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Hester Hill Schnipper, LICSW, OSW-CProgram Manager, Oncology Social Work
DECEMBER 05, 2017
Many of us are all too familiar with the total alopecia (hair loss/baldness) that accompanies some chemotherapy drugs. There is not much new to say about that except that it is horrible and traumatic, and we somehow get through it and are grateful when our new hair re-appears. Personally, I recall looking in the mirror at my very short and very curly hair and thinking that I must have been moved to the Witness Protection Program. Whoever that was in the mirror, it surely wasn't me. But it was.
This article from Medscape is about the less dramatic hair loss from the anti-estrogen/hormonal drugs taken by many women with breast cancer for years and years. I don't know whether the recommendation also applies to those chemo drugs that result in gradual hair thinning rather than total loss, but I would suspect that they do. If this is your situation, ask your doctor!
Helping Cancer Patients Through the Trauma of Hair Loss
Kate M. O'Rourke
Significant Impact of Hair Loss From Endocrine Therapy
According to Mario Lacouture, MD, director of the Oncodermatology Program at Memorial Sloan Kettering Cancer Center in New York City and an authority on hair loss in cancer patients, EIA can have a significant impact on patients' emotional well-being and adherence to treatment for breast cancer. Surveys show that two thirds of women view alopecia as one of the most traumatic events that occur during breast cancer treatment, and 8% of women say they would reject treatment because of alopecia alone.
Two thirds of women view alopecia as one of the most traumatic events that occur during breast cancer treatment.
Alopecia in women can spark dissatisfaction with one's appearance, depression, anxiety, obsession, and low selfesteem.[5,6] Many patients experience significant disturbance in their social life, such as avoiding social meetings.[5,6] In one survey of women with alopecia, 40% said that hair loss had caused marital problems and 63% said it had adverse career-related issues. Psychological morbidity can occur with equal frequency in women whose hair is typically covered by a headscarf.
EIA has a different clinical presentation from that of chemotherapy-induced alopecia. EIA is usually milder in severity, tends to be localized at the frontal hairline, and usually responds to topical minoxidil, said Dr Lacouture. At the 2017 annual meeting of the Multinational Association of Supportive Care in Cancer, Dr Lacouture highlighted unpublished data involving 41 patients with EIA who were treated with Minoxidil, of whom 75% had moderate to significant improvement. Minoxidil 5% foam daily is the only therapy approved by the US Food and Drug Administration for female pattern hair loss, and it has been shown to have varying degrees of effectiveness in patients with EIA.[4,8]
According to Rochelle Torgerson, MD, PhD, a dermatologist at the Mayo Clinic in Rochester, Minnesota, hair loss from endocrine therapy can be classified as a telogen effluvium. "It [EIA] really doesn't deserve its own name. It is a telogen effluvium," Dr Torgerson told Medscape. Telogen effluvium, which results in thinning or shedding of hair, occurs when a large number of hairs in the growing phase of the hair cycle abruptly enter the resting phase, triggered by metabolic stress, hormonal changes, or medication.