{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T05:35:20Z","timestamp":1735968920821,"version":"3.32.0"},"reference-count":52,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nAim<\/jats:title>\nThe perspectives and practices of healthcare professionals regarding ototoxicity in individuals with head and neck cancers are important for the implementation of ototoxicity monitoring. The current study aims to explore the oncologist\u2019s awareness and perspectives of ototoxicity and ototoxicity monitoring for individuals with head and neck cancer in a South-Indian district, using qualitative semi-structured interviews.<\/jats:p>\n<\/jats:sec>\n\nMethod<\/jats:title>\nThe COnsolidated criteria for REporting Qualitative research (COREQ) Checklist was used to guide the method of the current qualitative study. A conceptual framework was developed for the formulation of the interview guides. Three medical oncologists and six radiation oncologists from cancer care centres participated in the study. The interviews were audio recorded and transcribed verbatim. Thematic analysis was carried out using a hybrid inductive-deductive approach to present the findings under the respective overarching themes.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nAll oncologists are aware of the ototoxic effects caused by radiation therapy and chemoradiotherapy. It was consistently reported that the severity of the hearing loss was not substantial enough to warrant significant concern. Ototoxicity is not emphasized during the counseling process. All participants reported having awareness and knowledge of ototoxicity monitoring programs and understood their importance. However, none of them reported the implementation of an ototoxicity monitoring program in their facility.<\/jats:p>\n<\/jats:sec>\n\nDiscussion<\/jats:title>\nIt is imperative to enhance the knowledge and understanding of the ototoxic nature of cancer treatment modalities among oncologists. It is crucial to raise awareness regarding the significance of ototoxicity monitoring programs among all physicians involved in the treatment of patients with cancer for maximum impact. The barriers to implementing ototoxicity monitoring programs in high- and low-income countries are similar. The models implemented in high-income countries can be adapted for use in low-middle income countries with suitable restructuring.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nThe current study provides valuable insights into the status of ototoxicity monitoring in the South-Indian context. The findings align with the key components of the health belief model, including perceived susceptibility, perceived barriers, and cues to action. Involving oncologists in the planning phase of the ototoxicity monitoring programs can help tailor future research questions and solutions to improve quality of life, foster collaboration among healthcare professionals, and produce actionable outcomes that may influence policy on ototoxicity monitoring.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0312847","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T18:44:37Z","timestamp":1735929877000},"page":"e0312847","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oncologists\u2019 views on ototoxicity monitoring in head and neck cancer patients: A South Indian qualitative study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3633-6230","authenticated-orcid":true,"given":"Varsha","family":"Shankar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6023-1017","authenticated-orcid":true,"given":"Jayashree","family":"Seethapathy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satish","family":"Srinivas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raghu","family":"Nandhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prasanna Kumar","family":"Saravanam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"key":"pone.0312847.ref001","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1002\/jso.24545","article-title":"Head and neck cancers in India","volume":"115","author":"M Dandekar","year":"2017","journal-title":"J Surg Oncol"},{"key":"pone.0312847.ref002","article-title":"Head and neck cancer burden in India: an analysis from published data of 37 population-based cancer registries","volume":"17","author":"S Bagal","journal-title":"Ecancermedicalscience"},{"key":"pone.0312847.ref003","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1634\/theoncologist.2009-0289","article-title":"Changes in Survival in Head and Neck Cancers in the Late 20th and Early 21st Century: A Period Analysis; Changes in Survival in Head and Neck Cancers in the Late 20th and Early 21st Century: A Period Analysis","volume":"15","author":"D Pulte","year":"2010","journal-title":"Oncologist"},{"key":"pone.0312847.ref004","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1002\/hed.20045","article-title":"Radiation-induced xerostomia in patients with head and neck cancer: Pathogenesis, impact on quality of life, and management","volume":"26","author":"MS Chambers","year":"2004","journal-title":"Head and Neck"},{"key":"pone.0312847.ref005","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.ijrobp.2008.05.040","article-title":"Relative Contributions of Radiation and Cisplatin-Based Chemotherapy to Sensorineural Hearing Loss in Head-and-Neck Cancer Patients","volume":"73","author":"YJ Hitchcock","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"pone.0312847.ref006","first-page":"1213","article-title":"Multidisciplinary clinic management of head and neck cancer","author":"M Townsend","year":"2017","journal-title":"JAMA Otolaryngology\u2014Head and Neck Surgery. American Medical Association"},{"key":"pone.0312847.ref007","doi-asserted-by":"crossref","first-page":"59","DOI":"10.7874\/jao.2017.00360","article-title":"Ototoxicity: A challenge in diagnosis and treatment","volume":"22","author":"P Ganesan","year":"2018","journal-title":"J Audiol Otol"},{"key":"pone.0312847.ref008","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1749-6632.1999.tb00277.x","article-title":"Global problem of drug-induced hearing loss","volume":"884","author":"E Arslan","year":"1999","journal-title":"Ann N Y Acad Sci"},{"key":"pone.0312847.ref009","first-page":"1391","article-title":"Sensorineural hearing loss in patients with head and neck cancer after chemoradiotherapy and radiotherapy: A systematic review of the literature","volume":"36","author":"EAR Theunissen","year":"2014","journal-title":"Head Neck"},{"key":"pone.0312847.ref010","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s11764-022-01314-9","article-title":"The long-term impacts of hearing loss, tinnitus and poor balance on the quality of life of people living with and beyond cancer after platinum-based chemotherapy: a literature review","volume":"17","author":"OR Phillips","year":"2023","journal-title":"Journal of Cancer Survivorship"},{"key":"pone.0312847.ref011","article-title":"Cisplatin-Associated Ototoxicity: A Review for the Health Professional","author":"J Paken","year":"2016","journal-title":"J Toxicol"},{"key":"pone.0312847.ref012","unstructured":"ASHA. Audiologic Management of Individuals Receiving Cochleotoxic Drug Therapy. Med Pediatr Oncol 1994; 1\u201317."},{"key":"pone.0312847.ref013","unstructured":"AAA. American Academy of Audiology Position Statement and Clinical Practice Guidelines: Ototoxicity M onitoring. American Academy of Audiology 2009; 1\u201325."},{"key":"pone.0312847.ref014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4102\/sajcd.v67i1.685","article-title":"Perspectives and practices of ototoxicity monitoring","volume":"67","author":"J Paken","year":"2020","journal-title":"South African Journal of Communication Disorders"},{"key":"pone.0312847.ref015","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1080\/14992027.2017.1381769","article-title":"Ototoxicity monitoring through the eyes of the treating physician: Perspectives from pulmonology and medical oncology","volume":"57","author":"AC Garinis","year":"2018","journal-title":"International Journal of Audiology"},{"key":"pone.0312847.ref016","doi-asserted-by":"crossref","first-page":"362","DOI":"10.4103\/ijmr.IJMR_1711_18","article-title":"Cancer research in India: Challenges & opportunities","volume":"148","author":"M Singh","year":"2018","journal-title":"Indian J Med Res"},{"key":"pone.0312847.ref017","author":"A D\u2019cruz","journal-title":"Validation of the University of Washington quality of life questionnaires for head and neck cancer patients in India"},{"key":"pone.0312847.ref018","doi-asserted-by":"crossref","first-page":"261","DOI":"10.4103\/0019-5154.182410","article-title":"Methodology Series Module 3: Cross-sectional Studies","volume":"61","author":"MS Setia","year":"2016","journal-title":"Indian J Dermatol"},{"key":"pone.0312847.ref019","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups","volume":"19","author":"A Tong","year":"2007","journal-title":"International Journal for Quality in Health Care"},{"key":"pone.0312847.ref020","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1177\/109019817400200403","article-title":"Historical origins of the health belief model","volume":"2","author":"IM Rosenstock","year":"1974","journal-title":"Health Educ Monogr"},{"key":"pone.0312847.ref021","unstructured":"Liamputtong P. Qualitative Research Methods, https:\/\/researchdirect.westernsydney.edu.au\/islandora\/object\/uws%3A41009\/ (2009, accessed 20 August 2024)."},{"key":"pone.0312847.ref022","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4300\/JGME-D-11-00307.1","article-title":"Qualitative Research Part II: Participants, Analysis, and Quality Assurance","volume":"4","author":"J. Sargeant","year":"2012","journal-title":"J Grad Med Educ"},{"key":"pone.0312847.ref023","article-title":"Snowball Sampling: A Purposeful Method of Sampling in Qualitative Research","volume":"14","author":"M Naderifar","journal-title":"Strides in Development of Medical Education"},{"key":"pone.0312847.ref024","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","article-title":"Saturation in qualitative research: exploring its conceptualization and operationalization","volume":"52","author":"B Saunders","year":"2018","journal-title":"Qual Quant"},{"key":"pone.0312847.ref025","article-title":"A Hybrid Approach to Thematic Analysis in Qualitative Research: Using a Practical Example","author":"J. Swain","journal-title":"A Hybrid Approach to Thematic Analysis in Qualitative Research: Using a Practical Example"},{"key":"pone.0312847.ref026","unstructured":"QDA Miner Lite. Version 5.0. Montreal: Provalis Research; 2024. https:\/\/provalisresearch.com\/products\/qualitative-data-analysis-software\/free-qualitative-analysis-software\/"},{"key":"pone.0312847.ref027","article-title":"Teaching thematic analysis: Overcoming challenges and developing strategies for effective learning","author":"V Clarke","journal-title":"The SAGE Encyclopedia of Qualitative Research Methods"},{"key":"pone.0312847.ref028","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"V Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"pone.0312847.ref029","first-page":"73","article-title":"But Is It Rigorous? Trustworthiness and Authenticity in Naturalistic Evaluation","volume":"30","author":"YS Lincoln","year":"1986","journal-title":"Naturalistic evaluation"},{"key":"pone.0312847.ref030","doi-asserted-by":"crossref","first-page":"100051","DOI":"10.1016\/j.glmedi.2024.100051","article-title":"The pillars of trustworthiness in qualitative research","volume":"2","author":"SK Ahmed","year":"2024","journal-title":"Journal of Medicine, Surgery, and Public Health"},{"key":"pone.0312847.ref031","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s00280-019-04012-z","article-title":"Looking beyond the audiogram in ototoxicity associated with platinum-based chemotherapy","volume":"85","author":"DM Baguley","year":"2020","journal-title":"Cancer Chemotherapy and Pharmacology"},{"key":"pone.0312847.ref032","doi-asserted-by":"crossref","first-page":"84","DOI":"10.3857\/roj.2020.00213","article-title":"Late side effects of radiation treatment for head and neck cancer","volume":"38","author":"I. Brook","year":"2020","journal-title":"Radiation Oncology Journal"},{"key":"pone.0312847.ref033","doi-asserted-by":"crossref","DOI":"10.1186\/s40463-021-00506-0","article-title":"Insight into the current practice of ototoxicity monitoring during cisplatin therapy","volume":"50","author":"NM Santucci","year":"2021","journal-title":"Journal of Otolaryngology\u2014Head and Neck Surgery"},{"key":"pone.0312847.ref034","article-title":"Radiation Therapy and Hearing Loss","volume":"76","author":"N Bhandare","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"pone.0312847.ref035","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s40463-014-0030-x","article-title":"Cochlea sparing effects of intensity modulated radiation therapy in head and neck cancers patients: a long-term follow-up study","volume":"43","author":"EAR Theunissen","year":"2014","journal-title":"Journal of otolaryngology\u2014head & neck surgery"},{"key":"pone.0312847.ref036","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1016\/j.ijrobp.2008.01.050","article-title":"Hearing Loss After Radiotherapy for Pediatric Brain Tumors: Effect of Cochlear Dose","volume":"72","author":"C Hua","year":"2008","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"pone.0312847.ref037","doi-asserted-by":"crossref","first-page":"248","DOI":"10.4103\/jmp.jmp_21_23","article-title":"A dosimetric comparison of volumetric-modulated arc therapy and IMRT for cochlea-sparing radiation therapy in locally advanced nasopharyngeal cancer","volume":"48","author":"S Nanda","year":"2023","journal-title":"J Med Phys"},{"key":"pone.0312847.ref038","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1055\/s-0039-1677865","article-title":"Challenges of Hearing Rehabilitation after Radiation and Chemotherapy","volume":"80","author":"ME Nader","year":"2019","journal-title":"J Neurol Surg B Skull Base"},{"key":"pone.0312847.ref039","article-title":"The effect of radiation therapy on hearing loss in patients with head and neck cancer","volume":"11","author":"S Chaibakhsh","journal-title":"Int J Cancer Manag"},{"key":"pone.0312847.ref040","article-title":"Hearing loss in adult survivors of childhood cancer treated with radiotherapy","volume":"5","author":"A Khan","journal-title":"Children"},{"key":"pone.0312847.ref041","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.heares.2018.08.003","article-title":"A review of the effects of unilateral hearing loss on spatial hearing","volume":"372","author":"DP Kumpik","year":"2019","journal-title":"Hear Res"},{"key":"pone.0312847.ref042","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1146\/annurev-publhealth-032013-182510","article-title":"Hearing loss in an aging American population: Extent, impact, and management","volume":"35","author":"KE Bainbridge","year":"2014","journal-title":"Annu Rev Public Health"},{"key":"pone.0312847.ref043","doi-asserted-by":"crossref","first-page":"6557","DOI":"10.1007\/s00432-023-04634-0","article-title":"\u201cI do not hear you!\u201d: hearing-impaired cancer patients report their communication experiences","volume":"149","author":"M Keck","year":"2023","journal-title":"J Cancer Res Clin Oncol"},{"key":"pone.0312847.ref044","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.4102\/sajcd.v63i1.174","article-title":"Ototoxicity management: An investigation into doctors\u2019 knowledge and practices, and the roles of audiologists in a tertiary hospital","volume":"63","author":"A Wium","year":"2016","journal-title":"The South African Journal of Communication Disorders"},{"key":"pone.0312847.ref045","first-page":"307","article-title":"Perceptions of oncologists at two state hospitals in Gauteng regarding the ototoxic effects of cancer chemotherapy: A pilot study","volume":"3","author":"V De Andrade","year":"2009","journal-title":"Afr J Pharm Pharmacol"},{"key":"pone.0312847.ref046","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1080\/14992027.2017.1398421","article-title":"Applying U.S. national guidelines for ototoxicity monitoring in adult patients: perspectives on patient populations, service gaps, barriers and solutions","volume":"57","author":"D Konrad-Martin","year":"2018","journal-title":"Int J Audiol"},{"key":"pone.0312847.ref047","unstructured":"Dille M. Barriers and Potential Solutions to Increase the Success of Ototoxicity Monitoring Programs. ASHA, https:\/\/www.asha.org\/articles\/barriers-and-potential-solutions-to-increase-the-success-of-ototoxicity-monitoring-programs\/ (2018, accessed 8 November 2023)."},{"key":"pone.0312847.ref048","article-title":"The use of tele-audiology in ototoxicity monitoring: A scoping review","author":"N Peerbhay","journal-title":"J Telemed Telecare"},{"key":"pone.0312847.ref049","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2019.01161","article-title":"Ototoxic adverse drug reactions: A disproportionality analysis using the Italian spontaneous reporting database","volume":"10","author":"MA Barbieri","year":"2019","journal-title":"Front Pharmacol"},{"key":"pone.0312847.ref050","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1044\/2023_PERSP-23-00153","article-title":"What\u2019s New in Ototoxicity Management?","volume":"9","author":"KA Fernandez","year":"2024","journal-title":"Perspect ASHA Spec Interest Groups"},{"key":"pone.0312847.ref051","doi-asserted-by":"crossref","first-page":"S25","DOI":"10.1080\/14992027.2017.1370138","article-title":"Using tablet-based technology to deliver time-efficient ototoxicity monitoring","volume":"57","author":"D Brungart","year":"2018","journal-title":"Int J Audiol"},{"key":"pone.0312847.ref052","doi-asserted-by":"crossref","first-page":"750","DOI":"10.3766\/jaaa.15028","article-title":"A store-and-forward tele-audiology solution to promote efficient screenings for ototoxicity during cisplatin cancer treatment","volume":"26","author":"MF Dille","year":"2015","journal-title":"J Am Acad Audiol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312847","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T18:44:54Z","timestamp":1735929894000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312847"}},"subtitle":[],"editor":[{"given":"Ashish Wasudeo","family":"Khobragade","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,3]]},"references-count":52,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0312847","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,3]]}}}