Communication and hearing complications in patients with childhood cancers

ABSTRACT

The survival rates of childhood cancers have increased significantly in recent years, and the long-term complications of childhood cancers have become an important issue. Although communication and hearing complications have been documented in survivors, they have not been widely investigated across different types of cancer. Therefore, we conducted a retrospective cohort study at Queen Mary Hospital on 318 children with acute lymphoblastic leukaemia (ALL), stage-4 neuroblastoma (NB), head and neck (H&N) cancers, or brain tumours (BTs) to describe the prevalence, type, onset time, and associated factors of communication and hearing complications in each group. Communication deficit and hearing loss (overall prevalence rates, 13.8% and 10.7%, respectively) were most prevalent in the BT group. Dysarthria, language impairment, and bilateral sensorineural hearing loss were the most common complications. Diagnosis type was a predictive factor for developing complications, while the younger age of diagnosis was a protective factor against developing communication complications. Complications tended to occur within 5 years after diagnosis in the stage-4 NB and ALL groups, but after the fifth year in the H&N cancer and BT groups. Our findings suggest that tumour location and treatment method are associated with different risks of developing complications in patients with certain diagnoses. Neuroplasticity may act to protect younger patients from developing communication difficulties. These findings can help optimize the long-term care of cancer survivors in terms of treatment selection, counselling, and appropriate long-term follow-up and can guide future research in preventive measures and corresponding interventions.

KEYWORDS:

• Childhood cancer
• cancer treatment
• long-term complications
• dysarthria
• hearing loss
• prevalence
• onset time
• protective factor

Acknowledgements

The authors thank Hospital Authority for the approval of collecting data from patients’ medical records, as well as the Department of Paediatrics and Adolescent Medicine for the assistance in data collection. Thanks also go to the Speech Therapy Department for their support, especially the help and advice given by Mr Raymond Fong.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Oi-Yan Yiu http://orcid.org/0000-0001-6543-7551

Wilfred Hing-Sang Wong http://orcid.org/0000-0001-8396-2368

Alan Kwok-Shing Chiang http://orcid.org/0000-0002-1089-5325

Godfrey Chi-Fung Chan http://orcid.org/0000-0001-5032-8985