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Robinson W, McLellan BN. Utilization of scalp cooling to prevent chemotherapy-induced alopecia in woman of skin of color with type 3 hair. JAAD Case Rep 2024; 50:65-68. [PMID: 39044995 PMCID: PMC11263471 DOI: 10.1016/j.jdcr.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024] Open
Affiliation(s)
- Warner Robinson
- Division of Dermatology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Beth N. McLellan
- Division of Dermatology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
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Minta A, Rose L, Shareef SJ, Adame S, Dulmage B. Availability of Cranial Prostheses for Black Patients at Comprehensive Cancer Centers. JCO Oncol Pract 2024:OP2300750. [PMID: 38917378 DOI: 10.1200/op.23.00750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/04/2024] [Accepted: 05/17/2024] [Indexed: 06/27/2024] Open
Abstract
PURPOSE For patients who seek to camouflage cancer-related hair loss, cranial prostheses such as wigs and hair pieces exist. We sought to determine the availability of yaki-textured, type IV curls, and afro wigs at boutiques in Comprehensive Cancer Centers (CCCs). METHODS The 56 CCCs in the United States were surveyed to see whether they had an affiliated wig boutique for patients experiencing hair loss. Boutique workers were then asked a series of seven questions regarding cranial prostheses options for patients seeking yaki-textured, type IV curls, and afro wigs. The availability of wigs was compared with US Census data on population size and density of Black residents. RESULTS Of the 56 CCCs, 27 (46%) institutions had active affiliated hair boutiques. We were able to reach 19 (70%) of the 27 boutiques, of which 53% (n = 10) offered yaki-textured wigs, 37% (n = 7) offered type IV curls or afro wigs, and 47% (n = 9) offered neither. Two additional boutiques offered in-store catalogs for Black patients who were interested in naturally appearing wigs. Although two institutions offered a wig bank that was free to all patients, neither had yaki-textured or afro wigs in stock. There was no significant relationship between population size or density of Black residents and availability of these wigs. CONCLUSION Many Black patients undergoing cancer treatment interested in cranial prosthesis do not have consistent access to wigs with textures comparable with type IV hair at CCCs. With increased inventory of racially inclusive wigs, partnerships with third-party vendors, and support for the previous authorization process, we can better support Black patients experiencing cancer-related hair loss.
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Affiliation(s)
- Abena Minta
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Lucy Rose
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Sarah J Shareef
- Michigan State University College of Human Medicine, East Lansing, MI
| | - Stephanie Adame
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Brittany Dulmage
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH
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Novice M. More than just hair. PATIENT EDUCATION AND COUNSELING 2024; 123:108225. [PMID: 38430732 DOI: 10.1016/j.pec.2024.108225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 01/15/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
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Landeiro LCG, Lopes Paim Miranda D, Mathias Machado R, Dienstmann R, Costa E Silva M, da Silva CF, de Castro ALR, Dos Santos APT, Bomfim VHV, Teixeira Machado B, Viviane Carvalho Rodrigues Gonçalves M, Freitas Muniz Teixeira A, Jamile Santiago Costa M, de Oliveira Dantas Viana P, Almeida P, de Cerqueira Mathias CM. Electric hand warmer versus observation to avoid discomfort during scalp cooling for chemotherapy-induced alopecia prevention: a randomized study. Sci Rep 2023; 13:19555. [PMID: 37945813 PMCID: PMC10636030 DOI: 10.1038/s41598-023-46840-3] [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: 09/30/2022] [Accepted: 11/06/2023] [Indexed: 11/12/2023] Open
Abstract
Chemotherapy-induced alopecia (CIA) is a challenge in the management of cancer patients. Scalp cooling (SC) leads to reduction in CIA, however it is associated with significant adverse events, leading to 3-13% discontinuation rates. This pilot study evaluated the role of Electric Hand Warmers (EHW) on thermal (TC), sensorial (SCo) and general comfort (GC) in patients with breast cancer (BC) undergoing chemotherapy and SC to reduce CIA. Patients were randomly assigned to EHW use or observation. TC, SCo and GC were evaluated after each chemotherapy infusion. Favorable outcomes in both TC and SCo defined a positive result on GC. We analysed the impact of age, alopecia, chemotherapy regimen and EHW use in the different comfort scales using a Logistic Regression (LR) model. Forty women with early breast cancer were randomly assigned to EHW (n = 20) or observation (n = 20) during neo(adjuvant) chemotherapy. Median age was 53 years. In the EHW arm, favorable thermal response was reported by 79% versus 50% in the control arm (odds ratio [OR] 3.79, p < 0.001). SCo was satisfactory in 82% in the EHW arm versus 74% in the control arm (OR 1.62, p = 0.1). Overall, 73% in the EHW arm had favorable GC versus 44% in the control arm (OR 3.4, p < 0.001). Age, alopecia, and chemotherapy regimen did not impact on comfort measures. Conclusion: Our study suggests that the use of an EHW has a consistent favorable impact on TC and GC of BC patients under SC technology to prevent CIA.
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Affiliation(s)
| | - Diego Lopes Paim Miranda
- Complexo Hospitalar Universitário Professor Edgard Santos (C-HUPES) - Universidade Federal da Bahia (UFBA), Savador, BA, Brazil
| | | | | | | | | | | | | | | | - Bruno Teixeira Machado
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | | | | | | | | | - Pâmela Almeida
- Clínica AMO - Assistência Multidisciplinar em Oncologia, Salvador, BA, Brazil
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Robinson WM, McLellan BN. Addressing the Need for Diversity in Scalp Cooling Trials. JAMA Oncol 2023; 9:1331-1332. [PMID: 37561424 DOI: 10.1001/jamaoncol.2023.2906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
This Viewpoint emphasizes the importance of diverse representation in research on scalp cooling to avoid hair loss during chemotherapy.
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Affiliation(s)
- Warner M Robinson
- Division of Dermatology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Beth N McLellan
- Division of Dermatology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
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Heibloem RE, Komen MMC, Ilozumba OUC, van den Hurk CJG. Minimal added value of wetting hair before scalp cooling to prevent chemotherapy-induced alopecia in cancer patients - results from the Dutch Scalp Cooling Registry. Support Care Cancer 2023; 31:273. [PMID: 37067605 DOI: 10.1007/s00520-023-07687-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/12/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE Preventing chemotherapy-induced alopecia (CIA) is related to the degree of temperature reduction during scalp cooling. Wetting hair before scalp cooling reduces the scalp skin temperature. This observational study investigated the effects of wetting hair before scalp cooling on preventing CIA and on tolerance in cancer patients. METHODS This Dutch multi-center cohort study comprised 1825 patients receiving ≥1 cycle of docetaxel (D), 5-fluorouracil-epirubicin-cyclophosphamide (FEC), 5-fluorouracil-epirubicin-cyclophosphamide-docetaxel (FECD), paclitaxel (P), or paclitaxel-carboplatin (PC). Patients underwent scalp cooling with wet or dry hair. Primary and secondary outcomes were the effects of wetting hair on head cover use and tolerance, respectively. RESULTS None of the associations between wetting hair and head cover use in patients on D, FEC, P, or PC was significant; however, results all tended to be in favor of wetting hair. For FECD, univariate (p=0.005; OR=1.6; CI=1.1-2.1) and multivariable associations (p=0.007; OR=1.8; CI=1.2-2.6) were significant. Scalp cooling discontinuation due to intolerance differed significantly between groups that wetted hair or not (3% and 1% respectively; p=0.034). CONCLUSION In a large patient group with mainly a European hair type and a high hair mass, no convincing evidence was found whether wetting hair prior to scalp cooling contributes to better prevention of CIA. Since it is argued that a higher reduction in scalp skin temperature by wetting hair contributes positively to scalp cooling efficacy, only a randomized controlled trial can provide an ultimate conclusion at the highest level of evidence. Until that time, healthcare professionals have to take into account that wetting hair may introduce lower compliance to the scalp cooling procedure.
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Affiliation(s)
- Robin E Heibloem
- Department of Health Sciences, Vrije Universiteit Amsterdam, HV 1081, Amsterdam, The Netherlands
| | - Manon M C Komen
- Department of Oncology Research, Northwest Clinics Alkmaar, PO Box 501, AM 1800, Alkmaar, The Netherlands
| | - Onaedo U C Ilozumba
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - Corina J G van den Hurk
- Comprehensive Cancer Organisation the Netherlands, PO Box 19079, DB 3501, Utrecht, The Netherlands.
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Pleasant VA, Purkiss AS, Merjaver SD. Redefining the “crown”: Approaching chemotherapy‐induced alopecia among Black patients with breast cancer. Cancer 2023; 129:1629-1633. [PMID: 37158640 DOI: 10.1002/cncr.34732] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
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Ahmad M, Saeed S, Olamiju B, Silber A, Leventhal J. Dermatologic toxicities of chemotherapy: an educational intervention for skin of color women with breast cancer. Int J Womens Dermatol 2023; 9:e073. [PMID: 36733315 PMCID: PMC9886509 DOI: 10.1097/jw9.0000000000000073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/20/2022] [Indexed: 02/01/2023] Open
Abstract
Minority patients are more likely to require dose adjustments for chemotherapy, with cultural barriers and access to medical care cited as contributory factors. Objective We sought to pilot an educational intervention, in the form of a pamphlet, to evaluate the effectiveness of this tool in teaching skin of color (SoC) patients about potential dermatologic toxicities of chemotherapy that are relevant to their skin type. Methods At a chemotherapy infusion center, SoC patients (n = 26) who were receiving chemotherapy for breast cancer voluntarily consented to read an educational pamphlet and complete a series of survey questions before and after this educational intervention. Results Most participants identified as female (96%), African American/Black (81%), and non-Hispanic (85%); all respondents had obtained at least a high school degree. Survey responses revealed a significant increase in knowledge about the potential dermatologic effects of cancer treatment after this intervention. Notably, 100% of participants either agreed or strongly agreed that they would like to see other doctors use this educational tool as a form of patient education, that they would recommend this pamphlet to other patients who are starting cancer treatment, and that the pamphlet was easy to understand. Limitations Limitations of this study include small sample size and single-institution recruitment, which may limit generalizability. Furthermore, this study only included patients who are proficient in English. Conclusion This study pilots an effective educational tool that addresses dermatologic toxicities of chemotherapy that are relevant to SoC patients. Further multi-institutional studies with larger sample sizes and translation to other languages can overcome the limitations of this pilot study.
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Affiliation(s)
- Maham Ahmad
- Department of Dermatology, Yale School of Medicine, New Haven, CT
| | - Sabrina Saeed
- Department of Dermatology, Yale School of Medicine, New Haven, CT
| | - Brianna Olamiju
- Department of Dermatology, Yale School of Medicine, New Haven, CT
| | - Andrea Silber
- Yale Cancer Center, Yale School of Medicine, New Haven, CT
| | - Jonathan Leventhal
- Department of Dermatology, Yale School of Medicine, New Haven, CT
- * Corresponding author. E-mail address: (J. Leventhal)
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Rose L, Lustberg M, Ruddy KJ, Cathcart-Rake E, Loprinzi C, Dulmage B. Hair loss during and after breast cancer therapy. Support Care Cancer 2023; 31:186. [PMID: 36826602 DOI: 10.1007/s00520-023-07634-5] [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: 11/04/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
For patients diagnosed with breast cancer, alopecia can be a distressing side effect of treatment. Major surgeries, cytotoxic chemotherapy, and endocrine therapy may result in several different types of alopecia. This article reviews the underlying mechanisms, etiology, prevention strategies, and treatment options for chemotherapy-induced alopecia, telogen effluvium, and endocrine-induced alopecia. Here, we aim to provide breast oncologists with a review of the types of hair loss related to cancer therapy and current preventative and treatment options to facilitate informative patient counseling.
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Affiliation(s)
- Lucy Rose
- The Ohio State University College of Medicine, Columbus, OH, USA
| | | | | | | | | | - Brittany Dulmage
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Rose L, Schnell PM, Radcliff L, Lustberg M, Dulmage B. Retrospective cohort study of scalp cooling in breast cancer patients. Support Care Cancer 2023; 31:118. [PMID: 36645520 DOI: 10.1007/s00520-022-07562-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/21/2022] [Indexed: 01/17/2023]
Abstract
For patients with cancer, alopecia is a common side effect that negatively impacts personal identity, body image, self-esteem, quality of life, and medical decision-making. Scalp cooling is a technique used to prevent alopecia in patients undergoing chemotherapy in which patients wear a cooled cap during chemotherapy infusions, causing localized vasoconstriction of blood vessels on the scalp. Because of the recent emergence of scalp cooling, there is a need to explore further the reasons why patients pursue this treatment. A retrospective chart review of women with breast cancer treated at The Ohio State University was conducted to investigate how factors such as patient age, race, ethnicity, insurance status, stage of cancer, and chemotherapy regimen influenced patients' decisions to incorporate scalp cooling into their treatment plan as compared to those who did not. Findings revealed that patient age, race, insurance status, and chemotherapy regimen were predictors of a patient's likelihood to undergo scalp cooling. Patients diagnosed at younger age and those with private insurance were more likely to utilize scalp cooling. In comparison to White patients, non-White patients were less likely to choose scalp cooling. Furthermore, patients placed on the chemotherapy regimen of AC or AC-T were less likely to pursue scalp cooling than patients on PTCH or TC regimens. These findings provide background for the development of educational resources for both patients interested in this therapy and healthcare providers discussing this treatment option in dermatology and oncology settings.
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Affiliation(s)
- Lucy Rose
- The Ohio State University College of Medicine, Columbus, OH, USA
| | | | - Lindsey Radcliff
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Maryam Lustberg
- Breast Cancer Center, Smilow Cancer Hospital, Yale University, New Haven, CT, USA
| | - Brittany Dulmage
- The Ohio State University Wexner Medical Center, Columbus, OH, USA. .,Department of Dermatology, The Ohio State University Wexner Medical Center, 540 Officenter Place, Suite 240, OH, 43230, Gahanna, USA.
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Hrin ML, McMichael AJ. Chemotherapy-induced alopecia in African American women: A literature review demonstrates a knowledge gap. J Am Acad Dermatol 2021; 86:1434-1435. [PMID: 34197873 DOI: 10.1016/j.jaad.2021.06.858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/14/2021] [Accepted: 06/19/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Matthew L Hrin
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
| | - Amy J McMichael
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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