Jessica Paken

University of KwaZulu-Natal, South Africa

Title: Why is audiological monitoring crucial for patients with cervical cancer?

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Biography

Jessica Paken is currently a senior lecturer and Head of Department at the Discipline of Audiology at the University of KwaZulu-Natal in South Africa. With expertise in audiology, specifically electrophysiology, hearing aids and ototoxicity, she has contributed to the scientific community through numerous national and international publications and conferences. She is the recipient of research accolades, namely, the Archbishop Denis Hurley Scholarship and the South African Medical Research Council National Health Scholarship. Her research interests include ototoxicity and patient quality of life. She has won the UKZN College of Health Science Research Colloqium Best Poster Presentation (2013), the Discovery Best Poster Presentation (2015) and the Discovery Best Oral Presenter (2019).

Abstract

Concomitant chemoradiotherapy using cisplatin is the standard treatment for locally advanced cervical cancer. However, cisplatin affects the auditory system, potentially placing exposed patients at risk of developing ototoxic hearing loss, thus negatively impacting their quality of life. Given the paucity of information on ototoxicity among cervical cancer patients, the findings of a study that investigated the extent of cisplatin-associated ototoxicity and the feasibility of an ototoxicity monitoring programme (OMP) among this cohort will be presented. This concurrent embedded mixed-methods study, conducted at a hospital in South Africa, revealed that whilst the audiologist was considered a part of the oncology team, provision for ototoxicity monitoring in the chemotherapy protocols was not evident, nor was any OMP in place. Prospective recruitment of cervical cancer cases and regular audiological assessments revealed a 98% incidence of ototoxicity (cumulative cisplatin dose 150 mg/m2). HIV-seropositivity (53.7%) was significantly associated with the NCI-CTCAE Grading Scale at three- (p=0.022) and six-months (p=0.023) post-treatment. Feasibility assessment revealed that key stakeholders found the OMP beneficial. Costs to the service provider (equipment, personnel) and patient (transport, daily loss of income) were paramount to successfully implement and continue the programme. This study highlights cisplatin’s ototoxic effect and provides clear evidence for the need for an OMP. Through meaningful engagements with- and considerations from- patients and service providers regarding planning, delineation of responsibilities, and cost implications, such a program is feasible and will positively impact the quality of life of the affected patients.