Hair loss, or alopecia, is often associated with cancer therapies and, in particular, with cytotoxic chemotherapy. While this side effect is most often temporary – hair generally grows back three to six months after therapy has concluded – it is nevertheless concerning for many, so much so that some patients refuse chemotherapy and undergo sub-optimal treatment. Although there is still so much to be learned about this phenomenon, in general, we understand that the reason for hair loss is due to chemotherapy properties of targeting fast-dividing cells, like cancerous cells, but also hair follicle cells.
When it comes to mesothelioma treatment, however, we do not see this side effect often. While it is possible for mesothelioma patients to lose their hair during treatment, it is more likely that they will experience thinning of hair or even no effect on hair whatsoever.
The reason for this is found in the way that drugs used for the treatment of mesothelioma differ from those used in other cancers. Mesothelioma patients are usually treated systemically with the following chemotherapy drugs:
- Alimta (pemetrexed)
- Cisplatin
- Carboplatin
- Gemzar (gemcitabine)
- Navelbine (vinorelbine)
The mechanisms of action of these drugs typically do not interfere with hair follicle cells. But even among these drugs, some are a bit more likely than others to cause at least some hair thinning. As a result, using combination therapies, which are common in mesothelioma, also increases the risk.
Each drug has its own side effect profile, so speaking to the treating physician about expectations before treatment begins and informing the physician about side effects during treatment is equally important. Doctors have a variety of tools available to them to ease side effects and make treatment more tolerable. In the case of hair loss during chemotherapy, patients can discuss with their doctor the use of a cooling cap. Scalp cooling caps lower the temperature of the scalp, thus reducing the blood flow to that area and, consequently, the amount of medication to reach the hair follicles.
Ultimately, a patient able to tolerate a treatment is more likely to complete it and experience benefits from it, therefore patients shouldn’t hesitate to ask for help.
