Cancer can lead to mixed hearing loss through various mechanisms. Tumors in the head and neck region, such as nasopharyngeal carcinoma or acoustic neuroma, can physically obstruct the ear canal or damage the nerves involved in hearing. Additionally, certain chemotherapy drugs and radiation treatments can be ototoxic, meaning they have the potential to damage the inner ear structures and auditory nerve, leading to sensorineural hearing loss. Infections or secondary complications from cancer treatment can also contribute to conductive hearing issues.