Very Rare Permanent Alopecia

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Very Rare Permanent Alopecia

Posted 5/18/2012

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This is one of the most horrifying things I have ever read — way worse than monsters from the swamp, alien creatures invading bodies, or vampires prowling at midnight. This is a report of a study done in France that found permanent alopeica (hair loss, baldness) in a few women who were treated with FEC as adjuvant breast cancer therapy. I have never heard of this side effect (permanent hair loss) before, and I am certain there will be more studies to follow. Here it is, read it and weep, and be glad that this is a relatively unusual regimen rarely used in the U.S. This is the abstract and then a link:

Permanent scalp alopecia related to breast cancer chemotherapy by sequential fluorouracil/epirubicin/ cyclophosphamide (FEC) and docetaxel: a prospective study of 20 patients

N. Kluger, W. Jacot, E. Frouin, V. Rigau, S. Poujol, O. Dereure, B. Guillot, G. Romieu & D. Bessis

Background: To analyze the clinical and histological features of permanent alopecia following a sequential fluorouracil/epirubicin/cyclophosphamide (FEC) and docetaxel regimen for adjuvant breast cancer treatment. 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 IndexÒ (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.