Cancer Treatments and Hair Loss
Hair loss (alopecia) is a common, but often distressing, side effect of chemotherapy. It can also be caused by radiotherapy. The amount of hair lost will depend on the specific drugs and dose given, and your individual reaction to these drugs. Hair loss is usually temporary and normally hair grows back within a few weeks after finishing treatment; sometimes it may grow back with a slightly different texture and color. Scalp cooling is sometimes used to try and reduce the amount of hair loss, but it is not suitable for everyone. Scalp cooling may be ineffective for certain drugs/doses and usually not used for people with haematological cancers because of the increased risk of cancer cells surviving in the blood vessels of the scalp.
Web Resources: Alopecia
Latest Research Publications
Web Resources: Alopecia (11 links)
Latest Research Publications
The use of scalp cooling for chemotherapy-induced hair loss.
Br J Nurs. 2016 May 26-Jun 8; 25(10):S22, S24-7 [PubMed] Related Publications
Parental Experiences with Chemotherapy-Induced Alopecia among Childhood Cancer Patients in Indonesia.
Asian Pac J Cancer Prev. 2016; 17(4):1717-23 [PubMed] Related Publications
MATERIALS AND METHODS: Fifty parents of childhood cancer patients were interviewed using semi-structured questionnaires.
RESULTS: The moment that hair fell out was the moment that parents (84%) had to admit their child had cancer. Alopecia was a traumatizing painful experience (46%). Active strategies to hide alopecia, mainly hats, were used by 66% of children, while 34% never covered their bald head. If money had not been an issue, 40% would use another strategy. Alopecia made children limit outdoor daily activities (78%) and engagement with others (60%). Significantly more children from high-educated (95%) than low-educated (60%) parents received sympathy from other people (P=0.012). Significantly more Christian (29%) than Muslim (0%) families confirmed that alopecia lowered the quality of life (P=0.046). Most parents (82%) had no prior plans about alopecia management, yet for significantly more girls (26%) than boys (0%) such plans existed (P=0.044). Parents received most information about alopecia from other parents (66%). Parents (92%) needed more alopecia education from doctors. Of all school-attending children, 53% were bullied and 47% did not want to attend school due to alopecia. Significantly more high-educated than low-educated families received pity from teachers and pupils (94% vs. 0%, P=0.004), and acceptance by pupils (81% vs. 0%, P=0.021).
CONCLUSIONS: Alopecia is a severe, far-stretching side-effect of chemotherapy with physical, psychological and social consequences for children and parents. Parents should be better informed about occurrence and impact of alopecia. Extra attention is required to facilitate children's return to school. Health- care providers should facilitate optimal supportive care through open dialogue and provision of educational materials for parents, children and their community.
Prevention of alopecia in medical and interventional chemotherapy patients.
J Cutan Med Surg. 2015 Jan-Feb; 19(1):11-6 [PubMed] Related Publications
OBJECTIVE: This review aims to summarize the relevant evidence for the treatments available for chemotherapy-induced alopecia.
METHODS: A literature search using PubMed and the MEDLINE subengine was completed. The terms "chemotherapy," "alopecia," "quality of life," and "strategies" were used, and articles from the last 10 years were considered. The pediatric population was not investigated.
RESULTS: Physical therapies for alopecia prevention have shown some promise but range from insufficient to detrimental depending on the type of cancer. Cold caps may be more effective than tourniquets and may be associated with fewer metastatic events. Pharmacologic therapies, both immunomodulators and growth factors, have stood the test of several trials to date. In particular, cyclosporine has been shown either to prevent alopecia or promote hair growth during a chemotherapy regimen.
CONCLUSION: Although the evidence is not yet overwhelming, it is becoming clear that a combination of mechanical and chemical interventions may help compensate for the downfalls of either therapy alone.
Alopecia as surrogate marker for chemotherapy response in patients with primary epithelial ovarian cancer: a metaanalysis of four prospective randomised phase III trials with 5114 patients.
Eur J Cancer. 2015; 51(7):825-32 [PubMed] Related Publications
PATIENTS AND METHODS: We analysed retrospectively the meta-databank of four prospective randomised phase-III-trials with platinum- and taxane-based 1st-line-chemotherapy in patients with advanced epithelial ovarian cancer (EOC) regarding the impact of alopecia overall outcome.
RESULTS: For 4705 (92.0%) of a total of 5114 EOC-patients alopecia was documented. They had received on median six cycle platinum-taxane chemotherapy (range 0-11) with 4186 (89.0%) having completed ⩾ 6 cycles. Worst alopecia grade was 0 in 2.4%, 1 in 2.9% and 2 in 94.7% of the patients. In a univariate analysis, including all patients, grade-0/1 alopecia was associated with significantly lower progression free survival (PFS) and overall survival (OS) compared to grade-2 alopecia. However when assessing only those patients who completed ⩾ 6 chemotherapy-cycles and hence eliminating the bias of lower total dose of treatment, alopecia failed to retain any significant impact on survival in the multivariate analysis. Merely the time point of alopecia onset was an independent prognostic factor of survival: patients who developed grade-2 alopecia up to cycle 3 had a significantly longer OS compared to patients who experienced alopecia later during therapy (hazard ratio (HR): 1.25; 95% confidence interval (CI): 1.04-1.50).
CONCLUSIONS: Within a large EOC-patient cohort with 1st-line platinum- and taxane-based chemotherapy early onset alopecia appears to be significantly associated with a more favourable outcome in those patients who completed ⩾ 6 chemotherapy cycles. It remains to be elucidated if early onset alopecia is just a surrogate marker for higher sensitivity to chemotherapy or if other biological effects are underlying.
Efficacy of Scalp Cooling in Preventing Chemotherapy-Induced Alopecia in Breast Cancer Patients Receiving Adjuvant Docetaxel and Cyclophosphamide Chemotherapy.
Clin Breast Cancer. 2015; 15(5):332-4 [PubMed] Related Publications
METHODS: Women at the Weill Cornell Breast Center who independently elected to use scalp cooling with cold caps during adjuvant TC chemotherapy were asked to participate. Degree of hair loss was assessed by a single practitioner using Dean's alopecia scale (grade 1/excellent [< 25% hair loss], grade 2/good [25%-50% hair loss], grade 3/moderate [50%-75% hair loss], grade 4/poor [> 75% hair loss]), by digital photographs, and by patient self-report of hair thinning or the need to wear a wig/head covering, or both. Assessments were made before each chemotherapy treatment and at follow-up visits between 3 weeks and 3 months after completion of chemotherapy.
RESULTS: Of 20 evaluable patients, 10% reported a need to wear a wig/head covering at the follow-up visit. Dean's alopecia score was excellent for 65% of patients, good for 25% of patients, and moderate or poor for 10% of patients. The majority of patients reported hair thinning after every chemotherapy cycle. No patient discontinued therapy because of an intolerance to cold caps.
CONCLUSION: Scalp cooling with cold caps appears to be effective in preventing CIA among the majority of women undergoing treatment with TC chemotherapy.
Psychosocial reaction patterns to alopecia in female patients with gynecological cancer undergoing chemotherapy.
Asian Pac J Cancer Prev. 2015; 16(3):1225-33 [PubMed] Related Publications
Measurement of chemotherapy-induced alopecia-time to change.
Support Care Cancer. 2015; 23(5):1197-9 [PubMed] Related Publications
No effect of scalp cooling on survival among women with breast cancer.
Breast Cancer Res Treat. 2015; 149(1):263-8 [PubMed] Related Publications
Symptoms and symptom clusters in non Hodgkin's lymphoma patients in Turkey.
Asian Pac J Cancer Prev. 2014; 15(17):7153-8 [PubMed] Related Publications
MATERIALS AND METHODS: The study was carried out on a total of 110 inpatients and outpatients receiving treatment in 7 hospitals in Ankara, Turkey. A questionnaire form and the Memorial Symptom Assessment Scale (MSAS) were applied. Percentages, means, t test, one way analysis of variance (ANOVA) and cluster analysis were used for statistical analyses.
RESULTS: The most prevalent symptoms in this study were lack of energy, hair loss and change in the way food tastes. The most severe symptoms were hair loss, change in the way food tastes and constipation. The top three most distressing symptoms were taste change, constipation and mouth sores. Seven symptom clusters were determined in this study.
CONCLUSIONS: Findings of the study will provide an understanding of symptom experiences of Non-Hodgkin's lymphoma patients receiving chemotherapy and will guide determining appropriate nursing interventions. Receiving care of desired quality will contribute to increasing quality of life of affected individuals.
Efficacy of interventions for prevention of chemotherapy-induced alopecia: a systematic review and meta-analysis.
Int J Cancer. 2015; 136(5):E442-54 [PubMed] Related Publications
Survey about the use of scalp cooling to prevent alopecia during breast cancer chemotherapy treatment in Canada.
Can Oncol Nurs J. 2014; 24(2):102-8 [PubMed] Related Publications
Impact of chemotherapy-induced alopecia distress on body image, psychosocial well-being, and depression in breast cancer patients.
Psychooncology. 2014; 23(10):1103-10 [PubMed] Related Publications
METHODS: A cross-sectional survey was conducted at the breast cancer advocacy events held at 16 hospitals in Korea. Alopecia distress was assessed using the 'Chemotherapy-Induced Alopecia Distress Scale', body image and psychosocial well-being were measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and breast specific module (BR23), and depression was measured using the Center for Epidemiological Studies Depression scale. Means of outcomes were compared between low and high CIA distress groups. Univariable and multivariable linear regression models were used to analyze the relationship between the CIA distress and body image, psychosocial well-being, and depression.
RESULTS: One hundred sixty-eight breast cancer patients participated in the study; the mean age was 48.4 (SD = 8.4) years, and 55.3% of the patients experienced higher distress from alopecia. In fully adjusted models, the high distress group was more likely to have a poorer body image than the low distress group (35.2 vs. 62.0; p < 0.001). Distressed patients were also more likely to report lower emotional (55.3 vs. 76.9; p < 0.001), role (58.6 vs. 72.0; p < 0.001), and social functioning (51.3 vs. 70.9; p < 0.001). The high distress group was also more likely to have depression compared with the low distress group (19.6 vs. 14.8; p < 0.001).
CONCLUSIONS: Chemotherapy-induced alopecia distress was negatively associated with body image, psychosocial well-being, and depression in women with breast cancer. It is necessary to develop specific interventions to minimize distress due to alopecia for women with breast cancer.
Lichen planopilaris after imiquimod 5% cream for multiple BCC in basal cell naevus syndrome.
Australas J Dermatol. 2015; 56(4):e105-7 [PubMed] Related Publications
Development and validation of Chemotherapy-induced Alopecia Distress Scale (CADS) for breast cancer patients.
Ann Oncol. 2014; 25(2):346-51 [PubMed] Related Publications
PATIENTS AND METHODS: Twenty-five items for chemotherapy-induced alopecia distress were developed based on a qualitative study, and a cross-sectional survey was conducted with 305 Korean women with breast cancer. To extract factor structure and evaluate construct validity, exploratory and confirmatory factor analysis (CFA) was carried out. Concurrent and discriminant validity were tested by correlations with the psychosocial factors. In addition, external validity analysis was conducted using data from another prospective study of 428 breast cancer patients.
RESULTS: Exploratory factor analysis and CFA yielded 17 items in four domains and the model fit was good (CFI=0.925). Coefficient alphas ranged from 0.77 to 0.95 for subdomains and 0.95 for total, and it was similar with the validation dataset confirming its external validity. The total Chemotherapy-Induced Alopecia Distress Scale (CADS) was moderately correlated with the body image (r=-0.47, P<0.001), more weakly correlated with the patients' overall quality of life (QOL, r=-0.28, P<0.001), but did not correlate with self-esteem (r=-0.07, P=0.23).
CONCLUSIONS: Our study confirmed that the CADS is a reliable and valid tool for measuring distress of chemotherapy-induced alopecia.
Cost-effectiveness analysis of scalp cooling to reduce chemotherapy-induced alopecia.
Acta Oncol. 2014; 53(1):80-7 [PubMed] Related Publications
MATERIAL AND METHODS: Scalp-cooled patients (n = 160) were compared with non-scalp-cooled patients (n = 86) at 15 Dutch hospitals. Patients were enrolled prior to anthracycline and/or taxane-based chemotherapy for several types of cancer between 2007 and 2008. Cost-effectiveness of scalp cooling compared with that of usual care was determined by the ratio of costs to quality adjusted life years (QALYs). Costs for scalp cooling (machines and nursing time), hair dressers, wigs and head covers were estimated from a societal perspective. QALYs were measured using the Short Form-36.
RESULTS: Scalp cooling reduced the use of a wig or head cover by 40%, but wigs were still purchased unnecessarily by 38% of scalp-cooled patients. Average societal costs decreased therefore only by €269 per patient due to scalp cooling (p = 0.02). Given the eligibility for scalp cooling at the time, the insignificant difference in QALYs resulted from a balance of the benefits for those patients with successful scalp cooling and those without success. For the Dutch, given the generally accepted threshold of willingness to pay for a QALY (between €20 000 and €40 000), scalp cooling was cost-effective, therefore justifying the choice of scalp cooling or purchasing a wig or head cover.
CONCLUSION: Given the right indication, cost-effectiveness might be improved further by postponing wig and head cover purchases, by improving scalp cooling efficacy, as well as using the scalp cooling capacity more intensively.
Alopecia with endocrine therapies in patients with cancer.
Oncologist. 2013; 18(10):1126-34 [PubMed] Free Access to Full Article Related Publications
METHODS: An independent search of citations was conducted using the PubMed database for all literature as of February 2013. Phase II-III studies using the terms "tamoxifen," "toremifene," "raloxifene," "anastrozole," "letrozole," "exemestane," "fulvestrant," "leuprolide," "flutamide," "bicalutamide," "nilutamide," "fluoxymesterone," "estradiol," "octreotide," "megestrol," "medroxyprogesterone acetate," "enzalutamide," and "abiraterone" were searched.
RESULTS: Data from 19,430 patients in 35 clinical trials were available for analysis. Of these, 13,415 patients had received endocrine treatments and 6,015 patients served as controls. The incidence of all-grade alopecia ranged from 0% to 25%, with an overall incidence of 4.4% (95% confidence interval: 3.3%-5.9%). The highest incidence of all-grade alopecia was observed in patients treated with tamoxifen in a phase II trial (25.4%); similarly, the overall incidence of grade 2 alopecia by meta-analysis was highest with tamoxifen (6.4%). The overall relative risk of alopecia in comparison with placebo was 12.88 (p < .001), with selective estrogen receptor modulators having the highest risk.
CONCLUSION: Alopecia is a common yet underreported adverse event of endocrine-based cancer therapies. Their long-term use heightens the importance of this condition on patients' quality of life. These findings are critical for pretherapy counseling, the identification of risk factors, and the development of interventions that could enhance adherence and mitigate this psychosocially difficult event.
A genome-wide association study of chemotherapy-induced alopecia in breast cancer patients.
Breast Cancer Res. 2013; 15(5):R81 [PubMed] Free Access to Full Article Related Publications
METHODS: We performed a case-control association study of 303 individuals who developed grade 2 alopecia, and compared them with 880 breast cancer patients who did not show hair loss after being treated with conventional chemotherapy. In addition, we separately analyzed a subset of patients who received specific combination therapies by GWASs and applied the weighted genetic risk scoring (wGRS) system to investigate the cumulative effects of the associated SNPs.
RESULTS: We identified an SNP significantly associated with drug-induced grade 2 alopecia (rs3820706 in CACNB4 (calcium channel voltage-dependent subunit beta 4) on 2q23, P = 8.13 × 10(-9), OR = 3.71) and detected several SNPs that showed some suggestive associations by subgroup analyses. We also classified patients into four groups on the basis of wGRS analysis and found that patients who classified in the highest risk group showed 443 times higher risk of antimicrotubule agents-induced alopecia than the lowest risk group.
CONCLUSIONS: Our study suggests several associated genes and should shed some light on the molecular mechanism of alopecia in chemotherapy-treated breast cancer patients and hopefully will contribute to development of interventions that will improve the quality of life (QOL) of cancer patients.
Scalp cooling to prevent alopecia after chemotherapy can be considered safe in patients with breast cancer.
Breast. 2013; 22(5):1001-4 [PubMed] Related Publications
Comparative assessment of skin and subcutaneous toxicity in patients of advanced colorectal carcinoma treated with different schedules of FOLFOX.
Asian Pac J Cancer Prev. 2013; 14(3):1781-6 [PubMed] Related Publications
METHODS: The patients with histologically confirmed advanced colorectal carcinoma (CRC) were included in the study as per specified inclusion criteria. Toxicity was graded according to CTC v2.0. The frequency of grade 3 and 4 adverse effects were comparatively assessed in each treatment arm.
RESULTS: Very severe toxicity was attributed to the FOLFOX7 schedule. The difference between the incidence rate of grade 4 toxicity with all other grades for all parameters of skin and subcutaneous toxicity was highly significant (p=0.00<0.001). Grade 4 hand and foot syndrome was reported only in the FOLFOX7 treatment arm. The most frequent adverse symptom of skin and subcutaneous toxicity reported in the patients treated with modified schedule of FOLFOX was pruritus (grade 1). Frequency and onset of skin and subcutaneous toxic symptoms like alopecia (p=0.000), nail discoloration (p=0.021) and pruritis (p=0.000) was significantly different in each FOLFOX treatment arm. A few cases of oncholysis were also reported in the FOLFOX7 treatment arm. Hand and foot syndrome was fast progressing in patients with grade 1 toxicity.
CONCLUSION: Higher frequency and severity of hand and foot syndrome and pruritus wasa found in the FOLFOX7 treatment arm. Skin and subcutaneous toxicity was comparatively low in the FOLFOX6 treatment arm.
Factors influencing the effectiveness of scalp cooling in the prevention of chemotherapy-induced alopecia.
Oncologist. 2013; 18(7):885-91 [PubMed] Free Access to Full Article Related Publications
Efficacy and tolerability of two scalp cooling systems for the prevention of alopecia associated with docetaxel treatment.
Support Care Cancer. 2013; 21(9):2565-73 [PubMed] Related Publications
METHODS: In this open-label, prospective, nonrandomized trial, patients with solid tumors receiving docetaxel in a palliative setting were allocated according to patients' preference to short-term cooling (over 45 min postinfusion) with a Paxman PSC-2 machine (PAX), with cold cap (CC), or no cooling. The combined endpoint was alopecia World Health Organisation (WHO) III or IV or the necessity to wear a wig. Study identifier is Clinicaltrials.gov NCT01008774.
RESULTS: Two hundred thirty-eight patients were included in the trial (128 patients PAX, 71 CC, and 39 no cooling). Number of cycles (median 4) and median docetaxel doses were similar across groups (55-60 mg/day on weekly therapy, 135-140 mg/day on 3-weekly therapy). Alopecia occurred with PAX, CC, and no cooling under 3-weekly docetaxel in 23, 27, and 74% and under weekly docetaxel in 7, 8, and 17%, respectively. Overall, cooling (PAX and CC combined) reduced risk of alopecia by 78% (hazard ratio 0.22; 95% confidence interval 0.12 to 0.41). CC and PAX prophylaxis led to the same degree of prevention of alopecia. Adverse events (AE) were reported in 5% (most frequently, sensation of cold), and 30 patients (13%) discontinued cooling measures after cycle 1.
CONCLUSIONS: In this first comparison published to date, both PAX and CC offer efficacious protection against hair loss, in particular when docetaxel is administered in a 3-weekly interval.
The experience of chemotherapy-induced alopecia for Australian women with ovarian cancer.
Eur J Cancer Care (Engl). 2013; 22(4):503-12 [PubMed] Related Publications
Successful management of imatinib despite alopecia and nail necrosis.
Transfus Apher Sci. 2013; 48(2):271-2 [PubMed] Related Publications
Follicular mucinosis and mycosis-fungoides-like drug eruption due to leuprolide acetate: a case report and review.
J Cutan Pathol. 2012; 39(11):1022-5 [PubMed] Related Publications
Hair shaft abnormalities after chemotherapy and tamoxifen therapy in patients with breast cancer evaluated by optical coherence tomography.
Br J Dermatol. 2012; 167(6):1272-8 [PubMed] Related Publications
OBJECTIVES: This study aims to evaluate hair shaft alterations using OCT in chemotherapy-induced alopecia and in patients taking tamoxifen.
METHODS: The measurements of this prospective case series were performed on women aged 29-68 years, receiving either tamoxifen (n = 17) or chemotherapy (n = 17) prior to (T1) and after (T2) treatment. Each time, 20 hairs from two different sites of the scalp (frontal, occipital) were examined by OCT. The hair parameters were characterized by cross section (CS) and form factor (FF). The ratio of maximal to minimal hair diameters determined the FF.
RESULTS: After chemotherapy, the CS of hairs was significantly lower compared with hairs taken at T1. The FF did not vary between T1 and T2 for the frontal area, but it did for the occipital area. In patients treated with tamoxifen, changes were observed neither in CS nor in FF. However, comparing both therapeutic groups, there were significant differences in CS and FF for T2, but not for T1.
CONCLUSIONS: Reported changes in hair structure after chemotherapy may be due to reduction of hair shaft calibre and increase of FF in regrowing hair. The OCT technique is a promising method to gain more insight into chemotherapy-induced changes of hair morphology.
Perception, attitudes, preparedness and experience of chemotherapy-induced alopecia among breast cancer patients: a qualitative study.
Asian Pac J Cancer Prev. 2012; 13(4):1383-8 [PubMed] Related Publications
METHODS: Patients expected to experience or had experienced alopecia were recruited at a tertiary hospital in Seoul, Korea. Semi-structured in-depth interviews were performed in 21 patients. Recurrent issues were identified and placed into thematic categories.
RESULTS: All patients think that appearance is important and they pay attention to how they look like. They had negative perceptions about alopecia. Patients were not well prepared for alopecia, and experienced substantial physical, psychological and social distress. Lack of information and limited social support combined with negative images of cancer made it difficult for patients to overcome the trauma and deterred them from usual daily activities resulting in poor quality of life.
CONCLUSIONS: Patients were not well prepared for alopecia and negative perceptions, lack of preparedness, and limited social support and resources increased alopecia- related distress. Educational programs for preparing patients to cope with alopecia distress and advocate activities to change people's negative perception about alopecia are needed to reduce the burden imposed by alopecia in cancer patients.
Permanent scalp alopecia related to breast cancer chemotherapy by sequential fluorouracil/epirubicin/cyclophosphamide (FEC) and docetaxel: a prospective study of 20 patients.
Ann Oncol. 2012; 23(11):2879-84 [PubMed] Related Publications
PATIENTS AND METHODS: Women treated for breast cancer by a sequential adjuvant FEC and docetaxel regimen who developed permanent alopecia diagnosed between 2007 and 2011 were identified from the Department of Dermatology (Saint-Eloi Hospital, Montpellier, France) and the Department of Medical Oncology (CRLC Val d'Aurelle, Montpellier, France). Data were collected regarding demographics, type of cancer, delay of onset after chemotherapy, Dermatology Life Quality Index (DLQI), clinical description of the lesions, scalp biopsies, laboratory explorations investigating steroid hormonal, iron, zinc and thyroid status, therapy and outcome.
RESULTS: Twenty white Caucasian females were included. Hair loss presented with a moderate or intense androgenetic-like pattern of scalp alopecia. Biopsy specimen examinations were normal or displayed the androgenetic-like pattern. Laboratory explorations ruled out iron or zinc deficiency and thyroid disorders and confirmed hormonal menopause without hyperandrogenism. The overall mean DLQI score reflected the distressing psychological consequences in the patients' lives. No spontaneous regrowth of the scalp hair was noted. Treatment including vitamins, minoxidil, psoralen and ultraviolet A therapy and spironolactone proved to be ineffective.
CONCLUSION: Permanent and severe alopecia is a newly reported complication of the FEC 100-docetaxel breast cancer regimen.
Short post-infusion scalp cooling time in the prevention of docetaxel-induced alopecia.
Support Care Cancer. 2012; 20(12):3255-60 [PubMed] Related Publications
METHODS: Scalp cooling was applied in 53 patients receiving docetaxel chemotherapy with 90-min PICT (observational part). Also 15 non-scalp-cooled patients were included. If hair preservation was observed in >80 % of the patients, randomisation between 45 and 90-min PICT was planned. Patients reported tolerance of scalp cooling and use of head covering.
RESULTS: Observational study: 81 % of scalp-cooled patients did not require head covering versus 27 % of non-scalp-cooled patients. Randomised study: 79 % of 38 patients with 90-min PICT did not need head covering versus 95 % of 38 patients with 45-min PICT (p = 0.04). Scalp cooling was very well tolerated (visual analogue scale = 79).
CONCLUSION: A 45-min PICT can be recommended in 3-weekly docetaxel regimens with a dose of 75 or 100 mg/m(2), administered in 60 min. The shorter PICT is a major advantage in time investment for patients. Patients (women and men) who receive docetaxel, except combined with doxorubicin and cyclophosphamide (taxotere, adriamycin and cyclophosphamide (TAC)) should be informed about the protective effect and high tolerability of scalp cooling in avoiding CIA.
Scalp cooling for hair preservation and associated characteristics in 1411 chemotherapy patients - results of the Dutch Scalp Cooling Registry.
Acta Oncol. 2012; 51(4):497-504 [PubMed] Related Publications
MATERIAL AND METHODS: The Dutch Scalp Cooling Registry collected data on scalp-cooled patients in 28 Dutch hospitals. Nurses and patients completed questionnaires on patients, chemotherapy and scalp cooling characteristics. Logistic regression analysis was used to examine associated characteristics of the scalp cooling result.
RESULTS: Overall, 50% of the 1411 scalp-cooled patients did not wear a head cover during their last chemotherapy session. Patients were satisfied with the results in 8% of cases after TAC chemotherapy and up to 95% after paclitaxel treatment. Besides type of chemotherapy, higher dose and shorter infusion time, older age, female gender and non-West-European type of hair significantly increased the proportion head cover use. Hair length, quantity, chemical manipulation (dyeing, waving, colouring), wetting hair before scalp cooling, and treatment with chemotherapy ever before did not influence the degree of head covering among patients.
CONCLUSIONS: Scalp cooling results as recorded in this open patient registry were positive for most regimens, justifying it's use by all eligible patients, except for those needing TAC. Lengthening infusion time may improve the results.
Effects of alopecia on body image and quality of life of Turkish cancer women with or without headscarf.
Support Care Cancer. 2012; 20(10):2349-56 [PubMed] Related Publications
METHODS: This descriptive study was conducted with 204 women who received chemotherapy at the Istanbul University Institute of Oncology, Turkey. The Patient Description Form, Body Image Scale and Nightingale Symptom Assessment Scale were used in data collection. Statistical analyses were performed using descriptive statistics and non-parametric tests. Logistic regression analysis was done to predict the factors affecting body image and quality of life of the patients.
RESULTS: No difference was found between women wearing headscarves and those who did not in respect of their body image. However, women who wore headscarves who had no alopecia felt less dissatisfied with their scars, and women not wearing headscarves who had no alopecia have been feeling less self-conscious, less dissatisfied with their appearance. There was difference in terms of quality of life: women wearing headscarves had worse physical, psychological and general well-being than others.
CONCLUSION: Although there were many important factors, multivariate analysis showed that for body image, having alopecia and wearing headscarves; and for quality of life, having alopecia were the variables that had considerable effects.