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This year, June 2nd is National Cancer Survivor’s Day. To those who are currently living with or in remission of cancer, we celebrate you! According to the National Cancer Institute on their website cancer.gov, it is estimated that in 2024 in the US alone 2,001,140 new cases of cancer will be diagnosed. As of January 2022, there were an estimated 18.1 million cancer survivors in the United States.

Those who undergo chemotherapy can be exposed to drugs that are called “ototoxic.” Ototoxic means that it can cause permanent damage to structures of the inner ear, which can cause dizziness or imbalance. Not everyone is susceptible to ototoxicity due to chemotherapy drugs, some factors that play a part are age, dosage, and genetic susceptibility. Children are at a higher risk. The mechanism behind ototoxicity is not well understood, though there are several theories that merit further research.

When there is damage to the inner ear, there are many factors that determine the level of dizziness and imbalance. One important thing to remember is that some or most of your balance can be gained back! This is because your inner ear isn’t the only system of balance that your body has. You also use your eyes and your sense of touch to balance (see our blog post about systems of balance here). If your inner ear is damaged, you can learn to better utilize the other systems of balance.

What does that look like? To rely more on your sense of sight, you can develop strategies of “spotting,” which can help your brain orient your head and body in space. You can teach your brain how to use your vision to ground yourself. Yellow tinted glasses can help increase contrast in low lighting, which can make it easier to navigate dark spaces.

To rely more on your sense of touch, you can develop strategies of how to avoid more difficult terrain, or using tools such as canes, trekking poles, or walkers to navigate more tenuous environments. Learning to use your whole foot for balance and how to sense your feet on the ground can help stabilize you.

If you have dizziness, a therapist can work with you to lessen your symptoms by designing exercises that target your specific deficits. If it’s a matter of visual sensitivities, exercises can be performed to reduce the effects of specific activities. A Vestibular Physical Therapist would be able to test you for specific concerns and sensitivities and explain your options for therapeutic intervention.

When the inner ear is damaged, it does not necessarily indicate that it is damaged beyond repair. If there is functionality in your inner ear, then it can be strengthened. Exercises can be designed to improve the efficiency with which the brain processes the information from the inner ear to improve balance and reduce dizziness.

There may be a degree of imbalance or dizziness that lingers or is permanent. Sometimes this is the reality of harsh medical intervention, though the benefits of being cancer free outweigh the side effects. Substitution strategies such as assistive devices and strategic planning can also be discussed with a vestibular physical therapist to improve your quality of life.

Remember that you are not alone and there is likely room for improvement if you are living with dizziness or imbalance caused by ototoxic chemotherapy drugs. Ask your doctor about pursuing vestibular physical therapy and start your path to wellness.