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The following is an excerpt from the Portland, Oregon daily newspaper, the Oregonian, July 28, 2004. The full article, "Trials will test drugs to keep chemo from damaging ears," was written by Andy Dworkin.

"Your hearing or your life?

That painful choice faces many patients whose cancer is best treated with platinum-containing chemotherapy drugs, which can permanently damage the ears. That threat is bigger for young cancer patients still learning to speak and understand their world.

"You're talking about a third of all children with cancer having hearing loss," said Dr. Edward Neuwelt, a neurosurgeon at Oregon Health & Science University and the Portland Veteran's Affairs Medical Center.

But by adapting antidotes to cyanide and Tylenol poisoning, Neuwelt and colleagues think they can preserve patients' hearing while aggressively treating tumors. The two drugs, poised to enter separate human trials, also may let doctors give some patients larger chemotherapy doses while limiting other side effects, such as bruising or kidney problems.

The trick is determining how to protect the healthy body and not interfere with the chemotherapy. The same drugs that block the toxic effects on ears can hamper the tumor-fighting power of cisplatin and carboplatin, platinum-based chemotherapy drugs. Those are widely used against cancers of the liver, reproductive system, bones, brain and nerve cells.

.....Poison antidotes may be the answer -- one discovered by the husband of a cancer patient. In 1993, Neuwelt gave chemotherapy to Abbie Ziffren, a George Washington University religion professor who was dealing with a brain tumor. The treatment extended Ziffren's life another three years, said her husband, David Scheim. It also damaged her hearing.

Scheim turned to the Internet for answers and found a study that sought to battle chemo-related anemia and kidney damage with sodium thiosulfate, or STS, an antidote to cyanide poisoning. Scheim passed the idea on to Neuwelt.

Neuwelt said researchers think the STS can prevent half the expected cases of hearing loss. Doctors also will check whether it moderates the anemia and kidney damage chemotherapy can cause. And they will monitor for high sodium and blood-pressure levels, which high STS doses may cause.

The study will involve about 270 cancer patients, aged 1 to 21, being treated at medical centers in the Children's Oncology Group, which includes most big medical centers.

Meanwhile, the OHSU team is testing another ear-saving medicine called N-acetylcysteine, or NAC, now used to treat Tylenol overdoses. They just published one study, in the journal Hearing Research, showing that NAC protects the hearing of rats getting cisplatin. Now they are starting the earliest human trials, checking to see how much NAC people can tolerate without severe side effects. Eventually, Neuwelt said, doctors may combine NAC and STS to protect patients from chemotherapy."

  ©2004 Oregonian Publishing Co. All rights reserved. Used with permission of The Oregonian.