This page works best with JavaScript enabled. If interactive features aren’t working, you can still use the safety guidance and hub links below:
- Urgent symptoms: Emergency: Hearing, Tinnitus, and Balance Safety Guide
- Getting Care hub: /en/getting-care
- Understand results & audiograms: Hearing Test Results Decoder
Do not stop or change medicines on your own. Use this page to structure questions for your care team.
Building Your Hearing & Treatment Care Team
Ototoxicity monitoring works best when oncology, infectious disease, primary care, audiology, and rehab share the load. Use this navigator to organize your questions, then work with your clinicians to decide what makes sense for you.
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Educational only. Not medical advice. Do not stop or change medicines on your own. If symptoms are urgent, use /en/emergency.