Chemotherapeutic agents such as cisplatin, given alongside irradiation, offer a survival advantage in head and neck cancer. Some patients often complain bitterly about side-effects of their treatment, one of which is ototoxicity. In this paper, the authors propose the use of freshly squeezed pomegranate juice, allegedly known for its antioxidant properties, to prevent free-radical mediated damage to cochlear hair cells. The study used 56 albino rats, which were randomised to sham treatments, or various combinations of cisplatin, radiotherapy, and fresh pomegranate juice. Changes in hearing were measured using DPOAEs, and histopathological examination of the cochleas. The results appear to indicate that fresh pomegranate juice has the potential to eliminate damage to cochlear hair cells resulting from irradiation, cisplatin, and combined use of cisplatin and irradiation. These were small animal groups, and the study does not take into account more modern techniques that can reduce the dose delivered to radiation sensitive tissue. Nevertheless, in the current oncological environment, newer treatments are constantly being sought in order to cure cancer with minimal side-effects, and there is a vogue for ‘natural’ treatment options. If a freshly squeezed fruit juice has genuine potential for reducing the ototoxic effects of cancer treatment, this certainly seems to be a topic worth pursuing in human subjects. What’s the worst that could happen? 

Does short term usage of fresh pomegranate juice (FPJ) protect cochlear hair cells after cisplatin-based chemo-irradiation?
Akdağ M, Daşdağ S, Alabalık U, et al.
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Emma Stapleton

Manchester Royal Infirmary, UK.

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