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Ueberroth BE, Kosiorek HE, Nafissi NN, Ertz-Archambault N, Howland A, Haddad T, Northfelt DW. Patient and nursing staff perspectives on automated scalp cooling (ASC) for chemotherapy-induced alopecia in breast cancer. Support Care Cancer 2024; 32:412. [PMID: 38842732 DOI: 10.1007/s00520-024-08611-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/28/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE Automated scalp cooling (ASC) is available to patients undergoing chemotherapy for breast cancer to decrease chemotherapy-induced alopecia. This study sought to elucidate patient and chemotherapy nursing perspectives on the ASC experience. METHODS This is a survey-based study of chemotherapy nursing staff and patients with breast cancer regarding perceived efficacy, side effects, administration, support, and overall opinions of ASC. Chemotherapy nurses across a large, multi-regional tertiary healthcare system completed a one-time survey regarding their experiences in administering ASC. Breast cancer patients who utilized ASC were surveyed along with a control group who underwent alopecia-inducing chemotherapy without ASC use for comparison. RESULTS The majority of nursing responses reported inadequate technical support, an increased burden of administering ASC compared to other clinical duties, and that they would not recommend ASC to a family member or friend. Patients who underwent ASC reported significantly less hair loss and were significantly less likely to shave their heads or wear a wig, but this did not translate into significant differences in body image or psychosocial wellbeing responses. Time investment was the most significant burden related to ASC. CONCLUSION Patients using ASC reported significantly less hair loss compared to those not using ASC during alopecia-inducing breast cancer chemotherapy, but this did not translate to improved body image. The majority of chemotherapy nurses reported they lacked adequate support in administering ASC and would not recommend it. Enhanced nursing support may provide a means for improving the ASC experience for both nursing staff and patients.
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Affiliation(s)
- Benjamin E Ueberroth
- Department of Hematology/Oncology, University of Colorado Anschutz School of Medicine, 12801 E 17thAve, MS, Aurora, CO, 8117, USA.
| | - Heidi E Kosiorek
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, AZ, USA
| | - Nellie N Nafissi
- Department of Hematology/Oncology, University of CA-Irvine, Irvine, CA, USA
| | | | | | - Tufia Haddad
- Mayo Clinic Comprehensive Cancer Center, Rochester, MN, USA
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Rose L, Novice M, Kobayashi S, Minta A, Novice T, Sicco KL, Dulmage B. Characterization of the role of Facebook groups for patients who use scalp cooling therapy: a survey study. Support Care Cancer 2024; 32:351. [PMID: 38748328 PMCID: PMC11096238 DOI: 10.1007/s00520-024-08534-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/29/2024] [Indexed: 05/18/2024]
Abstract
Since the emergence of scalp cooling therapy (SCT) for the prevention of chemotherapy-induced alopecia (CIA), support groups on social media platforms for interested patients have surfaced. Though there are over 20,000 active members across SCT Facebook groups, little is known about how members use this platform. A 23-question survey was posted in five scalp cooling Facebook groups, reaching 219 women. Results indicated that these Facebook groups play clear roles in providing the following: (1) a supportive community for patients, (2) instructions for SCT use, (3) advice regarding insurance coverage and reimbursement, and (4) recommendations for over-the-counter products for hair loss. Despite reported interest in hair loss products, only 5% of patients sought medical treatment from dermatologists. Due to group-specific access restrictions, private Facebook groups provide patients with a protected platform to learn more about SCT from both those with personal experience and SCT company specialists. Providers may consider recommending these online groups to interested patients during the scalp cooling counseling process. As patients with CIA express a growing interest in over-the-counter hair, eyebrow, and eyelash products, it is important for dermatologists to be aware of where their patients obtain recommendations, and further, if these recommendations have clinical evidence of efficacy.
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Affiliation(s)
- Lucy Rose
- The Ohio State University College of Medicine, Columbus, OH, USA.
| | - Madison Novice
- The University of Michigan Medical School, Ann Arbor, MI, USA
| | - Sonja Kobayashi
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Abena Minta
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Taylor Novice
- Department of Dermatology, Henry Ford Health System, Detroit, MI, USA
| | - Kristen Lo Sicco
- Department of Dermatology, NYU Grossman School of Medicine, The Ronald O. Perelman, New York City, NY, USA
| | - Brittany Dulmage
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Delgado Rodríguez J, Ramos-García V, Infante-Ventura D, Suarez-Herrera JC, Rueda-Domínguez A, Serrano-Aguilar P, Del Mar Trujillo-Martín M. Ethical, legal, organizational and social issues related to the use of scalp cooling for the prevention of chemotherapy-induced alopecia: A systematic review. Health Expect 2023; 26:567-578. [PMID: 36585793 PMCID: PMC10010082 DOI: 10.1111/hex.13679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Scalp cooling (SC) aims to prevent chemotherapy-induced alopecia. The goal of this systematic review is to tackle ethical, legal, organizational and social issues related to SC. METHODS A critical appraisal of the literature was carried out using a systematic review design. MEDLINE, Embase and Web of Science databases were searched up until 2 June 2021. Studies addressing these aspects in English or Spanish were considered. Representatives of both patient associations and professional scientific societies related to the topic participated in the design of the protocol and the review of the findings. RESULTS A total of 17 studies were included. Articles were critically appraised using the MMAT and SANRA. Findings were organized into four categories: (1) ethical aspects focused on equal access, gender equity and doctor-patient communication supported by Patient Decision Aids (PtDAs); (2) patient perspective and acceptability; (3) professional perspective and acceptability; (4) organizational aspects focused on accessibility and feasibility. CONCLUSION Cancer patients' expectations when using SC need to be adjusted to reduce the potential distress associated with hair loss. PtDAs could help patients clarify their values and preferences regarding SC. Equal access to technology should be guaranteed. PATIENT OR PUBLIC CONTRIBUTION In this systematic review, the representatives of the patient associations (Ms. María Luz Amador Muñoz of the Spanish Association Against Cancer [AECC] and Ms. Catiana Martinez Cánovas of the Spanish Breast Cancer Federation [FECMA]) participated in the review of the study protocol, as well as in the results, discussion and conclusions, making their contributions. In the type of design of these studies (systematic reviews), it is not usual to have the direct participation of patients, but in this one, we have done so, as it is a systematic review that is part of a report of the Spanish Network of Health Technology Assessment Agencies (ETS).
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Affiliation(s)
- Janet Delgado Rodríguez
- Department of Philosophy, University of Granada, Granada, Spain.,The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain
| | - Vanesa Ramos-García
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain.,Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Diego Infante-Ventura
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain.,Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
| | - José Carlos Suarez-Herrera
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain.,Department of Strategy, Entrepreneurship and Sustainable Development KEDGE Business School, Marseille, France.,Cátedra UNITWIN/UNESCO de IPD-SILOS Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Antonio Rueda-Domínguez
- Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Málaga, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Málaga, Spain
| | - Pedro Serrano-Aguilar
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain.,Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain
| | - María Del Mar Trujillo-Martín
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain.,Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain
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Renehan S, Tencic M, Jackson K, Krishnasamy M. Improving preparation for scalp cooling: Learning from women undergoing chemotherapy for early-stage breast cancer-The COOL study. J Clin Nurs 2022; 31:3222-3234. [PMID: 34866261 DOI: 10.1111/jocn.16160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES This study set out to understand the experiences and expectations of scalp cooling among women with early-stage breast cancer. The objective was to develop patient co-produced information resources to better inform and prepare women considering scalp cooling during chemotherapy. BACKGROUND Treatment-induced alopecia is a common concern among women preparing for chemotherapy. Evidence indicates that many women feel inadequately prepared for scalp cooling, resulting in potentially mitigable distress and disappointment. DESIGN A single-site, sequential, explanatory mixed-methods design was used. Participants included women with early-stage breast cancer who had previously or were currently using, scalp cooling. Women completed an online survey exploring scalp cooling experiences and expectations and self-selecting participants took part in one semi-structured, audio-recorded interview. Guidelines for Good Reporting of a Mixed Methods Study were followed. RESULTS Forty-nine women (69%) consented to take part in the survey and 23 took part in an interview. Most women described losing more hair than they expected. Many described feeling inadequately prepared for the discomfort of scalp cooling; the additional time needed to accommodate scalp cooling during treatment and, that they lacked information about self- care to help minimise hair loss. Importantly, several participants described variability in nurses' knowledge and practical skills regarding scalp cooling. CONCLUSIONS To optimise experience of scalp cooling, women need comprehensive preparatory information about variability in efficacy of scalp cooling; time needed to accommodate scalp cooling; hair care during treatment, and the potential discomfort associated with it. They also need nurses to be confident and well informed about scalp cooling processes. RELEVANCE TO CLINICAL PRACTICE Our study led to the development of online, patient co-produced resources to help prepare and inform women considering using scalp cooling; and an online scalp cooling training module and checklist for nurses. Links to the resources are included in the manuscript.
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Affiliation(s)
- Steffi Renehan
- Academic Nursing Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia
| | - Monika Tencic
- Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia
| | - Kylie Jackson
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Meinir Krishnasamy
- Academic Nursing Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
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Novice T, Novice M, Portney D, Goyert J, Henry NL, Jeruss JS, Burness ML. Factors influencing scalp cooling discussions and use at a large academic institution: a single-center retrospective review. Support Care Cancer 2022; 30:8349-8355. [DOI: 10.1007/s00520-022-07285-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022]
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Versluis A, van Alphen K, Dercksen W, de Haas H, van den Hurk C, Kaptein AA. "Dear hair loss"-illness perceptions of female patients with chemotherapy-induced alopecia. Support Care Cancer 2022; 30:3955-3963. [PMID: 35048177 DOI: 10.1007/s00520-021-06748-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/07/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Chemotherapy-induced alopecia (CIA) is one of the most common and distressing side effects of chemotherapy treatment. This study aims to assess the illness perceptions of female patients dealing with CIA, and their associations with demographic and clinical characteristics, coping strategies, and quality of life. The secondary aim was to compare the illness perceptions of patients with CIA with other samples, to help elucidate the specific perceptions of patients with CIA. METHOD Forty female patients at risk of severe hair loss due to chemotherapy treatment were included at the oncological daycare unit of a teaching hospital in the Netherlands. Patients were asked to complete the Brief-Illness Perception Questionnaire (B-IPQ) and the Hair Quality of Life (Hair-QoL) questionnaire. RESULTS Illness perceptions indicated that although patients understood their hair loss, they lacked being able to make sense of managing it, negatively impacting patients' lives. Psychological quality of life was significantly correlated with the B-IPQ domains: consequences, degree of concern, and emotional response. Social quality of life was significantly correlated with psychological quality of life. Patients with CIA felt significantly less able to manage their hair loss, compared to patients with breast cancer and psoriatic arthritis. CONCLUSION As patients' beliefs of being able to manage their hair loss are important for adopting and maintaining adequate coping behaviors, additional effort of health care providers in fostering patients' sense of control is indicated, focusing on patients' strengths during and after chemotherapy treatment. In the context of developing interventions for patients with CIA, consequences, concern, and emotional response are the major dimensions that should be taken in account to help patients deal with hair loss.
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Affiliation(s)
- Anne Versluis
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands.
| | - Kirsten van Alphen
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands
| | - Wouter Dercksen
- Department of Medical Oncology, Máxima Medical Centre, Eindhoven, The Netherlands
| | - Henk de Haas
- Department of Medical Oncology, Máxima Medical Centre, Eindhoven, The Netherlands
| | - Corina van den Hurk
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands
| | - Ad A Kaptein
- Department of Medical Psychology, Leiden University Medical Centre, Leiden, The Netherlands
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Novice M, Novice T, Henry NL, Johnson K, Jeruss JS, Kidwell KM, Burness ML. Identifying Barriers and Facilitators to Scalp Cooling Therapy Through a National Survey of the Awareness, Practice Patterns, and Attitudes of Oncologists. JCO Oncol Pract 2021; 18:e225-e234. [PMID: 34529505 DOI: 10.1200/op.21.00273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Scalp cooling therapy (SCT) is the most effective method to reduce chemotherapy-induced alopecia (CIA), a highly distressing side effect of cancer treatment. Despite data supporting SCT efficacy and safety, SCT use in the United States is not widespread. Oncologists' interactions with scalp cooling were examined to identify facilitators and barriers to SCT implementation. METHODS A 33-question survey was distributed through the ASCO Research Survey Pool to a nationally representative, random sample of 600 oncology providers. Outcome measures included knowledge of SCT, frequency of initiating conversations about SCT with patients, degree of support, and barriers for SCT. Significance was defined as P < .001. RESULTS Of 155 (25.8%) responding providers, 62% of providers were in favor of SCT always or most of the time, but only 26% reported initiating discussions about SCT always or most of the time. Providers who treat breast cancer (P ≤ .0001), those who report being very familiar with SCT (P ≤ .0001), those who report having read SCT literature in the past 2 years (P ≤ .0001), and those who work at a facility with machine SCT (P ≤ .0001) were significantly more likely to initiate conversations with patients about SCT. Financial concerns (58%) were the primary reason for not recommending SCT use; efficacy (31%), staff or facility (24%), and safety (15%) concerns were also noted. Although safety concerns have decreased markedly over time, 14% of providers report patients who continue to express these concerns and 17% of providers see safety issues as barriers to supporting SCT. CONCLUSION Our findings suggest that oncology provider familiarity and experience with SCT lead to increased support for scalp cooling, which may ultimately result in greater availability and utilization of SCT when indicated.
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Affiliation(s)
| | - Taylor Novice
- Department of Dermatology, Henry Ford Hospital, Detroit, MI
| | - N Lynn Henry
- Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, MI
| | - Kyle Johnson
- Department of Urology, University of Michigan, Ann Arbor, MI
| | | | - Kelley M Kidwell
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI
| | - Monika L Burness
- Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, MI
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8
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Coolbrandt A, T'Jonck A, Blauwens K, Dejaeger E, Neven P, Punie K, Vancoille K, Wildiers H. Scalp cooling in breast cancer patients treated with docetaxel-cyclophosphamide: patient- and nurse-reported results. Breast Cancer Res Treat 2021; 186:715-722. [PMID: 33452953 DOI: 10.1007/s10549-020-06063-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Recent evidence supports the efficacy of scalp cooling in preventing chemotherapy-induced alopecia in breast cancer treatments. However, efficacy largely varies between treatment regimens. The aim of this study was to explore the patient- and nurse-reported results of scalp cooling in terms of hair loss and need for a wig/head cover in patients with breast cancer treated with 3-weekly docetaxel 75 mg/m2- cyclophosphamide 600 mg/m2. METHODS We studied nurse-reported efficacy as noted in the electronic patient files of 85 patients treated with docetaxel 75 mg/m2- cyclophosphamide 600 mg/m2 between 1/1/2017 and 1/1/2020. Sixty-nine of them also self-reported on their scalp cooling results up to one year after adjuvant chemotherapy in a retrospective way. RESULTS Nurse- and patient-reported data showed that scalp cooling was successful (i.e., hair loss < 50%) in 47.1 and 44.9% of patients, respectively, and 55% of patients were (very) satisfied with the result of scalp cooling. Scalp cooling was perceived as (very) uncomfortable in 36.2% of patients. Regarding hair status one year after treatment, 47 patients (55.3%) reported no changes compared to their hair status before treatment. CONCLUSIONS Scalp cooling is successful in preventing severe chemotherapy-induced alopecia in almost half of the patients with breast cancer treated with docetaxel 75 mg/m2- cyclophosphamide 600 mg/m2. Better understanding of the success rate of scalp cooling enables correct patient information and decision-making support.
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Affiliation(s)
- A Coolbrandt
- Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. .,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
| | - A T'Jonck
- Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - K Blauwens
- Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - E Dejaeger
- Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - P Neven
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - K Punie
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - K Vancoille
- Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - H Wildiers
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
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Boland V, Brady AM, Drury A. The physical, psychological and social experiences of alopecia among women receiving chemotherapy: An integrative literature review. Eur J Oncol Nurs 2020; 49:101840. [PMID: 33120213 DOI: 10.1016/j.ejon.2020.101840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To conduct an integrative scoping review of the physical, psychological and social experiences of women who have experienced chemotherapy-induced alopecia (CIA). METHOD An integrative review was undertaken. A systematic search of MEDLINE, CINAHL and PsycInfo identified 23 studies meeting the inclusion criteria. Data relating to women's experiences of alopecia was extracted and synthesized thematically. RESULTS Four analytical themes were formed; 'the physical and psychological effect of alopecia', 'more than the loss of hair', 'the complexities of a visual cancer identity' and 'coping with new internal and external relationships'. CIA involves a public and private representation of illness which disrupts women's identity and their acceptance in public, yet this is a highly individualised experience. There is disparity in current evidence regarding the experience of CIA for women among older age groups, with rarer forms of cancer, haematological malignancies and those receiving palliative care or targeted treatment modalities. CONCLUSIONS This review highlights the continued pervasive psychosocial implications arising from CIA, however this is not exclusive to scalp hair as alopecia from the face and body has also been found to require adaptation and effective coping. Limited knowledge exists on the experience of alopecia induced by treatment for haematological cancers and rarer-tumour groups and emerging systemic anti-cancer treatment modalities. Healthcare professionals must endeavour to support and discuss the potential risks of alopecia, and provide patients with an opportunity to voice their fears, concerns, and experiences of CIA. Future research should incorporate the identified underserved populations and the experience of newer therapies.
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Affiliation(s)
- Vanessa Boland
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, 24 D'Olier Street, Dublin 2, D02 T283, Ireland.
| | - Anne-Marie Brady
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, 24 D'Olier Street, Dublin 2, D02 T283, Ireland.
| | - Amanda Drury
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, 24 D'Olier Street, Dublin 2, D02 T283, Ireland; School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland.
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Paterson C, Kozlovskaia M, Turner M, Strickland K, Roberts C, Ogilvie R, Pranavan G, Craft P. Identifying the supportive care needs of men and women affected by chemotherapy-induced alopecia? A systematic review. J Cancer Surviv 2020; 15:14-28. [PMID: 32683651 DOI: 10.1007/s11764-020-00907-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/14/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To systematically evaluate evidence regarding the unmet supportive care needs of men and women affected by chemotherapy-induced alopecia (CIA) to inform clinical practice guidelines. METHODS We performed a review of CINAHL, MEDLINE, PsychINFO, Scopus, the Cochrane Library (CCRT and CDSR) controlled trial databases and clinicaltrials.gov from January 1990 to June 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Twenty-seven publications were selected for inclusion in this analysis. RESULTS Included reports used qualitative (ten) and quantitative (17) studies. Across these studies men and women reported the major impact that CIA had on their psychological well-being, quality of life and body image. Hair loss had a negative impact irrespective of gender, which resulted in feelings of vulnerability and visibility of being a "cancer patient". Men and women described negative feelings, often similar, related to CIA with a range of unmet supportive care needs. CONCLUSIONS Some patients are not well-prepared for alopecia due to a lack of information and resources to reduce the psychological burden associated with CIA. Hair loss will affect each patient and their family differently, therefore, intervention and support must be tailored at an individual level of need to optimise psychological and physical well-being and recovery. IMPLICATIONS FOR CANCER SURVIVORS People affected by CIA may experience a range of unmet supportive care needs, and oncology doctors and nurses are urged to use these findings in their everyday consultations to ensure effective, person-centred care and timely intervention to minimise the sequalae associated with CIA.
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Affiliation(s)
- C Paterson
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia.
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia.
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia.
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia.
- Robert Gordon University, Aberdeen, Scotland.
| | - M Kozlovskaia
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
| | - M Turner
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
| | - K Strickland
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia
| | - C Roberts
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia
| | - R Ogilvie
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
| | - G Pranavan
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- Australian National University, Canberra, Australia
| | - P Craft
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- Australian National University, Canberra, Australia
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11
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Singer S, Tkachenko E, Sharma P, Nelson C, Mostaghimi A, LeBoeuf NR. Geographic disparities in access to scalp cooling for the prevention of chemotherapy-induced alopecia in the United States. J Am Acad Dermatol 2020; 85:1248-1252. [PMID: 32610170 DOI: 10.1016/j.jaad.2020.06.073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 06/14/2020] [Accepted: 06/17/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Chemotherapy-induced alopecia is psychologically challenging for patients undergoing cancer treatment, and scalp cooling has been shown to prevent or decrease the hair loss. OBJECTIVE To evaluate whether access to scalp cooling varies by geographic area in the United States. METHODS Cancer treatment centers offering scalp cooling were identified using data from the Rapunzel Project. Medicare claims data were queried to evaluate the number of chemotherapy infusions occurring in each zip code in the United States. Geographic distribution of chemotherapy infusions and scalp cooling centers was determined using ArcGIS software. The average distance from the geographic center of all 5-digit zip codes in which chemotherapy infusions occur to the nearest scalp cooling center was calculated in miles. RESULTS There are 366 chemotherapy infusion centers in the United States that offer scalp cooling. Overall, 43.9% of Medicare-billed chemotherapy infusions in the United States occur in zip codes less than 12.5 miles from a scalp cooling center, 24.8% occur between 12.5 and 49.9 miles away, and 31.3% occur more than 50 miles away. LIMITATIONS Our results are only generalizable to patients seen at Medicare-accepting institutions in the United States. CONCLUSIONS Geographic disparities affect which patients can access scalp cooling therapy, and implementation in suburban and rural areas would increase access for patients who wish to preserve their hair while undergoing chemotherapy.
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Affiliation(s)
- Sean Singer
- Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Elizabeth Tkachenko
- Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Priyank Sharma
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Caroline Nelson
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Center for Cutaneous Oncology, Department of Dermatology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts
| | - Arash Mostaghimi
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Nicole R LeBoeuf
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Center for Cutaneous Oncology, Department of Dermatology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.
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12
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van Alphen K, Versluis A, Dercksen W, de Haas H, Lugtenberg R, Tiemensma J, Kroep J, Broadbent E, Kaptein AA, van den Hurk C. Giving A Face to Chemotherapy-Induced Alopecia: A Feasibility Study on Drawings by Patients. Asia Pac J Oncol Nurs 2020; 7:218-224. [PMID: 32478141 PMCID: PMC7233558 DOI: 10.4103/apjon.apjon_8_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/03/2020] [Indexed: 11/10/2022] Open
Abstract
Objective: Individuals with cancer experience the impact of chemotherapy on hair loss in different ways. The aim of this pilot study was to explore patients' experiences of alopecia through patients' drawings. Methods: Fifteen female patients diagnosed with cancer and treated with chemotherapy were recruited at the oncological day-care unit of a teaching hospital in the Netherlands. Participants completed a semi-structured interview about alopecia. They drew their head and hair before and during chemotherapy and completed the Brief Illness Perception Questionnaire (B-IPQ). Results: The drawings revealed predominantly physical effects, rather than emotions. Emotions were evident in the text that patients wrote under the drawings and in the B-IPQ open question about the perceived consequences of alopecia. The overall impact of alopecia that emerged from the drawings and the B-IPQ corresponded to the information retrieved from the interviews, namely disappointment, insecurity, sadness, and confrontation. Conclusions: Drawings expose cognitive and emotional responses to alopecia that may be relatively unexplored when using traditional assessment methods such as questionnaires or interviews. In future research, the drawing instructions need to be more specifically focused on feelings in order to better capture emotional reactions to hair loss.
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Affiliation(s)
- Kirsten van Alphen
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
| | - Anne Versluis
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
| | - Wouter Dercksen
- Department of Medical Oncology, Máxima Medical Centre, Eindhoven, Netherlands
| | - Henk de Haas
- Department of Medical Oncology, Máxima Medical Centre, Eindhoven, Netherlands
| | - Rieneke Lugtenberg
- Departments of Medical Oncology, Leiden University Medical Centre, Leiden, The, Netherlands
| | - Jitske Tiemensma
- Department of Psychological Science University of California, Merced, CA, USA
| | - Judith Kroep
- Departments of Medical Oncology, Leiden University Medical Centre, Leiden, The, Netherlands
| | - Elizabeth Broadbent
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Ad A Kaptein
- Medical Psychology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Corina van den Hurk
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
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13
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van den Hurk C, Keizer-Heldens P, Raats I, Hoeijmakers K, Mols F. Improving Information Provision on Chemotherapy-Induced Alopecia and Scalp Cooling: A Comprehensive Approach Including A Website and Web-Based Decision Tool. Asia Pac J Oncol Nurs 2019; 6:336-342. [PMID: 31572752 PMCID: PMC6696804 DOI: 10.4103/apjon.apjon_19_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective Alopecia is a frequently occurring side effect of chemotherapy and has high impact on many patients. Currently, scalp cooling is the only method to prevent this chemotherapy-induced alopecia (CIA) and it is effective in about half of the patients. Since determinants of the success are largely unknown, all patients should be prepared for potential hair loss. The objective was to provide up-to-date online information about CIA and scalp cooling to support patients in coping with CIA and in their choice regarding scalp cooling. Methods Essential aspects of delivering information and lack of information were identified during focus groups, interviews, and a questionnaire survey among cancer patients, and in discussions with nurses. Results The obtained information was used to develop a website (www.scalpcooling.org) and a web-based tool. It combines scientific evidence and practical advice about CIA and regrowth of hair, scalp-cooling tolerance, efficacy and safety, as well as an overview of possible advantages and disadvantages. The web-based tool provides tailored information about the probability of CIA with and without scalp cooling in particular chemotherapy regimens. Besides, the tool offers patients' support in decision-making by allowing them to reflect and consider their values and opinions about scalp cooling. Conclusions This comprehensive information is useful during nursing consultations.
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Affiliation(s)
- Corina van den Hurk
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | | | - Ilse Raats
- Dutch Institute for Healthcare Improvement (CBO), Utrecht, The Netherlands
| | - Kim Hoeijmakers
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Floortje Mols
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
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14
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Shah VV, Wikramanayake TC, DelCanto GM, van den Hurk C, Wu S, Lacouture ME, Jimenez JJ. Scalp hypothermia as a preventative measure for chemotherapy-induced alopecia: a review of controlled clinical trials. J Eur Acad Dermatol Venereol 2017; 32:720-734. [PMID: 28976026 DOI: 10.1111/jdv.14612] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 08/14/2017] [Indexed: 11/26/2022]
Abstract
Chemotherapy-induced alopecia (CIA) is a temporary, yet psychologically devastating form of hair loss that affects 65% of patients receiving cancer chemotherapy. In the 1970s, scalp hypothermia was introduced as a preventative measure against the development of CIA. Numerous studies provide evidence for the effectiveness of scalp cooling to prevent CIA, although results varied because of differences in chemotherapy regimen, cooling technique, mode of administration and patient factors. However, many of the existing studies are uncontrolled or consist of small sample sizes, and data from randomized, randomized studies are limited. To date, no clear guidelines have been established for optimum scalp cooling use as a treatment modality and its efficacy remain unknown. Nonetheless, scalp cooling remains the most widely utilized method for the prevention of CIA, and in December 2015, the United States Food and Drug Administration (FDA) cleared the DigniCap® Scalp Cooling System (Dignitana AB, Sweden) for marketing and the Orbis from Paxman® Coolers Ltd. received clearance in 2017. This literature review is one of the first to provide up-to-date review and side-by-side comparisons of controlled and randomized clinical trials (CCTs and RCTs) evaluating scalp hypothermia for the prevention of CIA. Our analyses of CCTs and RCTs to date show that scalp hypothermia is effective in reducing the occurrence rate of CIA, by 2.7-fold in the CCTs and 3.9-fold in the RCTs. These results suggest that scalp hypothermia represents an effective preventative measure for CIA, and provide guidance for management of anticipated alopecia following chemotherapy and for future investigations.
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Affiliation(s)
- V V Shah
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - T C Wikramanayake
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - G M DelCanto
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - C van den Hurk
- Research Department, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - S Wu
- Department of Medicine, Stony Brook, Stony Brook, NY, USA
| | - M E Lacouture
- Department of Medicine, Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - J J Jimenez
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
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15
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Shaw JM, O'Brien J, Chua S, De Boer R, Dear R, Murray N, Boyle F. Barriers and enablers to implementing scalp cooling in Australia: a qualitative study of health professionals' attitudes to and experience with scalp cooling. Support Care Cancer 2017; 26:305-312. [PMID: 28852873 DOI: 10.1007/s00520-017-3849-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 07/27/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Chemotherapy-induced alopecia is a common and distressing adverse event for patients. Scalp cooling to reduce this alopecia has been available in Europe for more than a decade, but only recently introduced in Australia. The aim of this study was to qualitatively explore health professionals' perceptions of the barriers and enablers to the implementation of scalp cooling in Australian cancer centres. METHODS Using a qualitative methodology, telephone interviews were conducted with 21 health professionals working in a tumour stream where chemotherapy-induced alopecia is an adverse event of treatment. Participants were recruited from five centres in Australia where scalp cooling is currently available and one centre without access to the technology. RESULTS Four interrelated themes were identified: (1) health professional attitudes, (2) concerns for patient equity, (3) logistical considerations and (4) organisational support. CONCLUSIONS This qualitative study provides the first methodological exploration of Australian health professionals' perceptions of barriers and enablers to scalp cooling uptake. The results highlighted health professional support drives the introduction of scalp cooling. Integration of the technology requires adjustments to nursing practice to manage the increased time, workload and change in patient flow. Strategies to manage the change in practice and organisational support for change in work flow are essential for successful implementation into routine care.
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Affiliation(s)
- Joanne M Shaw
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Chris O'Brien Lifehouse (C39Z), Missenden Road, Sydney, NSW, 2006, Australia.
| | - Jane O'Brien
- Epworth Breast Service, Epworth Centre, Richmond, VIC, Australia
| | - Susan Chua
- Epworth Eastern Breast Service, Epworth Eastern, Box Hill, VIC, Australia
| | - Richard De Boer
- Epworth Breast Service, Epworth Centre, Richmond, VIC, Australia
| | - Rachel Dear
- The Kinghorn Cancer Centre, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Nicholas Murray
- Medical Oncology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Fran Boyle
- The Patricia Ritchie Centre for Cancer Care and Research, The Mater Hospital, North Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
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16
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Smith K, Winstanley J, Boyle F, O'Reilly A, White M, Antill YC. Madarosis: a qualitative study to assess perceptions and experience of Australian patients with early breast cancer treated with taxane-based chemotherapy. Support Care Cancer 2017; 26:483-489. [PMID: 28831569 DOI: 10.1007/s00520-017-3852-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 08/15/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE Eyebrow and eyelash loss (madarosis) is a common and distressing side effect of chemotherapy for which no protective strategies have yet been developed. The purpose of this study was to develop an overview of perceptions and experiences of women undergoing taxane-based treatment for early breast cancer. METHODS A total of 25 women with a diagnosis of invasive early breast cancer participated in a focus group (n = 5), ages ranging from 35 to 64 (median 50), all had completed therapy with a taxane-based chemotherapy treatment. This focus group used targeted questions to explore participants' perceptions and experience of madarosis during and following chemotherapy and identified issues associated with impact of madarosis on quality of life (QoL). Thematic analysis was conducted to identify important issues experienced by participants. RESULTS Seven themes emerged from the data: (1) timing of regrowth and permanent changes, (2) meaning/importance of eyebrow/eyelashes, (3) preparedness/information given, (4) impact of the hair loss of self, (5) impact of hair loss on others, (6) physiological side effects of loss of eyebrows/eyelashes, and (7) management of loss of eyebrows/eyelashes. In addition, participants noted physical symptoms of eye irritation during their treatment that they attributed to madarosis. CONCLUSION This study highlights the significant impact of madarosis on patients, providing the first published analysis of patient's attitude and perception of eyelash and eyebrow loss during chemotherapy. Further research in this area is required and will be benefitted from the development of a dedicated instrument/questionnaire that can capture and measure the impact of madarosis on QoL and allow development of clinical trial strategies.
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Affiliation(s)
- K Smith
- Cabrini Hospital, Medical Oncology, Melbourne, Australia. .,Peter MacCallum Cancer Centre, Medical Oncology, 305 Grattan St, Melbourne, VIC, 3000, Australia.
| | - J Winstanley
- Patricia Ritchie Centre for Cancer Care and Research, University of Sydney-The Mater Hospital, Medical Oncology, Sydney, Australia
| | - F Boyle
- Patricia Ritchie Centre for Cancer Care and Research, University of Sydney-The Mater Hospital, Medical Oncology, Sydney, Australia
| | - A O'Reilly
- Patricia Ritchie Centre for Cancer Care and Research, University of Sydney-The Mater Hospital, Medical Oncology, Sydney, Australia
| | - M White
- Cabrini Hospital, Medical Oncology, Melbourne, Australia.,Monash Medical Centre, Medical Oncology, Melbourne, Australia
| | - Y C Antill
- Cabrini Hospital, Medical Oncology, Melbourne, Australia
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17
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de Barros Silva G, Donati A, van den Hurk CJ. Comments regarding "Hair regrowth during chemotherapy after scalp cooling technique". Int J Dermatol 2017; 56:e57-e59. [PMID: 28083923 DOI: 10.1111/ijd.13526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 10/26/2016] [Accepted: 11/11/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | - Aline Donati
- Department of Dermatology, Hospital do Servidor Publico Municipal de Sao Paulo, Sao Paulo, Brazil
| | - Corina J van den Hurk
- Netherlands Comprehensive Cancer Organisation (IKNL), Research Department, Utrecht, The Netherlands
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