In the treatment of lung cancer patients, we often encounter several hair related problems, some of which are distressing, some of which are difficult to laugh or cry. What causes these problems and how to solve them?
Does chemotherapy necessarily lead to hair loss, and it is the kind of hair that is completely bald?
When it comes to chemotherapy, most friends have the impression of vomiting, hair loss and low blood count. Perhaps it was mainly misguided by some films and TV works, or influenced by rumors in the street, which caused a wrong impression of many people: there was a drug called chemotherapy, and everyone responded the same when they used it. In fact, chemotherapeutic drugs are a series of drugs that have the ability to interfere with the proliferation of actively proliferating cells. There are more than ten commonly used drugs in lung cancer.
These actively proliferating cells include tumor cells, so chemotherapy may be effective; There are bone marrow hematopoietic stem cells, so chemotherapy has bone marrow suppression, neutrophils, hemoglobin, and platelets may decline; There are also cells at the root of hair, not only hair, eyebrows, beard (if any) and other body hairs, which may be affected by chemotherapy drugs. Therefore, chemotherapeutics will more or less have symptoms such as hair loss, but not necessarily very serious.
At present, there are two categories of commonly used chemotherapy drugs for lung cancer:
Non cycle specific drugs
Non cycle specific drugs include cisplatin, carboplatin, nedaplatin, lobaplatin. Other similar drugs are rarely used in lung cancer, but still used in breast cancer, gynecological tumors, blood tumors, etc., such as (isocyclophosphamide), and various other nitrogen mustard commonly used in blood tumors.
Cycle specific drugs
The cycle specific drugs include pemetrexed, gemcitabine, paclitaxel, docetaxel, vinorelbine, etoposide, irinotecan, topotecan, 5-fluorouracil, which is rarely used in lung cancer, and its enhanced drug, tegeol. Liposome paclitaxel, albumin paclitaxel and micellar paclitaxel are only different from ordinary paclitaxel dosage forms. They are not new drugs but multiple dosage forms of the same drug. Docetaxel, also known as docetaxel, is not another form of paclitaxel, but another drug.
In addition, anthracycline drugs such as doxorubicin and epirubicin, which are not commonly used in lung cancer, have the characteristics of the above two types of effects.
The drugs that make almost all drug users suffer from severe hair loss are paclitaxel, docetaxel and etoposide, while the other extreme is pemetrexed and gemcitabine. The hair loss is very mild, even undetectable. Only when platinum is combined, some people may have the melancholy of "whitehead scratching is shorter, and the appetite is too strong to hairpin".
Chemotherapy alopecia is effective, does not alopecia mean that medication is ineffective?
There are many similar "accidents" using side effects to infer the efficacy. Today, we only talk about chemotherapy alopecia.
Although it is not ruled out that in some cases, the dosage is too conservative, or there is no obvious hair loss after the use of paclitaxel and other hair loss prone drugs due to individual differences, but after reading the above, have you ever thought that the side effect of hair loss is first related to the type of drugs. People with thick hair may end the treatment and return to normal life without having time to feel "hair loss is full of hair loss and looks bad" after the "short and smooth" four cycles (about three months) of pemetrexed plus carboplatin adjuvant chemotherapy.
It is even more unreliable to use the severity of side effects to infer the efficacy. When chemotherapy drugs are sufficient, the effectiveness is the relationship between chemotherapy drugs and tumors, and the side effects are the relationship between chemotherapy drugs and other human tissues and cells, which cannot be confused. Even healthy people without malignant tumors will lose their hair after chemotherapy such as paclitaxel.
Is there any good prevention and treatment method for chemotherapy alopecia?
Before introducing the feasibility of the various methods that you usually put forward, we should first tell you that psychological counseling of hair loss is more important than actual treatment. Even if the attempt fails, you should not be too concerned about such a side effect without substantial harm. The impact is mainly concentrated on the fact that a few family members did not tell the patient about their condition, and hair loss exposed the purpose of treatment. Therefore, the problem of psychological counseling should be prepared first. The author does not suggest that we hide the condition when the patient has autonomous behavior (except for Alzheimer's).
The ice cap concerned by some people may alleviate hair loss during the treatment, but the relief is not to stop, and the effect varies from person to person. Its principle is mainly to consider that the drug concentration is high during the chemotherapy infusion, and the drug concentration drops soon after the chemotherapy infusion is completed. Therefore, during the infusion, the scalp is cooled, the blood vessels are contracted, and the local chemotherapy drugs may be less, and the hair root cells are less affected by the chemotherapy drugs. But what about the eyebrows and mustaches? It is suggested that the ice cap should be designed like this in the future.
The preventive and therapeutic effects of traditional Chinese medicine vary from person to person. It is suggested that friends who have this idea should go to the regular hospital for special interview with the consent of the doctor in charge. Under the principle of "thousands of people and thousands of square meters", it is possible to fill medicine for yourself according to others' prescriptions.
All kinds of folk formulas can't be easily tried. It is common to discuss that people use ginger to wipe and eat a lot of black sesame seeds. Local stimulation and increased oil are likely to aggravate the situation of "little willow on the branches".
When can the hair loss caused by chemotherapy be recovered?
Normal cells often have the ability of complete self-regulation and recovery. Because chemotherapy drugs inhibit the reproductive capacity of some cells, instead of "killing everything", after chemotherapy, there will be a "recovery period" of cells with hair follicles, and then they will gradually resume hair growth.
Taxol, docetaxel, and etoposide, the drugs that cause severe hair loss, are generally not used for too many consecutive times. Except for small cell lung cancer treatment in individual cases, these drugs are not suitable for maintenance treatment. Therefore, we should ignore the hair loss caused by chemotherapy as much as possible, and pay more attention to improving the curative effect and other side effects that have substantial physical harm. We can always wait until the time when the spring wind blows again.
Chemotherapy generally does not cause permanent hair loss. Are other treatments possible?
Is the hair loss of brain radiotherapy permanent?
Not necessarily, depending on the type of radiotherapy and individual recovery ability.
Hair loss often occurs when the dose of whole brain radiotherapy and preventive brain radiotherapy reaches 1000cGy in the treatment process, but this kind of "flat hit" method of radiation (left in the figure below) often does not cause the death of hair follicle cells in a certain part of the hair root and permanent hair loss. Generally, a small amount of hair loss is encountered in a large area, which can be recovered. A few people will lose hair seriously, but most of them can recover. The incidence and degree of hair loss caused by various stereotactic precise radiotherapy, including gamma knife (in the figure below), is lower because the radiation energy reaching the tumor is further spread out. It is easy to cause permanent hair loss by non stereotactic, non whole brain local high-dose radiotherapy (right in the figure below). Now, it is rarely used in the treatment of brain metastasis, and the permanent hair loss is also the local location of the lineation, which generally does not cover a large range.
The above is only a schematic diagram. Only when the tumor (black sphere in the figure) receives enough radiation (blue arrow in the figure) can it be effective. As we all know, it is good that the radiation density affects the lethality when passing through the scalp. The specific radiotherapy plan will not be so simple.
How is hair loss when taking targeted drugs?
Hair loss during targeted treatment is relatively mild, most of which are indirect side effects, usually accompanied by skin rash and folliculitis at the scalp. If it occurs, go to the dermatology department to treat the direct side effects of targeted drugs first, and the skin damage is usually relieved after it is reduced.
Hair loss without skin rash and folliculitis can be classified as a direct side effect similar to skin rash at present. Don't "think you have taken chemotherapy drugs". The cells of hair roots and hair follicles also have the expression of some genes corresponding to targeted drugs (the most typical is EGFR), which is inhibited as the tumor cells. The number of hair loss does not increase every day, but the number of new hair decreases, which gradually means that "strong combing and sparse hair scarves, and empty walking with sticks to test the disease". Similar to the original straight hair, new curly hair, and even some black hair has grown out of white hair. The specific principle has not been studied for the time being. Since it is a good thing to save perm and hair dyeing, I will not say much about it.
Write at the end
I hope that when we face the problem of hair loss, we should calm down and analyze the causes of hair loss, and not scare ourselves with the effect; Don't worry too much about the image problem caused by hair loss. The key is to live a high quality life for a long time. Don't focus on pleasing others; Don't interfere with the original priority treatment in order to avoid hair loss. If hair loss can't be solved, why bother about treatment.
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