1 (edited by PCL1029 Fri, 22 Jul 2011 08:15:18)

Topic: Information and Recommendations about Chemo-related Hair Loss

Hi,
Some facts about hair growth:
On an average,there are 100,000 hairs on the scalp and of which  100-150 are lost normally daily in the cycle.
Hair grows at a rate of 0.35mm per day.
Approximately 85-90% of hair follicles are in the active growth phase at any time.

there are 3 grades of hair loss.
Grade1=less than 25% of hair;obvious to patients but not to others.
Grade2=25-50% loss; obvious thinning but enough to lead to the use of a wig.
Grade 3=>50% loss and a wig may be needed.
Randomized controlled trials suggest significantly less hair loss with scalp hypothermia but  it may not be as effective in patients with liver dysfunction.

Among the drugs used to treat CC, ,epirubicin,paclitaxel,irinotecan are those most likely to cause complete hair loss.;5FU,gemcitabine ,mitomycin are less common and Carpoplatin,Cisplatin and Capecitabine are the least common to cause hair loss. EGFR inhibitors like erlotinib(Tarceva) ,sorafenib(Nexavar) and sunitinib (up to 50% of patients) and MoAb like cetuximab(Erbitux) may cause hair thinning and most of them are reversible except in some cases after treatment of gefitinib(Iressa).
In short,high dose of chemo, and combination chemotherapy reigmens are more likely to result in hair loss than are single agents , by oral administration and low -dose therapy and weekly administration.
Because the chemotherapy-associated hair loss is transient and reversible after cessation of the treatment; counseling and psychological support before  and during therapy should be considered first over the use of devices such as scalp hypothermia and scalp tourniquet because of case reports of cutaneous metastases and therefore preclude the recommendation for there use.

No  pharmacologic interventions is available to treat chemo-related hair loss effectively at this point.--From uptodate.com literature review version. 18.2.
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: Information and Recommendations about Chemo-related Hair Loss

Hi Percy,
I noticed that UCSF is using this with their patients:
http://www.msnbc.msn.com/id/40718154/ns … heir-hair/

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: Information and Recommendations about Chemo-related Hair Loss

Hi,Marion,
They did not recommend the scalp hypothermia method because out of the concern that in one case study, after a patient  who had used cooling cap finished chemo therapy,but later develop recurrent disease LIMITED  to the scalp;subsequent treatment without  a cooling device resulted in complete clinical remission.there were 7 other reports suggesting possibility scalp metastasis too.
there are case reports suggest that cooling devices may be contraindicated in patients with circulating tumor cells eg lymphoma or in those with liver dysfunction resulting in prolonged drug half-lives. I do not think FDA has approved any of those devices ;so I think all those cooling method are still under clinical trials.But I could be wrong.
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: Information and Recommendations about Chemo-related Hair Loss

Thanks Percy....something to keep an eye on.

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER