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Management of Alopecia Due to Cancer Therapies

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The MASCC Textbook of Cancer Supportive Care and Survivorship

Abstract

Alopecia is a common and distressing side effect of many cytotoxics used in cancer treatment and of radiotherapy directed at hair-bearing areas. Alopecia is most prominent on the scalp but affects the eyebrows, eyelashes, beard, axillary and pubic hair. Newer targeted therapies also may induce alopecia, hair damage and depigmentation, and endocrine therapies for breast cancer may induce longer-lasting grade 1 alopecia similar to androgenetic alopecia. For most patients, regrowth occurs after treatment completion, but the colour and structure of hair can be altered, prolonging the negative impact on patients’ sense of well-being. Permanent alopecia has also been described with chemotherapy and radiotherapy. Management is typically to alter drug choice, to shave the head or to camouflage the loss by wearing a wig, head scarf or hat/turban. Scalp cooling is the most effective prevention strategy for chemotherapy-induced alopecia (CIA). Recent trials demonstrate the feasibility and safety of gel caps and coolant devices in anthracycline and/or taxane adjuvant chemotherapy for early breast cancer and for single-agent docetaxel in a range of malignancies. Limited data suggest a role for minoxidil in promoting hair regrowth. New techniques are being investigated for prevention of scalp alopecia after whole-brain radiotherapy. Given the significance of alopecia to patients, further research to ameliorate this common side effect of chemotherapy treatment is urgently required.

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Boyle, F.M. et al. (2018). Management of Alopecia Due to Cancer Therapies. In: Olver, I. (eds) The MASCC Textbook of Cancer Supportive Care and Survivorship. Springer, Cham. https://doi.org/10.1007/978-3-319-90990-5_38

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