May 31st, 2015 Written by a Staff Member at Hair Loss in Women
Hair loss due to chemotherapy can make the fight against cancer even more difficult. Many patients feel that their hair loss is one of the most stressful parts of their treatment. Every time they pass by a mirror, or habitually scratch their head, it’s a reminder of what they’re going through. And it lets everyone else know too.
Chemotherapy drugs attack cancer cells, as well as healthy cells- and this includes your hair follicles. Some drugs are more likely to cause hair loss than others, depending on your dose and how you respond to the treatment, but hair loss usually begins within 2 weeks to a month after you start taking the drugs. It may come out slowly, or in large clumps.
According to the Cancer Association of South Africa (CANSA), the chemotherapy drugs most often cause hair loss are:
- Adriamycin (doxorubicin) – often causes hair loss. When administered as an injection every three to four weeks, hair loss is usually total including eyebrows, eyelashes and pubic hair. Weekly injections of lower doses are associated with minimal or no hair loss.
- Carboplatin – when used alone rarely causes hair loss. When used in combination with Cytoxan (cyclophosphamide), hair loss occurs about half of the time.
- Cisplatin – may cause hair loss; however, this side effect is uncommon.
- Cytoxan (cyclophosphamide) – commonly causes hair loss.
- Dactinomycin – may cause hair loss which is not limited to the scalp.
- Etoposide – may cause mild hair loss in some patients, although some patients develop total baldness.
- Hexamethamelamine (HMM, altretamine) – may cause hair loss; however, this side effect is uncommon.
- Ifosfamide – commonly causes hair loss.
- Taxol – causes hair loss in almost 100% of patients. Hair loss usually occurs 14 to 21 days after treatment and often affects all body hair including eyebrows, eyelashes, and pubic hair.
- Vincristine – causes hair loss in less than half of patients.
Other chemotherapy drugs which are less frequently associated with hair loss, either because the frequency of hair loss or degree of hair loss is less, include: bleomycin, 5- fluorouracil (5-FU), and methotrexate.
There is good news though. The first is that if you decide to undergo chemotherapy treatment, your hair will start to grow back within 3 to six 6 weeks after you stop chemo (and it may grow back a different texture and/or color for a while). The second is that there is something you can do to stop your hair from falling out during treatment- cryotherapy.
Cryotherapy is the medical treatment using low temperatures for many different purposes. It was developed by a Japanese doctor for the treatment of rheumatoid-arthritis, but it is also now used to burn off warts, help athletes recover from intense training, to reduce inflammation, for beauty, and some are even using it to try to lose weight. But one of its most important uses is to prevent hair loss during chemotherapy, also known as scalp hypothermia.
It works by reducing the blood flow to the scalp, which prevent the chemotherapy drugs from attacking your hair follicles. The inconvenient and uncomfortable part of this treatment is that your scalp must be kept cold 20 to 50 minutes before chemotherapy, during the treatment, as well as after (the amount of time depends on the type of chemotherapy). Some patients also experience headaches (so this may not be a good option for patients that suffer from migraines).
Candidates For Cryotherapy
According to MacMillan Cancer Support, scalp cooling is not effective with all chemotherapy drugs. It’s most likely to be effective with:
- docetaxel (Taxotere ®)
- paclitaxel (Taxol ®)
The following circumstances may disqualify a patient from being a good candidate for cryotherapy:
- If a patient has a haematological cancer such as myeloma, leukaemia or lymphoma, there’s s a high risk of cancer cells surviving in the blood vessels of the scalp, causing the cancer to come back after treatment.
- Patients who need very high doses of chemotherapy, as this makes scalp cooling less likely to work.
- Patients having continuous chemotherapy through a pump for several days, as this makes it impractical to have scalp cooling.
- Patients whose liver are not working as well as it should be. This may lead to the chemotherapy drugs circulating in the body for longer than usual, and it may not be possible to keep the scalp cold for long enough.
- Patients who have severe migraines.
- Patients who have already had a first course of chemotherapy and did not have scalp cooling for it.
Using ice or gel packs may not be practical, but there are several ways to keep your scalp cold during your chemotherapy treatments. One option is a cool cap. The most popular is Penguin Cold Caps.
Another of these caps is called the “Dignicap,” made by a Swedish company named Dignitana, and is being used in a clinical trial. Dignicaps have been available in Sweden since the mid 1990s, and are used throughout the world, except for the U.S. Dignitana is hoping to get FDA approval in 2015.
An Assistant Professor of Medicine, Haematology and Medical Oncology at the Icahn School of Medicine at Mount Sinai, Dr. Paula Klein, a is one of the principal investigators for the clinical trial. She reported Dignicap has been effective at limiting hair loss in nearly all of her patients who participated in the trial and on average, the women lost about 25% of their hair. Dignitana claims that their studies show that 80% of women in Europe and Asia that use their system retain their hair.
In the U.S., patients are using Penguin Cold Caps. They don’t require FDA approval because they aren’t a device- they’re just a cooled cap that is strapped to the patient’s scalp.
Penguin Cold Caps cost $580 / month at the minimum, and aren’t covered by insurance. But they claim that 95% of all users would use it again.
Concerns And Side Effects
Some doctors argue that if cancer cells have spread to the scalp and you cool the scalp to prevent the chemotherapy drugs from reaching the scalp, cancer may spread on the scalp. Clinical trials have shown that the risk of this happening is very low, except in cases of haematological cancers such as myeloma, leukaemia or lymphoma.
Patients get very cold during the treatments, so it’s recommended that you dress very warm, and bring blankets. And some patients get a headache from the cold.
Hope For Chemotherapy Patients
Dr. Hope Rugo, lead investigator for the clinical trial at UCSF, told local San Francisco TV station ABC7: “The chance of keeping their hair makes [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][patients] psychologically approach the chemotherapy with a much healthier attitude and more like they have control over something.”
Cryotherapy can help make an extremely stressful situation less of struggle. It may be uncomfortable, expensive, and may not save all of your hair from coming out. But as many women equate losing their hair with losing a limb, it can be well worth it.
Do you have any experience with cryotherapy? Please share your experience or any other thoughts in the comments below.[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]