Abstract
Despite advances in the treatment of many side effects associated with chemotherapy, alopecia remains an issue that is difficult to resolve. Chemotherapy-induced alopecia (CIA) is a condition that can have profound psychosocial and quality-of-life consequences, resulting in anxiety, depression, a negative body image, lowered self-esteem, and a reduced sense of well-being. Patients who fear CIA may sometimes select regimens with less favorable outcomes or may refuse treatment. When supporting patients with CIA, health care providers should use an individualized approach with a focus placed on the actual moment of hair loss. Education, support groups, and self-care strategies are important components of any management approach. No treatment modality for preventing CIA has been clearly shown to be effective. Recent evidence suggests that new scalp hypothermic regimens may be safe and effective. There remains a critical need for effective new approaches to this problem.
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Batchelor D (2001) Hair and cancer chemotherapy: consequences and nursing care—a literature study. Eur J Cancer Care 10:147–163
Botchkarev VA, Komarova EA, Siebenhaar F, Botchkareva NV, Komarov PG, Maurer M, Gilchrest BA, Gudkov AV (2000) p53 is essential for chemotherapy-induced hair loss. Cancer Res 60:5002–5006
Carelle N, Piotto E, Bellanger A, Germanaud J, Thuillier A, Khayat D (2002) Changing patient perceptions of the side effects of cancer chemotherapy. Cancer 95:155–163
Cassileth B, Zupikis R, Sutton-Smith K, March V (1980) Information and participation preferences among cancer patients. Ann Intern Med 92:832–836
Cella D (1997) The Functional Assessment of Cancer Therapy-Anemia (FACT-An) Scale: a new tool for the assessment of outcomes in cancer anemia and fatigue. Semin Hematol 34:13–19
Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J et al (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579
Christodoulou C, Klouvas G, Efstathiou E, Zervakis D, Papazachariou E, Plyta M, Skarlos DV (2002) Effectiveness of the MSC cold cap system in the prevention of chemotherapy-induced alopecia. Oncology 62:97–102
Coates A, Abraham S, Kaye SB, Sowerbutts T, Frewin C, Fox RM, Tattersall MH (1983) On the receiving end—patient perception of the side-effects of cancer chemotherapy. Eur J Cancer Clin Oncol 19:203–208
Cordova M, Giese-Davis J, Golant M, Kronenwetter C, Spiegel D (2003) Presented at the Society of Behavioral Medicine, 24th Annual Meeting and Scientific Sessions, Salt Lake City, Utah, USA, March 19–22, 2003
Cotsarelis G, Millar S (2001) Towards a molecular understanding of hair loss and its treatment. Trends Mol Med 7:293–301
de Boer-Dennert M, de Wit R, Schmitz PI, Djontono J, v Beurden V, Stoter G, Verweij J (1997) Patient perceptions of the side-effects of chemotherapy: the influence of 5HT3 antagonists. Br J Cancer 76:1055–1061
Dean JC, Salmon SE, Griffith KS (1979) Prevention of doxorubicin-induced hair loss with scalp hypothermia. N Engl J Med 301:1427–1429
Duvic M, Lemak NA, Valero V, Hymes SR, Farmer KL, Hortobagyi GN, Trancik RJ, Bandstra BA, Compton LD (1996) A randomized trial of minoxidil in chemotherapy-induced alopecia. J Am Acad Dermatol 35:74–78
Fallowfield L (1992) Behavioural interventions and psychological aspects of care during chemotherapy. Eur J Cancer 28A:S39–S41
Griffin AM, Butow PN, Coates AS, Childs AM, Ellis PM, Dunn SM, Tattersall MH (1996) On the receiving end. V: Patient perceptions of the side effects of cancer chemotherapy in 1993. Ann Oncol 7:189–195
Hennessey JD (1966) Alopecia and cytotoxic drugs. Br Med J 2:1138
Hidalgo M, Rinaldi D, Medina G, Griffin T, Turner J, Von Hoff DD (1999) A phase I trial of topical topitriol (calcitriol, 1,25-dihydroxyvitamin D3) to prevent chemotherapy-induced alopecia. Anticancer Drugs 10:393–395
Hillen HF, Breed WP, Botman CJ (1990) Scalp cooling by cold air for the prevention of chemotherapy-induced alopecia. Neth J Med 37:231–235
Horowitz M, Wilner N, Alvarez W (1979) Impact of Event Scale: a measure of subjective stress. Psychosom Med 41:209–218
Hussein AM (1995) Protection against cytosine arabinoside-induced alopecia by minoxidil in a rat animal model. Int J Dermatol 34:470–473
Hussein AM, Stuart A, Peters WP (1995) Protection against chemotherapy-induced alopecia by cyclosporin A in the newborn rat animal model. Dermatology 190:192–196
Jimenez JJ, Yunis AA (1992) Protection from chemotherapy-induced alopecia by 1,25-dihydroxyvitamin D3. Cancer Res 52:5123–5125
Johansen LV (1985) Scalp hypothermia in the prevention of chemotherapy-induced alopecia. Acta Radiologica 24:113–116
Katsimbri P, Bamias A, Pavlidis N (2000) Prevention of chemotherapy-induced alopecia using an effective scalp cooling system. Eur J Cancer 36:766–771
Keller J, Blausey L (1988) Nursing issues and management in chemotherapy-induced alopecia. Oncol Nurs Forum 15:603–607
Kennedy M, Packard R, Grant M, Padilla G, Presant C, Chillar R (1983) The effects of using Chemocap on occurrence of chemotherapy-induced alopecia. Oncol Nurs Forum 10:19–24
Kiebert GM, Hanneke J, de Haes CJ, Kievit J, van de Velde CJ (1990) Effect of peri-operative chemotherapy on the quality of life of patients with early breast cancer. Eur J Cancer 26:1038–1042
Lieberman MA, Golant M, Giese-Davis J, Winzelberg A, Benjamin H, Humphreys K, Kronenwetter C, Russo S, Spiegel D (2003) Electronic support groups for breast carcinoma. Cancer 97:920–925
Maurer M, Handjiski B, Paus R (1997) Hair growth modulation by topical immunophilin ligands: induction of anagen, inhibition of massive catagen development, and relative protection from chemotherapy-induced alopecia. Am J Pathol 150:1433–1441
McGarvey EL, Baum LD, Pinkerton RC, Rogers LM (2001) Psychological sequelae and alopecia among women with cancer. Cancer Pract 9:283–289
Muller-Rover S, Rossiter H, Lindner G, Peters EM, Kupper TS, Paus R (1999) Hair follice apoptosis and Bcl-2. J Investig Dermatol Symp Proc 4:272–277
Munstedt K, Manthey N, Sachsse S, Vahrson H (1997) Changes in self-concept and body image during alopecia induced cancer chemotherapy. Support Care Cancer 5:139–143
Paus R, Cotsarelis G (1999) The biology of hair follicles. N Engl J Med 341:491–497
Paus R, Schilli MB, Handjiski B, Menrad A, Henz BM, Plonka P (1996) Topical calcitriol enhances normal hair regrowth but does not prevent chemotherapy-induced alopecia in mice. Cancer Res 56:4438–4443
Perlin E, Amin D (1991) Protection from chemotherapy-induced alopecia. Med Pediatr Oncol 19:129–130
Pesce A, Cassuto JP, Joyner MV, DuJardin P, Audoly P (1978) Scalp tourniquet in the prevention of chemotherapy-induced alopecia. N Engl J Med 298:1204–1205
Peters EM, Foitzik K, Paus R, Ray S, Holick MF (2001) A new strategy for modulating chemotherapy-induced alopecia, using PTH/PTHrP receptor agonist and antagonist. J Invest Dermatol 117:173–178
Pickard-Holley S (1995) The symptom experience of alopecia. Semin Oncol Nurs 11:235–238
Pozo-Kaderman C, Kaderman R, Toonkel R (1999) The psychosocial aspects of breast cancer. Nurse Pract Forum 10:165–174
Protiere C, Evans K, Camerlo J, d’Ingrado M, Macquart-Moulin G et al (2002) Efficacy and tolerance of a scalp-cooling system for prevention of hair loss and the experience of breast cancer patients treated by adjuvant chemotherapy. Support Care Cancer 10:529–537
Rhodes V, McDaniel R, Johnson M (1995) Patients education: self-care guides. Semin Oncol Nurs 11:298–304
Ridderheim M, Bjurberg M, Gustavsson A (2003) Scalp hypothermia to prevent chemotherapy-induced alopecia is effective and safe: a pilot study of a new digitized scalp-cooling system used in 74 patients. Support Care Cancer 11:371–377
Rodriguez R, Machiavelli M, Leone B, Romero A, Cuevas MA, Langhi M, Romero Acuna L, Romero Acuna J, Amato S, Barbieri M, et al (1994) Minoxidil (Mx) as a prophylaxis of doxorubicin-induced alopecia. Ann Oncol 5:769–70
Sitzia J, Hughes J, Sobrido L (1993) A study of patients’ experience of side-effects associated with chemotherapy: pilot stage report. Int J Nurs Stnd 32:580–600
Takahata K, Tada M, Yazawa K, Tamaki T (1999) Protection from chemotherapy-induced alopecia by docosahexaenoic acid. Lipids 34:S105
Tierney AJ (1987) Preventing chemotherapy-induced alopecia in cancer patients: is scalp cooling worthwhile? J Adv Nurs 12:303–310
Tierney A, Taylor J (1991) Chemotherapy-induced hair loss. Nurs Stand 5:29–31
Tsuda T, Ohmori Y, Muramatsu H, Hosaka Y, Takiguchi K, Saitoh F, Kato K, Nakayama K, Nakamura N, Nagata S, Mochizuki H (2001). Inhibitory effect of M50054, a novel inhibitor of apoptosis, on anti-Fas-antibody-induced hepatitis and chemotherapy-induced alopecia. Eur J Pharmacol 433:37–45
Wheelock JB, Myers MB, Krebs HB, Goplerud DR (1984) Ineffectiveness of scalp hypothermia in the prevention of alopecia in patients treated with doxorubicin and cisplatin combinations. Cancer Treat Rep 68:1387–1388
Whelan T, Rath D, Willan A, Neimanis M, Czukar D, Levine M (1998) Evaluation of a patient file folder to improve the dissemination of written information materials for cancer patients. Cancer 83:1620–1625
Williams J, Wood C, Cunningham-Warburton P (1999) A narrative study of chemotherapy-induced alopecia. Oncol Nurs Forum 26:1463–1468
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Hesketh, P.J., Batchelor, D., Golant, M. et al. Chemotherapy-induced alopecia: psychosocial impact and therapeutic approaches. Support Care Cancer 12, 543–549 (2004). https://doi.org/10.1007/s00520-003-0562-5
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DOI: https://doi.org/10.1007/s00520-003-0562-5