chemotherapy and hair loss

FAQ: Chemotherapy and hair loss

You might not be aware of the importance of your hair to your self image and state of mind until you face the prospect of losing it and, in fact, both men and women note that hair loss is one of the side effects that they worry about most when they are diagnosed with cancer.

Here we have answered some of the most common questions we get asked about chemotherapy and hair loss, as we have found that talking through any concerns and fears is the best way to prepare patients for their breast cancer care journey.

Does chemo automatically cause hair loss?

It depends on the kind of treatment you get because hair loss occurs with some – but not all – chemotherapy drugs.

Why do certain treatments cause hair loss?

Because certain chemo procedures use cytostatic drugs – which are designed to quickly detect and destroy any rapidly-dividing cells, such as cancer cells. Unfortunately, they can also wipe out other rapidly-dividing cells, such as the cells in hair follicles that make hair grow. However, because chemo is a bespoke treatment involving a cocktail of specific drugs depending on the circumstances of the cancer you have, it’s not a given that your treatment will result in hair loss.

If hair loss occurs, when will it start to happen?

Usually two to three weeks after the first course of treatment. With some people, hair loss will happen gradually, while with others it’ll be more sudden – again, it depends on the treatment. The amount of hair loss varies from a slight thinning to complete baldness, and affects the scalp, eyelashes, eyebrows, legs, armpits and pubic area. By the second course of treatment, the hair loss will be more pronounced.

Is there any pain during hair loss?

Some people will experience a pain in the scalp area, while others could experience itching.

Will my hair ever grow back?

Yes. Hair will grow back when the course of treatment has ended. Some people will notice immediate growth, while others will experience it a month or two afterwards.

Will my regrown hair look or feel different?

Hair that grows back after chemo often looks different at first: there may be a different tint to it – usually darker. Sometimes the texture changes as well, with straight hair going curlier, and vice versa. Sometimes this is a temporary effect which lasts for a few months. Sometimes it isn’t. Sometimes it comes back thicker: sometimes it feels finer.

What should I do to prepare for chemotherapy and hair loss?

This is a very personal thing, and it depends on two main factors – the treatment you are about to receive, and your personality. If you have been advised that your treatment will result in hair loss, you could get the jump on it and cut your hair shorter beforehand: a gradual experience of losing hair can help people cope better than a sudden loss.

If you really can’t handle changing your looks and intend to wear a hairpiece as you recover from chemo, make sure you shop around for one that suits your current look well in advance – or maybe it’s an opportunity to try out another look altogether.

And, of course, more and more women are choosing not to hide their hair loss at all. If you’re one of those people, remember that your exposed scalp will feel very sensitive – and not always in a negative way – at first. A huge amount of body heat is lost through the top of the head, so stock up on headscarves and hats. And an exposed scalp can be extremely sensitive to UV rays, so keep the sun cream handy.

If you have any other questions, one of the cancer care team at Thames Breast Clinic is always on hand to discuss every aspect of your treatment.

breast cancer screening importance

Breast cancer screening: the pros and cons

Breast cancer screening aims to identify signs that breast cancer is developing, spotting breast cancers early when they are often too small to see or feel but are usually easier to treat. One in eight women in the UK will be diagnosed with breast cancer at some point in their life and the UK breast cancer screening programme finds cancer in about eight of every 1,000 women tested. The NHS states that early screening saves approximately 1,300 lives per year.

However, researchers at University College London have found that women who fall into the low-risk category when it comes to breast cancer – estimated to be a third of the population – would actually be better off not being screened at all.

Their findings showed that a screening programme based on the level of risk of developing cancer over a lifetime will not substantially increase the number of women who are missed but will reduce the number of women who go through unnecessary breast cancer screening tests.

Overdiagnosis and breast cancer

On first evaluation of breast cancer screening, it might seem to patients that there are no downsides to tests that could pick up early signs of breast cancer and potentially save your life. Yet, breast cancer screening can deliver an abnormal result that means women are called back for further and more invasive tests, often experiencing great distress, and eventually they are found to be cancer-free.

A more sophisticated approach to breast cancer

The researchers at UCL propound the view that genetic testing could inform women of their individual risk and the sector of the population that are most at risk could be entered into the screening programme. Genetic screening brings with it its own set of concerns, though, and at the Thames Breast Clinic we can discuss all the possible implications before you decide to go ahead.

childbirth after cancer

Childbirth after cancer: a new breakthrough?

Deciding to start or build upon a family after cancer is a difficult decision, for many reasons – especially if you’ve gone through certain treatments.

In the main, pregnancy after cancer treatment is safe for both mother and baby: the medical community is in agreement that pregnancy does not seem to raise the odds of cancer returning. However, when it comes to exactly when a cancer survivor should embark on pregnancy, the waters become a little muddy, depending on the cancer type and stage, your age, and – especially – the type of treatment you’ve undergone. Let’s start with those:

  • Radiation therapy can affect the support cells and blood supply of the uterus, which can also increase the chances of miscarriage, early birth, low birth weight, and other complications.
  • Cervical surgery – whether partial or complete –  may increase the risks of miscarriage or early birth.
  • Chemotherapy is loaded with chemicals which can may damage heart cells and weaken the heart, which will cause it to have to work harder during pregnancy and labour. When chemo is combined with radiation therapy to the upper abdomen or chest, the risks of heart problems increase.

Consequently, there is no one-size-fits-all advice to dispense when it comes to post-cancer pregnancy. Some medical experts advise chemo patients to put off pregnancy for six months after the end of treatment, to give any eggs damaged by the treatment the time to leave the body. Others advise that you put off pregnancy for anything from two to five years, as the chance of cancer returning is always higher in the earlier years.

Another major worry that potential parents who have survived cancer wrestle with are the chances of their child contracting cancer too. In actual fact, research demonstrates that children of cancer survivors are not at higher risk. As we know, however, a few cancers are hereditary, and can be passed on through genes. It also goes without saying that a brush with cancer forces people to contemplate their own mortality a litter sooner than everyone else, and the idea of bringing a child into the world and then not being around for them can be a sobering thought.

A new breakthrough in post-cancer motherhood?

For those willing to pursue motherhood after a cancer diagnosis, the usual procedure involves having ovarian tissue removed and frozen before fertility-harming treatments commence. If all goes to plan and the cancer is eradicated, the tissue is put back. It’s mostly a safe procedure – but there are certain cancers which invade the ovarian tissue, meaning that when restored, there is a risk that the cancer will return.

However, science continues to find a way. The latest breakthrough comes from the Rigshospitalet in Copenhagen, where doctors have created an ‘artificial ovary’ from human tissue and eggs, in an attempt to help women have children after cancer treatment.

A recent demonstration showed that a lab-made ovary could keep human embryos alive, which could then be implanted in the future. This is created by stripping donated ovarian tissue of all of its cells (including any potential cancer cells) in order to leave a bare framework of collagen – which is then pitted with scores of human follicles, which can host early-stage eggs.

Returning you to normal life after successful cancer treatment is the goal of the breast cancer specialists at Thames Breast Clinic.

breast cancer chemotherapy

Your chances of undergoing breast cancer chemotherapy just got smaller

Data presented at the world’s biggest meeting of cancer doctors and scientists at the annual meeting of the American Society of Clinical Oncology in Chicago has caused a stir amongst the worldwide cancer treatment community, and for good reason: its findings on trials of a genetic test that analyses the danger of a tumour have concluded that as many as 70% of women with the most common form of early-stage breast cancer can safely avoid the challenges inherent in chemotherapy treatment.

We know that chemotherapy – the course of treatment designed to reduce the chance of breast cancer spreading or coming back, can (and has) saved lives across the world, but the side-effects of the toxic drugs deployed in the treatment are manifold. In ‘mild’ cases, these range from vomiting, fatigue and infertility to permanent nerve pain – and in extremely rare cases, it can lead to heart failure and leukaemia.

However, the trial – which involved the studying of cancer in 10,273 women using a genetic test that is already widely available, including on our NHS – is set to change practices across the world immediately, meaning that many women with breast cancer can be treated safely with surgery and hormone therapy.

An end to uncertainty?

The genetic test has been used for a while now, and women who get a low score on the test are told they do not need chemotherapy, while those with a high score are told they definitely do. But the problem has been that the vast majority of test results fall into an intermediate range, with an unclear result – which results in them undergoing chemo as a precautionary measure.

The data presented in Chicago by the Albert Einstein Cancer Center in New York, however, has demonstrated that women in the intermediate range have practically the same survival rates with or without chemo: the nine-year-survival-rate was 93.9% without chemotherapy and 93.8% with chemotherapy. This is a doubly important development: not only will fewer women have to undergo chemo, but it will also save a lot of money for a cash-strapped health service and instantly change the way the medical community deals with cancer.

According to experts, this means that an estimated 3,000 women a year in the UK will no longer need chemotherapy because of this trial.

A ‘life-changing breakthrough’

The test focuses specifically upon early-stage breast cancers – specifically those that can still be treated with hormone therapy, have not spread to the lymph nodes and do not have the HER2 mutation, which makes them develop faster. The test is performed on a sample of the tumour when it is removed during surgery, and examines the activity levels of 21 genes, which are markers of how aggressive the cancer is.

As Rachel Rawson, from the charity Breast Cancer Care, pointed out: “Every day, women with certain types of breast cancer face the terrible dilemma of whether or not to have the treatment, without hard facts about the benefit for them.

“This life-changing breakthrough is absolutely wonderful news as it could liberate thousands of women from the agony of chemotherapy.”

breast screening error

The breast screening computer error: what you need to know

If you’ve been worried about the recent news about an IT error which meant that 450,000 women in England aged 70 to 79 were not informed about crucial breast cancer screenings, you’re not alone: there are fears that as many as 270 women may have died because of a computer error. And according to a letter published in the Lancet recently, there may be even more women who should have been screened than first thought.

While no-one likes being reminded about being tested, not being reminded at all is a far more troubling experience. So how do you know if you missed a breast screening, and what can you do about it? Here are the main points…

How will I know if I’ve missed a breast screening appointment?

Of all the women who weren’t informed about screenings, over 309,000 are still alive and have been sent a letter, which should have arrived before the end of May. The letters invited women under 72 for a catch-up screening and directed women over the age of 72 towards a helpline to discuss whether a screening is appropriate.

According to Public Health England (PHE), women aged between 70-79 who are currently registered with a GP and have not received a letter are not affected, and do not need a catch-up screening. They advise that if you not currently registered with a GP and you believe they have been affected, you should call their helpline on 0800 169 2692.

What should I do now?

The PHE have advised – as always – that women should be aware of any changes to their breasts, while the Ministry of Health advised that if women had any concerns about their breasts, they should visit their GP at the first opportunity. They also re-stressed that everyone registered with a family doctor who did not receive a letter by the end of May should be reassured they had not missed a screening.

What about women currently under 70 and over 80?

The Ministry of Health has stated that no-one under 70 has been affected, and only a small proportion of women at the upper age limit of the NHS programme who were aged between 70 and 71 were affected. People over 80 are not affected.

What is being done to ensure this doesn’t happen again?

The government claims that urgent work is being carried out on the computerised invitation system, and an additional failsafe procedure has been introduced to ensure that the problem does not reoccur.

What if I have noticed a change in my breasts?

As always, if you have noticed any changes in your breasts or had any breast cancer symptoms, then you should go to see your GP. The symptoms of breast cancer include:

  • A lump in the breast
  • Dimpling of the skin or thickening in the breast tissue
  • A nipple that has turned inward
  • Pain or discomfort in the breast that has not gone away

For more advice, call us on 0800 612 9490 or email us on info@thamesbreastclinic.com to arrange an immediate consultation.

chemotherapy risks

Breast cancer treatment and heart damage: is it worth worrying about?

It’s a sad fact that many of the breast cancer therapies currently available can cause heart damage, but a new study conducted by the German Cancer Research Centre in Heidelberg has provided some good news. According to their report, the risk of death from heart disease in breast cancer patients following radiotherapy or chemotherapy is no higher than it is among the average population.

We know that many of the breast cancer treatments – especially chemotherapy and radiotherapy – have done a lot to give women an excellent chance in their fight against breast cancer, but the fact remains that a number of clinical trials point to a correlation between chemotherapy and radiotherapy treatment and an increased risk of developing heart disease.

In certain cases, patients who underwent either treatment may be at higher risk from death by heart disease than succumbing to breast cancer. So, when we undergo such treatment, are we just eliminating one risk in exchange for developing another? This was the conundrum that the DKFZ sought to investigate.

Getting to the heart of the matter

The study, headed up by Dr Hermann Brenner of the DKFZ, analysed data from almost 350,000 patients in America who were diagnosed with breast cancer in the years 2000-2011 and underwent radiotherapy or chemotherapy. Comparing that data like-for-like with the female average population in the United States, the researchers concluded that the long-term risk of mortality from heart disease is not higher following breast cancer treatment than in the average female population, be it chemotherapy or radiation therapy.

Why is this? Well, experts are deducing that hospitals have caught up to the idea of good risk management, where the potential dangers are flagged up well in advance and by avoiding a one-size-fits-all approach to patient care. When a new patient checks in, their potential risk of suffering heart disease due to breast cancer treatment will be immediately taken into account when it’s time to select the choosing the best possible method of treatment.

Not only that, but testing for any side-effects on the heart are being conducted at certain points during the course of treatment, meaning that doctors can make the necessary ‘tweaks’ to the treatment quickly and effectively, in an attempt to nip any potential heart problems in the bud as soon as possible.

No need for heart-related stress

“We consider the result of our study to be very positive for the treatment of breast cancer,” says Dr Brenner, and he claims that the benefit-risk ratio in modern-day breast cancer treatment is of a high standard. “It is particularly good news for the large number of affected patients that if they are in good medical care and have survived breast cancer, they do not need to be more worried about deadly heart diseases than women at the same age without breast cancer.”

So, in short: while the risk of side-effects is still prevalent in today’s breast cancer treatment, the chances of developing heart disease whilst eliminating the risk of breast cancer should be one less thing to worry about.

breast cancer testing

Coming soon – a pee test for breast cancer?

A lot of us have been familiar with a take-home urine test when we suspect we’re pregnant – and some of us have undergone a urine test at work – but how would we feel about a pee test for breast cancer? Thanks to a medical company in Japan, that prospect could be a reality over the next decade.

The engineering and IT corporation Hitachi might be best known in the UK for their home electrical equipment, but in actual fact, they’re a highly diversified company with their fingers in many pies, including medical equipment. And now, two years after developing a prototype for the basic technology to detect breast and colon cancer from urine samples, they have announced a new round of tests with 250 new samples, in an attempt to see if batches at room temperature would be fit for analysis.

Breast cancer testing: quicker, more accurate, cheaper?

Unsurprisingly, Hitachi spokesperson Chiharu Odaira is very positive about this development, spelling out the benefits of this method of testing. “If this method is put to practical use, it will be a lot easier for people to get a cancer test, as there will be no need to go to a medical organisation for a blood test,” he said. Not only that, but it would be a boon in detecting paediatric cancers, pointing out that it would be especially beneficial in testing for needle-phobic kids.

As we know, the most common diagnostic method for the detection of breast cancer consists of a mammogram, which is followed by a biopsy if a risk is detected. Hitachi’s proposed method focuses on the detection of waste materials inside urine samples which act as a ‘biomarker’—in other words, a naturally occurring substance by which a particular disease can be identified.

Does it hold water?

If the new test – which commences in September, in collaboration with Nagoya University – goes well, it’s fair to say that this will have a massively positive effect on early detections and the saving of lives, not to mention a huge boost to social and medical budgets.

Remember: the earlier cancer is detected, the better chance a carrier has of surviving it, meaning that more than a few experts are getting very excited about this development. However, it’s worth bearing in mind that this is the first experiment of its kind in medical history, and urine-based cancer detection is, for want of a better word, essentially uncharted waters.

But when you combine this news with the report which was published earlier this year – about a new blood test which has ‘shown promise’ towards detecting eight different kinds of tumours before they spread elsewhere in the body – and it’s clear that we could be on the verge of a wave of breakthroughs in the field of cancer detection.

Hitachi claims that if their suspicions about the effectiveness of their urine test are correct a product will be rolled out over the next decade that would effectively be a huge step towards improved and earlier cancer detection.

radiotherapy study

Radiotherapy: is it time to lower the dose?

For thousands of women with breast cancer, radiotherapy is a necessary evil. As well as killing off cancer cells, it brings myriad side-effects, including fatigue, hair loss, diarrhoea and loss of appetite. Sometimes, when a high dose of radiation is deployed, the effects are severe.

However, a recent study claims that targeted treatments of radiotherapy – or even lower doses – were just as effective. The study, led by Cambridge University and London’s Institute of Cancer Research, claims that irradiating the tumour – rather than the whole breast – was just as good and came with fewer side-effects. Not only that but a second technique – bathing the whole breast with radiation but using a lower dose – was also equally effective and also reduced adverse effects.

Study into radiotherapy dosage and breast cancer

The trial involved over 1,200 women who were being treated at hospitals across the country. Half were given the usual high dose, while the other half underwent a lower dose, and were then monitored them for five years after treatment. Along the way, the subjects were questioned about adverse side-effects (such as a hardening of tissue, pain, over-sensitivity of the treated area and build-up of fluid) at the start of the study, after six months and one, two and five years after radiotherapy. Most of the side-effects reported alluded to changes affecting the breast: the most commonplace side-effect was an overall change in breast appearance.

The researchers discovered no difference in rates of cancer recurrence with the less aggressive approaches, and the patients in the lower-dose group reported significantly lower side-effects. Furthermore, it was discovered that women were more likely to report adverse side-effects if they were younger, had larger breasts, had a larger volume of breast tissue removed at surgery, if the cancer had spread to any of their lymph nodes, and if, at the start of the study, they were feeling anxious or depressed.

A reassuring development

“The findings from this study are reassuring for women who are offered either whole breast or partial breast radiotherapy using this technique of radiotherapy, which is simple to deliver and already available in centres worldwide,” claimed Dr Indrani Bhattacharya, a clinical research fellow at the Institute of Cancer Research. “This new information will help doctors discuss the risks and benefits of this type of radiotherapy with patients and may improve shared decision-making, as well as enabling them to tailor treatment for individual patients.”

As well as an interesting development in terms of how we treat breast cancer with radiotherapy, the study has also shed light on who is more likely to experience adverse side effects and can help practitioners identify these patients and then offer the necessary support.

mindfulness and coping with cancer

Could mindfulness help you cope with cancer?

There has been much coverage of the concept of mindfulness and its importance as a remedy for all manner of modern-day ailments. But what about when your entire life has been knocked out of kilter by a breast cancer diagnosis?

In a nutshell, mindfulness involves focusing upon what is occurring in the here and now: on the inside, on what’s running through your head, and what’s taking place around you. Essentially, it’s an attitude – a way of taking time out and zoning in on yourself, in order to put your everyday hassles on hold and make sense of your current thoughts and emotions.

Obviously, when you’re dealing with breast cancer, thinking about yourself, processing your thoughts and trying to divine any changes in your body – as well as wringing as much ‘me time’ out of your day as possible – is a natural reaction. But the point of mindfulness, according to experts, is to remind you not to neglect your mental health while you spend time keeping as physically well as possible. To filter out as many bad sensations and thoughts as possible and remind yourself of the many positive things that are still occurring.

So how easy – or otherwise – is it to step into a mindful attitude? According to experts, there are four steps to take in order to take control of the here and now:

  • Noticing: being able to switch off the autopilot that carries you through the day, and tune in to what changes are occurring both inwardly and outwardly
  • Observing: taking the time to experience and log how things look, feel, smell, and taste
  • Naming: developing the ability to isolate and nail down why certain feelings are cropping up more often than others, and getting to the root of them
  • Accepting: having the ability of know that certain things are happening and being able to work a way around them

What mindfulness isn’t, is fatalistic, or pessimistic, or even passive: it’s a coping tool geared to get people to stop, think, hold back an overwhelming flood of emotions, and cherry-pick the positive ones. For example, one mindfulness technique – the body scan – requires the participant to either lie on their back or sit down, and focus on one thing or action, such as one’s breathing or background noise, and go through the noticing-observing-naming-accepting checklist. The point to all this is to arrive at a level of concentration where you can start regulating and even amending your emotions.

Could mindfulness help breast cancer patients?

You may have noticed by now that mindfulness is nothing new, and it draws heavily on exercises used in yoga and meditation for hundreds of years. But can it really work as part of a toolkit in coping with breast cancer? Seeing as fear and uncertainty can be just as prevalent a symptom of cancer as the physical elements, it certainly won’t do any harm. At a time when it’s vital to be as focused and positive as possible, pursuing and honing a mindfulness regime which suits your lifestyle and attitude could be an essential weapon in your armoury.

stress and breast cancer

The stress and breast cancer link: there’s no such thing…is there?

A disturbing conclusion from a survey conducted by YouGov on behalf of the World Cancer Research Fund: half of Britons polled think that stress can cause cancer, even though there is no scientific evidence to support that belief.

The survey, which attempted to divine the general public’s knowledge of what does and does not cause cancer, asked 2,070 adults about stress and whether it causes cancer or not – and exactly half of those questioned claimed that it does. And the proportion of people who think that is increasing, according to the annual survey: last year, 46% of the people polled believed that theory – which, according to everything we know, is untrue.

However, nothing is ever that simple when it comes to cancer. While there is no evidence to support the stress/cancer link, the World Cancer Research Fund is quick to point out that stress provides an element of risky behaviour that can lead to cancer. “People under stress can sometimes behave in unhealthy ways, such as smoking, overeating or drinking heavily, which do increase their risk of many cancers,” the Fund pointed out in a press release to support the survey findings. “If you’re under stress, it’s important to try to find other ways of coping, such as doing physical activity.”

‘Poor’ evidence of stress and breast cancer link

This opinion has been backed up in over here by Cancer Research UK, which zones in on the risks (or otherwise) of stress when it comes to breast cancer. As their literature points out;

“It has been suggested that stress can cause cancer, particularly breast cancer. But the evidence for this has been poor. While a few studies have found a link, they have often only looked at a small number of participants or asked women to recall if they were stressed before they developed the disease, which isn’t a reliable way of measuring stress.”

But again, CRUK spokesperson Fiona Osgun was quick to point out the knock-on effects of stress. “Research shows there’s no direct link between stress and cancer, but being stressed can make us more likely to reach for a glass of wine or the biscuit barrel. On the upside, healthy ways of dealing with stress like going for a brisk walk can help cut cancer risk.”

Don’t let stress get on top of you

While no-one is saying that cancer is nothing to worry about, it’s clear that stress doesn’t help. And obviously, we all have different ways of dealing with stress, but the key is to find coping mechanisms which don’t lead to bad habits and unhealthy lifestyles. The NHS has a handy checklist of the symptoms of stress, as well as a swathe of strategies to tackle whatever life throws at you when things don’t go to plan – such as being more active, staying socially busy whilst ensuring a sufficient amount of Me Time, stepping back and evaluating what exactly is winding you up, and staying positive.