Keeping Your Hair During Cancer

The loss of hair during cancer treatment really can be devastating. I can remember at the age of 36 feeling the insult added to injury when my hair started falling out the 14th day after my first chemo session. It did provide a rather intimate moment when my husband shaved my head if you are into that kind of foreplay.

I find it funny when people ask why I would shave my head and not hang on to my hair for as long as possible. The reason, dear friends, is that the hair is not hanging on, it is falling out in your bed, in your clothes, in your food while cooking and eating, in your car while driving and in your baby’s mouth while holding her. It was terrible, and I felt the easiest thing to do was just bite the bullet. But, hey, I had terrible hair so losing it wasn’t as hard as it is for some women who really see their hair as their shining glory.

Hair falls out because many cancer drugs go after rapidly dividing cells, which are the intestine and hair follicles, as well as cancer. Thus, there are strong reactions, read vomit and hair loss.

Hair loss is hard. It is a very visible sign that we are going through treatment, and when I was treated, the wigs looked like wigs—ick. I bought one very expensive human hair wig, and let me tell you, the problem with human hair is that it acts like human hair and you never know what it’s going to do. (I developed a theory that women buy three wigs, one for what they want to look like, one for what they think they look like and one for how they really look.)

I did try to keep my hair on the first chemo, using what was available back then, which was a cold cap. Before starting chemo, they crammed all my hair under what looked like a frozen swim cap. That lasted all of about three seconds before I started screaming to take it off. If you have ever had an ice cream headache, you know how terrible it feels when your nose feels like it’s freezing. I could not do it. No way, no how. So, I just shaved my head and got three wigs: one that hit me at the shoulders with a blonde streak down the side because I always wanted sassy long hair; one that was short and heavily frosted (or streaked); and one that was permanently curly that I could shake out and put on.

Well you can figure which one I wore every day, just giving it a good shake before putting it on. Scarves didn’t work either because to wear a scarf you have to have the correctly shaped head, which I don’t. I ended up looking like a Russian peasant woman in a babushka (read scarf tied under the chin). My hair did grow back and it was actually thicker for a while. Today, it’s the same wimpy dishwater brown I have come to know and love.

Today there are a few more options than what I had. Two studies have come out confirming that women with early-stage breast cancer who underwent scalp cooling treatments were significantly more likely to keep at least some of their hair throughout chemotherapy.

The cooling system used in these studies, and the only one approved by the FDA, keeps liquid coolant circulating through a tightly fitted cap while the patient is getting chemotherapy and for 90 minutes after. The reduced blood flow from the cold limits the effects of the chemicals on the hair follicles. These machines are purchased by the cancer center.

The study says 5 percent kept all their hair and with others keeping some of their hair, depending on the duration and kind of drugs used.

The bad news is that these studies did not include women on anthracyclines such as Adriamycin. Also, the cost of $1,500 to $3,000 is seldom covered by insurance.

While the studies were done on the systems that keep the coolant circulating, another option is cold caps in the infusion room, which are kept in a fridge to be replaced frequently. The caps, which the women rent, are cold enough to constrict the blood vessels to keep the drug from hitting the cells.

For more information on cooling systems using the replaceable caps go to the Rapunzel Project http://www.rapunzelproject.org/coldcaps.aspx. They also offer financial support. Another nonprofit who wants to help is http://www.hairtostay.org/how-scalp-cooling-works/. It shows both methods and provides support.

Good luck! And if you can’t keep your hair, just remember it puts a bad hair day in perspective. And today's wigs are great.