Why does chemotherapy cause hair loss?

Because many chemotherapy drugs are designed to effectively kill all rapidly dividing cells, hair is the unfortunate bystander that takes the fall along with the cancer cells. While some find the thought of losing their hair so distressing that they refuse chemotherapy, most people will see their locks grow back after the treatment has finished.

The level of hair loss, or chemotherapy-induced alopecia (CIA), depends on the type of cancer, the specific drug, and the dose and pattern of the treatment. Many patients experience the first wave of CIA within 1 to 2 weeks of starting their treatment. Areas that experience high friction during sleep, such as the top of the head and the sides above the ears, are often the first to see hair loss. Yet the precise pattern depends on the individual's hair. Those hairs that are actively growing will be most affected, but because growing hair follicles can be arranged in patches or evenly distributed all over the scalp, it is unfortunately impossible to predict the pattern of hair loss for any given individual.

Hair regrowth after chemotherapy usually starts within 1 to 3 months after the therapy has finished. Up to 60 percent of patients report a change in hair color or structure during the first wave of hair regrowth, with many experiencing curlier hair. However, these changes are mostly temporary, and hair returns to normal eventually.

Hair has important functions in culture and communication, and so CIA is consistently ranked top of the list of traumatic events for many patients that undergo chemotherapy. Some patients even consider refusing chemotherapy as a result of the impending threat of CIA. Treatments for CIA are, at best, experimental. Cooling the scalp with ice packs or special caps was first introduced in the 1970s. The theory underlying this treatment is that cooling will narrow the blood vessels leading to the hair follicles. Some studies have reported success rates of up to 50 percent with this technique, but there is clearly a need for more effective therapies.

Very little is known about how chemotherapy drugs cause CIA. Most information stems from studies using mouse models. Here, research has shown that programmed cell suicide, or apoptosis, is the most likely cause of cell death in the hair follicle, causing the hair to fall out. Researchers in the Department of Medicine at the University of Chicago, IL, used genome-wide association studies to compare the genetic signature of breast cancer patients who had experienced CIA with that of those who had not. They found several candidate genes that might be implicated in the loss of functional hair follicles. One of these, CACNB4, is part of a calcium channel that plays an important role in cell growth and apoptosis. Another gene, BCL9, was active in a subset of CIA patients and is known to play a role in hair follicle development. Armed with this knowledge, scientists are continuing their quest to develop effective inhibitors of chemotherapy-induced hair loss, hoping to reduce the burden that this unwanted side effect has on cancer patients.

Preventing Hair Loss From Chemotherapy

For many women, one of the first and scariest thoughts when diagnosed with breast cancer is not about the loss of their breast, but about losing their hair. A 2010 survey found that nearly half of breast cancer patients feel that hair loss is the most traumatic side effect of chemotherapy, with some experiencing less distress over losing their breast than their hair. And 8 percent of the women polled would choose to forego chemotherapy because it meant losing their hair. It's not hard to understand why hair loss can be so emotionally devastating. For many women, hair is an important part of their identity and sexuality, and losing it diminishes their sense of self. Hair loss can also take away your privacy – since it's such a very visible and constant reminder that you're sick with cancer. Unfortunately, until recently, most American women did not know about nor have access to a treatment that helps prevent chemotherapy-induced hair loss. Cold caps have been used in Europe for more than 40 years, and in 2015, a newer scalp cooling technology, called DigniCap, was Food and Drug Administration-cleared for use in the U.S. Two studies published recently in the Journal of the American Medical Association found that approximately half the women who used this scalp cooling device were able to keep more than 50 percent of their hair while undergoing chemotherapy. The news was even better for women receiving taxane-based chemotherapy (Taxol, Taxotere and Abraxane), with two-thirds of women able to preserve more than half their hair. According to hair experts, that 50-percent mark is important because hair loss isn't noticeable to other people until more than half of it is lost.

How Scalp Cooling Prevents Hair Loss

The hair-making cells, called hair follicles, are very sensitive to chemotherapy. Cold caps and scalp cooling systems keep the scalp cold, which narrows the blood vessels, reducing the amount of the chemotherapy medicine that reaches the hair follicles. It also decreases the activity of the hair follicles, slowing down cell division and making the follicles less affected by the chemo treatment. To be effective, cold caps need to be worn for a period of time before, during and after a chemotherapy treatment. It's also important for a cap to be tightly fitted to ensure it's coming in contact with the entire scalp.

Weighing Your Options

There are two different types of devices used for preventing hair loss: cold caps and scalp cooling systems. Cold caps are similar to ice packs and are kept in a special refrigerator before they're used. Because they thaw during a chemotherapy session, they have to be replaced with a new cap every half hour. It's difficult to change the caps on your own while having an infusion, so another person is usually needed to help with the process. Both the caps and fridges are usually rented by the patient. The cost depends on the number of chemotherapy sessions needed and how many months of treatment is involved. A typical cost for these caps is about $500 per month. Depending on your insurance plan, the cost of renting the cap may be covered. There are also charitable programs that provide financial assistance to women who can't afford to pay for a cold cap. Scalp cooling systems are a newer computer-controlled cap device attached to a small refrigeration machine that circulates coolant throughout the chemotherapy session, eliminating the need to change caps during the treatment. As mentioned earlier, DigniCap has been FDA cleared; another, the Orbis Paxman System, is pending FDA clearance. These systems are owned by a limited number of cancer treatment centers around the country and offered at a cost to patients receiving chemotherapy. Patients are usually charged between $1,500 and $3,000, which may or may not be covered by insurance.

Results and Side Effects

The results of scalp cooling treatments vary and, for some women, they are not that effective. An important factor is the type of chemotherapy and the dosage you're taking. Studies have found that women who are given only taxane chemotherapy have far better results than those who get only anthracycline-based chemotherapy (Adriamycin, Ellience and daunorubicin). Hair type may also impact hair loss. There is some evidence that women with thicker hair may not respond as well to scalp cooling as those with thinner hair. This may be because thicker hair prevents the scalp from getting as cold as it needs to be for the treatment to be effective. It's essential that the caps be tightly fitted and cover the entire scalp. If not, hair loss can occur in the areas where the cap is not close enough to the scalp. There can also be some discomfort when using both cold caps and scalp cooling systems. Reactions can include cold-induced headaches, chills and neck and shoulder pain. Additionally, there are some concerns about the risk that the caps prevent the chemotherapy from fully killing off the cancer cells that might be in the scalp, and therefore put women at risk for a future cancer. However, many studies in Europe where it's been used for decades have not found any increased risk of cancer in the scalp after the use of the caps, and the FDA considers such cases extremely rare. If chemotherapy is part of your treatment plan and preventing hair loss is important to you, make sure to discuss the options with your physician before chemo begins. Ask about the effects that your chemo regimen and hair type might have on the results, as well as whether a scalp cooling system is available at your treatment center and their success rate in preventing hair loss. And make sure to find out whether your insurance covers any of the costs so you're not stuck having to pay unexpected bills. If hair preservation is not possible or the right choice for you, but you feel that hair is important to preserve some sense of normalcy, there are wonderfully styled wigs that are far more natural looking and comfortable than in the past. Many are available at a low cost, but high-quality human hair wigs can be pricey. Some women find scarves and turbans work best for them and can get very creative with their design, while others discover a sense of empowerment and beauty in baring their bald head.

Cooling Cap May Limit Chemo Hair Loss In Women With Breast Cancer

It's no surprise that most women with breast cancer consider hair loss one of the most traumatic aspects of chemotherapy. That has led to a big market for cooling caps, which are purported to limit hair loss. But cooling caps haven't been extensively studied in the U.S., and womens' experiences with the caps have been hit or miss. And just one cooling cap, the DigniCap, is approved by the Food and Drug Administration.

Two studies released Tuesday show that at least half the women who used either the DigniCap or another scalp cooling system, the Paxman, lost less than 50 percent of their hair. "These findings appear to represent a major step forward in improving the quality of life of individuals with cancer," says Dr. Dawn Hershman, who studies the effects of cancer treatments at the Columbia University School of Medicine in New York. She wrote an editorial accompanying the studies in JAMA, the journal of the American Medical Association.

But Hershman cautions that more study is needed to determine whether there is psychological benefit in using the caps to prevent hair loss. And the cost and who will pay for the treatment are also issues, she says. The average cost is $1,500 to $3,000, depending on the number of chemotherapy cycles. In the DigniCap study, 67 of 106 women (66.3 percent) lost less than half their hair after four rounds of taxane chemotherapy. The women had either stage I or II breast cancer. In contrast, all of the 16 women who did not use the cap lost all of their hair during chemotherapy. The DigniCap system uses a double cap fitted to the scalp 30 minutes before an infusion, which keeps the scalp at 37 degrees Fahrenheit, plus or minus 2 degrees, during the session.

The system was approved by the FDA in 2015 and is available at infusion centers in 17 states. The other study found similar results using the Paxman system. It was led by oncologist Julie Nangia of the Baylor College of Medicine in Houston. Half of the 95 women (50.5 percent) using the Paxman system lost less than half their hair after four rounds of anthracycline and taxane chemotherapy, including five women who had no significant hair loss, as judged by independent observers from photographs. Among the 47 who did not use the cooling system, all lost all of their hair. The Paxman study was stopped earlier than planned, after four cycles of chemotherapy, because findings showed the cooling cap was highly effective at preventing hair loss. That cooling system is not yet available commercially in the U.S. and is under review at the FDA. "It's nice now to have two good studies focusing on the quality of life to make the cancer journey easier for women," Nangia tells NPR. There were no serious side effects related to either cooler.

A few people reported headaches, and some stopped using the device because they got too cold. Nangia says most patients described the device as "reasonably comfortable." The studies were funded and designed, in part, by their respective manufacturers, with varying levels of company input to the university investigators. In both cases, the researchers were free to publish results they deemed appropriate. Researchers don't know exactly how the cooling caps work. One theory is that cooling constricts the blood vessels in the scalp, slowing the circulation and thereby reducing the amount of toxins to which hair follicles are exposed. Or it may be that cold slows the growth of hair follicles, making them less susceptible to damage from chemotherapy, which targets rapidly dividing cells.

Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, says it could be that "by slowing down those cells whatever mechanism it may be — either starving their blood flow or slowing them down straightforwardly — the net effect is beneficial, causing hair not to fall out." While chilling the scalp may seem to carry few risks, Lichtenfeld says there is a theoretical risk that inhibiting the effect of chemotherapy in the scalp could allow metastases to take hold there. "These techniques are relatively new," he says, and "breast cancer is a disease that can take a long time before it comes back and if one is to be 100 percent certain then you need a long period of time to answer the question." So far, cancer recurrence on the scalp has not been seen in the U.S. studies, but authors of both JAMA papers say longer follow-up is needed to be sure that this is not a risk.

Cold cap can combat hair loss from chemo for breast cancer

A cooling cap that prevents hair loss during chemotherapy has come through its clinical trials and can make a huge difference to the quality of life of patients, Dr. Paula Klein, medical director, Breast Cancer Clinical Trials, Mount Sinai Health System in New York told NY1.

One such happy patient was Donna Tookes, a patient who was treated with the cap during her breast cancer therapy and had been resigned to hair loss. She told the station, “I accepted it.” In fact, she did not have to. Thanks to her participation in a trial of the Dignicap from Dignitana headed by Klein, she didn't lose any hair at all. The cap “literally freezes the scalp so that it shuts down blood vessels,” Klein told NY1. “Less chemotherapy is delivered to the scalp.”

The cap Klein used pumps coolant through it. The patient's hair is wet and this keeps the temperature of scalp and hair near freezing during therapy. This constricts the blood vessels in the region, and thus reduces the amount of anti-cancer drugs that reach hair follicles. The scalp-cooling technique has been in use for years in Europe, but is only now gaining FDA approval and greater use in the U.S. There had been fears that sparing the scalp from treatment might allow cancer to spread to that area. But clinical evidence from Europe has now suggested that this is not the case.

“In Europe they do not show a significant increase in scalp metastases,” said Klein. The cooling system which chills the hair and scalp to just above freezing during therapy received the agency's okay for a multicenter clinical trial in 2015. “Some of today’s most powerful, lifesaving chemotherapy treatments still cause complete hair loss, a side effect that many women consider to be emotionally devastating,” Dr. Hope S. Rugo, principal investigator for the study and Director of Breast Oncology and Clinical Trials Education at the UCSF Helen Diller Family Comprehensive Cancer Center noted in a 2015 statement about the trials.

In the Mt. Sinai trials about seven out of 10 early-stage breast cancer patients kept at least half their hair without any negative events linked to the cooling cap. The FDA approval is, for the present, limited to early-stage breast cancer, but Klein stated that she thinks it will eventually find more widespread use. “I am extremely excited to finally be able to offer patients scalp cooling during chemotherapy, which allows them to retain normalcy and privacy in their lives,” she stressed.

For patients, the loss of hair is among the most important chemo side effects, according to a 2008 article published in the journal Psycho-Oncology by Julie Lemieux, Elizabeth Maunsell and Louise Provencher. They found that “chemotherapy-induced hair loss is considered to be the most important side effect of chemotherapy, frequently ranking among the first three for breast cancer patients, and can lead to refusal of chemotherapy. Secondly, it is described by breast cancer women as causing distress and as being traumatizing. Thirdly, there might be an impact on body image, although not all studies reported this association.”

Preventing hair loss from chemo

Breast cancer treatment can be uncomfortable, but a newly approved product may allow some patients to avoid one unpleasant side effect to chemo treatment. A new cooling cap may help some patients save their hair.

 

“I feel like having long hair has always been a big part of who I am,” said Heather Chemtov.

She's half way through her chemotherapy for breast cancer and she still has her long, flowing hair. She wears the new DigniCap during chemotherapy.

 

She says, “I can rest. I can have a conversation. I can watch a movie, whatever I want to do to help pass the time.” 

 

Chemo patients lose their hair because blood flow delivers the toxins throughout the body, including to the hair follicles.

 

Elisa Krill-Jackson, M.D., a medical oncologist at Mount Sinai Comprehensive Cancer Center in Miami, Florida explained, “If we put a frozen cap on somebody’s head, it slows the blood flow down significantly.” 

 

That means the hair follicles get less chemo. During the procedure, a machine circulates 32 degree gel into the cap.  FDA trials show the new cap works. Seventy percent of early stage breast cancer patients kept at least 50% of their hair, like  Heather, who’s grateful to recognize herself when she looks in the mirror.

 

“It makes this whole process so much easier and more comfortable at a time when really nothing is easy or comfortable,” Heather says.

 

An older gel-filled cap used to be an option for some patients, but that cap had to be replaced when it thawed. For Heather, the old cap had to be replaced up to 18 times a session. The new cap was FDA approved December 2015.

The FDA Just Approved a New Treatment That Reduces Hair Loss During Chemotherapy

It's already stressful to come to terms with a breast cancer diagnosis, but losing your hair during chemotherapy treatment can cause so much distress for any patient. Fortunately, there's now a device that women can use to regain some form of normalcy in their lives during treatment.

Last Tuesday, for the first time, the FDA approved a scalp cooling system, Dignitana DigniCap Cooling System, which reduces hair loss in female breast cancer patients undergoing chemotherapy. The cap, made by Swedish manufacturer, Dignitana Inc, is intended to reduce the frequency and severity of alopecia during chemotherapy. Operated by a computer-controlled system, the cap circulates cooled liquid to a cooling cap during chemo. A second cap is placed over the cooling cap, which holds it in place and serves as insulation to prevent the loss of coolness.

The FDA described the process in their release, saying, "The cooling action is intended to constrict blood vessels in the scalp, which, in theory, reduces the amount of chemotherapy that reaches cells in the hair follicles (hair roots). The cold also decreases the activity of the hair follicles, which slows down cell division and makes them less affected by chemotherapy. The combined actions are thought to reduce the effect chemotherapy has on the cells, which may reduce hair loss."

According to Dignitana, 7 out of 10 patients with early stage breast cancer kept at least 50 percent of their hair. For one clinical trial participant, Deanna King, none of her hair fell out.

"I had 100 percent success rate," King says. "I was very fortunate. I was on the right chemo regimen and my hair didn't fall out at all. Had my scalp not frozen, all of my hair would have fallen out."

For breast cancer patients, this was a way to regain control. King told Cosmopolitan.com, "I started doing research and what I wanted to do is try to have some control over my treatment plan. You know I wanted to be really proactive and advocate for myself."

Dr. Hope Rugo, principal investigator for the study and director of Breast Oncology and Clinical Trials Education at the UCSF Helen Diller Family Comprehensive Cancer Center, explained that this cap can be used for different cancers as well. "It's not as if, for example, someone with an ovarian cancer can't use it. They could; it's just that the FDA gives specific approval to what you studied in your trial. But you can certainly use it and it's being used worldwide for other cancers. We don't recommend it for liquid tumors like leukemia because [tumor cells are] everywhere at once and it would be very hard for it to work."

There are currently different non-FDA approved cooling caps being used on the market, such as the Penguin Cooling Cap, which you have to freeze and change the cap every 30 minutes. The Penguin Cap, however, is manufactured with FDA-approved materials.

King was enthusiastic about the DigniCap specially since there was less room for human error, which would make the process ineffective. "It's a device where people who use cold caps have to have another person changing the caps all the time and making sure they're the right temperature, so there's a lot more room for error. It's much harder to do. Whereas this is an actual machine and all you have to do is just sit there."

The FDA noted that side effects included cold-induced headaches, neck and shoulder discomfort, and chills and pain associated with wearing the cap for a long period of time.

CBS News spoke to Dignitana's chief operating officer, Bill Cronin, who said that depending how many rounds of chemo a woman would goes through, the total cost of using the cap could be between $1,500 to $3,000.

Dignitiana is currently finalizing their agreements with major centers and community oncology groups across the country so DigniCaps will be available to patients as soon as possible.

Selena Gomez And Pantene Beautiful Lengths Challenge You to Join #8or8; This Is What It's About

Pantene Ambassador Selena Gomez joined in the cause by asking fans nationwide to ‘choose their 8,’ by either donating $8 or 8 inches of hair to the Pantene Beautiful Lengths program, to help create free, real-hair wigs for women who have lost their hair due to cancer treatment. “Pantene Beautiful Lengths helps women with cancer feel better about themselves,” said Selena.  “I love that you can support the cause in a variety of different ways with the #8or8 Challenge.”

There are also a number of easy ways to get involved and donate to Pantene Beautiful Lengths: there’s ‘Charitweet’ which means to donate via Twitter by retweeting @Pantene’s “Charitweets” on September 8th for instructions on how to donate to the cause. There’s also ‘One Today by Google,’ for which you have to visit the Pantene Beautiful Lengths Fund page here. There’s also ‘Pantene Beautiful Lengths Fund’ for which you donate via The Greater Cincinnati Foundation here. And finally, there’s ‘Donate Your Hair’ where, to donate hair, simply go to your local salon, measure a ponytail of at least 8 inches and make the cut. 

Don't forget to challenge your friends by sharing your donation and encourage your friends to participate in the #8or8 Challenge by using #8or8 and #BeautifulLengths hashtags, tagging @Pantene.

From Latin Times

Enter Our Free Contest for a Chance to Win Wigs!

A Houston-Area woman with any type of cancer can enter by writing about her personal journey with cancer, or a friend or family member of a Houston-Area woman with cancer can share how their loved one inspires them. 

All stories must be submitted by 11:59 pm on Sunday, November 2, 2014. 

Stories can be submitted via email to kristen@hairandwellness.com, or by US mail to: Ricky Knowles Hair and Wellness 4141 Southwest Freeway, Suite 315 Houston, TX 77027 

Contestants will have a chance to win several great prizes, including: 

The grand prize of a completely customized human hair wig, beautifully designed and styled by world-renowned hair duplication master stylist, Ricky Knowles. 

Two (2) - second place winners will receive a completely customized synthetic hair wig, beautifully designed and styled by world-renowned hair duplication master stylist, Ricky knowles. 

Ten (10) - third place winners will receive a beautiful pre-tied head scarf and Neuma travel size shampoo, conditioner and organic scalp treatment. 

Grand prize, second and third place winners will be announced Friday, November 7th at 
www.facebook.com/RickyKnowlesHairAndWellness. 

Grand prize, second place and third place winners will be chosen by an independent judge. 

Every contestant will be automatically entered into a special weekly drawing for a chance to win a beautiful pre-tied head scarf. 

The weekly drawings will be announced every Friday on www.facebook.com/RickyKnowlesHairAndWellness from Friday, November 7th through Friday December 19th for a total of 7 weekly winners. 

For more information about the contest, visit: http://www.hairandwellness.com/winwigs.html 

Wigs for Wonderful Women - A Women's Cancer Wig Giveaway

In observance of October’s Breast Cancer Awareness Month, Ricky Knowles Hair and Wellness, the leading master stylists of high-quality, natural and synthetic wigs and hairpieces, is hosting “Wigs for Wonderful Women” a Women’s Cancer Wig Giveaway throughout the month of October.

Participants from the Houston-area can write a story about their personal journey with cancer, or a friend or family member of a woman with cancer can share how their loved one who has cancer inspires them.

The grand prize winner will receive a completely customized human hair wig, beautifully designed and styled by world-renowned hair duplication master stylist, Ricky Knowles. Two (2) second place winners will receive a completely customized synthetic hair wig, beautifully designed and styled by world-renowned hair duplication master stylist, Ricky Knowles. Ten (10) third place winners will receive a beautiful pre-tied head scarf and Neuma travel size shampoo, conditioner and organic scalp treatment.

All entries must be submitted by 11:59 pm on Sunday, November 2, 2014.

Submit stories via email to kristen@hairandwellness.com.

For more information about the contest, visit: http://www.hairandwellness.com/winwigs.html

New Clinical Trial By US Oncology Research Tests Chemotherapy-Induced Hair Loss Therapy

US Oncology Research, one of the leading community-based cancer research networks in America based in The Woodlands, Texas, and Baylor College of Medicine, have launched a clinical trial titled “Scalp Cooling Alopecia Prevention Trial” (SCALP), which will examine an existing scalp cooling system aiming to critically reduce or completely stop chemotherapy-related hair loss, which occurs in about 65% of cancer patients undergoing chemotherapy and is one of the most disturbing and stressful factors in cancer patient care.

So far, a total of 15 patients have registered and approximately 50 more are being recruited at three US Oncology Research sites: Texas Oncology-Baylor Charles A. Sammons Cancer Center, Dallas, Texas, led by Cynthia Osborne, M.D.; Texas Oncology-Memorial City, Houston, Texas, led by Frankie Ann Holmes, M.D., and Hematology-Oncology Associates of Northern New Jersey, P.A., Morristown, N.J., led by Steven Papish, M.D., F.A.C.P.

Newly diagnosed female patients (18 years or older) with stage 1-2 breast cancer planning to undergo at least 4 cycles of full-dose anthracycline or taxane neoadjuvant or adjuvant chemotherapy are encouraged to contact one of these three participating centers for more information.

Here is the link for the trial and contact information for recruiting:
http://clinicaltrials.gov/show/NCT01986140

Read What a Recent Client Said About Our Services!

"THE BEST!!!!! Words can not describe the experience we had with Ricky and Kristen. Hearing the words cancer and chemo are devastating. The first thing my mother thought about was loosing her hair. As her daughter I did the research and Ricky Knowles Hair & Wellness kept on coming up. So we traveled to Houston, me from New York and my mother from Miami. WOW, what a great decision!!

In 2 days Ricky ordered, colored, and cut a beautiful new wig. He spent so much time talking and listening. And Kristen, well what can I say, the patience of a Saint; always talking about the health side, what to look out for, how to manage expectations......so much that the Doctor never covered!!!

I am filled with Gratitude that we have Ricky and Kristen in our lives they are truly ANGELS!!!" 

- Debra L, Manhattan, NY

Starting Chemotherapy: Nutrition Tips

If you are undergoing chemotherapy, you want to stay as healthy and comfortable as possible during treatment. What you eat during treatment can make a big difference in helping you achieve that goal.

Keep Food Tasty. Chemo can do a number on your taste buds, making certain foods and drinks taste metallic or unpleasant. Water and meat are the two most common items that become distasteful during chemo. If it becomes difficult to drink plain water, try drinking flavored mineral water or add sliced lemon to tap water. If certain meats become difficult to enjoy, try other sources of protein such as eggs, low-fat dairy, beans, and fish.

Fight Constipation. While some people experience diarrhea with chemo, others deal with constipation. Keeping hydrated is important to help prevent constipation. Including all types of fiber in your diet also can be helpful. If you aren't accustomed to large amounts of fiber, make sure to increase your fiber slowly. Getting some exercise -- even just a 20-minute walk -- can be a powerful intestinal stimulant.

Manage Weight Gain. Some cancer patients tend to gain weight during treatment.  Stick to low-fat meals, snacks, and lots of vegetables.

Improve Your Appetite. Many people undergoing chemo find that their appetites suffer. Since carbohydrates are usually digested well, try snacks such as hot cereals, toast with peanut butter or other nut butter, or pita bread with hummus. Other foods to consider include yogurt and blended soups.

Ease Diarrhea. If you are experiencing diarrhea, avoid greasy and fried foods, caffeine, sugary drinks and fruit juices, salad greens, raw produce, and sugar alcohols. Foods that are generally well-tolerated include oatmeal, most fruits without skin, sweet potatoes, and squash.

Keep a Food and Symptom Diary. Write down what you eat and drink, and record any symptoms you experience daily. This will help you and your health care team identify what you are eating that may be causing nausea, constipation, or diarrhea. This way, medications and other dietary suggestions can be tried before problems escalate.

What you need to know about BRCA gene testing

What is BRCA gene testing?
Everyone has BRCA genes that produce tumor-suppressing proteins. But risky BRCA1 and BRCA2 gene mutations leave a person more susceptible to cancers, including breast and ovarian cancers. BRCA testing is used to determine whether a person has such a mutation, which can be inherited from either parent. Each child of a parent who has a mutation in one of these genes has a 50 percent chance of inheriting the mutation.

What does the test entail?
BRCA gene mutations are detectable through DNA from a blood or saliva sample. It usually takes about a month to get results once your sample is sent to a lab for analysis.

What does a positive result mean?
A woman's lifetime risk of developing cancer is “greatly increased,” if she has a harmful BRCA mutation, according to the National Institutes of Health. About 12 percent of women will develop breast cancer at some point compared with up to 65 percent of women who inherit a harmful BRCA1 mutation. Other cancers are linked to mutations in BRCA1 and BRCA2, including fallopian tube, abdominal and pancreatic cancers. Men with harmful BRCA gene mutations face higher risk of prostate cancer.

How common are high-risk BRCA gene mutations?
The likelihood of carrying a BRCA gene mutation is extremely low for people with no family history of breast or ovarian cancer. Only about 10 percent of all breast cancers and 15 percent of all ovarian cancers can be traced back to inherited genetic mutations.

Who should take the test?
Because BRCA gene mutations are relatively rare, many doctors agree only those who have specific family patterns of cancer should consider the test. Such patterns include having multiple family members who have been diagnosed with breast or ovarian cancer, especially at a young age; cases of male breast cancer; and two or more cancers in one family member.

For anyone thinking about such testing, experts strongly recommend genetic counseling by someone who is experienced in cancer genetics. Counseling can help assess the need for testing in the first place, as well as facilitate discussion about what kinds of decisions a person faces once she gets her results.

What kinds of decisions should you be prepared to make?
A person who finds out she has a BRCA gene mutation faces some difficult decisions. Some women choose enhanced cancer screening, beginning with regular mammograms in their 20s, for example. Others choose risk-reducing surgeries like mastectomies or the removal of the ovaries and fallopian tubes. People also consider chemo-prevention regimens of drugs and vitamins to delay or reduce cancer risk. Finding out you have a harmful BRCA mutation indicates a higher risk for your siblings, too, so what you learn can affect multiple family members.

How much does it cost?
Some insurance companies cover BRCA testing, which can range in cost from hundreds to thousands of dollars. The National Cancer Institute urges people to contact their insurance companies to discuss cost before getting the test. For those without insurance, some genetic testing companies offer free or discounted pricing for individuals who meet certain medical or financial eligibility standards.

Who can help?
There are myriad resources for people considering BRCA gene testing, including the Cancer Information Service at the National Institutes of Health (NIH) and many nonprofit organizations. Live and anonymous online chatting is available from the NIH weekdays from 8 a.m. to 11 p.m. ET (5 a.m. to 8 p.m. PT at http://livehelp.cancer.gov. You can also call 1-800-4-CANCER.

Fight Breast Cancer with Food

Broccoli, cauliflower, Brussels sprouts, cabbage . . . these veggies aren’t at the top of many people’s favorite foods lists. Many children hate them, most adults aren’t fans, and some people find that these foods have an unpleasant odor and bitter flavor. But because these types of vegetables, known as cruciferous vegetables, are so good for your health—and can play an important role in fighting breast cancer—they are worth a second chance.

Joel Fuhrman, M.D., a physician and New York Times best-selling author who is a renowned expert in nutrition, writes on his website that “Eating a diet rich in cruciferous vegetables is your best defense for fighting and preventing cancer.” Why? Fuhrman’s studies have demonstrated that cruciferous vegetables are twice as effective as other vegetables, beans, and fruits at reducing cancer rates.

According to the National Cancer Institute, the substances that give cruciferous veggies their sulfur scent and sometimes bitter taste are plant compounds known as glucosinolates, which are a current focus of anticancer research. Glucosinolates have been effective at treating cancer in animal and cellular studies, and current research is looking at their effectiveness in treating cancer in humans. Cruciferous veggies are also high in other key nutrients:
•vitamins C, E, and K
•beta-carotene, lutein, and zeaxanthin, known as carotenoids
•folate
•minerals
•fiber

In addition to broccoli, cauliflower, Brussels sprouts, and cabbage, the cruciferous vegetable family includes salad superstars arugula, radishes, and watercress; dark leafy greens like kale, collards, and mustard greens; zingy, flavorful horseradish and wasabi; and root vegetables such as turnips, rutabagas, and kohlrabi.

Walk to Support Breast Cancer Awareness!

Join us for a day of fun for the whole family as we attend the Fifth Annual "Celebrate Your Princess" Breast Cancer Awareness Walk in Fulshear, TX on Saturday October 26th!

Breast cancer is the most common cancer in women in the United States, aside from skin cancer. According to the American Cancer Society (ACS), an estimated 230,000 new cases of invasive breast cancer are expected to be diagnosed among women in the United States this year. Today there are about 2.5 million breast cancer survivors living in the United States. Early detection and prevention are critical. Celebrate Your Princess benefits the CHRISTUS St. Catherine Breast Cancer Awareness Fund, promoting community outreach, health, wellness and education.

We will be showcasing our latest and greatest hair loss, mastectomy and lymphedema solutions and will be available to answer any questions about our products and services.

Join us:

Saturday, October 26, 2013 @ 7:30 AM
Cross Creek Ranch
6450 Cross Creek Bend Lane
Fulshear , TX 77441

You can still sign up for the walk online, or registration is available the day of the walk at the event.

Walk for the cause, enjoy music and food while the kids play in the kid's zone bounce house, decorate pumpkins and much more!

Chemotherapy and Hair Loss

What is hair loss and how is chemotherapy related?

• Believe it or not, hair loss (alopecia) due to chemotherapy is one of the most distressing side effects of chemo treatments.  
• Hair loss happens because the chemotherapy affects all cells in the body, not just the cancer cells.  The lining of the mouth, stomach, and the hair follicles are especially sensitive because those cells multiply rapidly just like the cancer cells. The difference is that the normal cells will repair themselves, making these side effects temporary. 
• Hair loss does not occur with all chemotherapy.  Whether or not your hair remains as it is, thins or falls out, depends on the drugs and dosages.  
• Hair loss may occur as early as the second or third week after the first cycle of chemotherapy, although it may not happen until after the second cycle of chemotherapy.  
• Hair loss can be sudden or slow.  
• You may lose all of your hair or just some of it.  
• Often it comes out in clumps rather than an even pattern.  
• It is common for hair loss to include hair that grows anywhere including eyelashes, eyebrows, and even pubic hair.

In almost all cases of chemotherapy-induced hair loss, your hair will resume growth after treatments.  

• It may take from three to six months after therapy is completed or it may start growing back while you are still receiving chemotherapy.  Be prepared for your "new" hair to possibly have a slightly different color, texture, or curl.

Can you prevent hair loss during chemo treatments?

• Through the years, attempts have been made to reduce hair loss by using tight bands or ice caps.  While these techniques may reduce hair loss by reducing blood flow to the scalp and limiting chemotherapy exposure to hair follicles, there is a theoretical concern that this could reduce the effectiveness of treatment in that area. 

What can be done to manage hair loss due to chemotherapy?

Our dedicated RNHW team will help guide you through your hair loss by:

• educating you about the effects of chemotherapy and when to expect hair loss to occur 
• verifying and billing your insurance 
• assisting you in choosing the right cranial prosthesis for your lifestyle prepping your new hair for delivery serving as your extended support system throughout the whole process.

When a client is faced chemotherapy hair loss, we ask them to immediately come in with their cranial prosthesis prescription before chemotherapy treatment begins, for a complimentary consultation.  During this consultation we will discuss all of your options to help you stay confident during your temporary hair loss.

We will then educate you about the different types of wigs (human hair wigs and synthetic hair wigs) and help you decide what hair loss solution will work best for you to give you the most realistic duplication of your natural hair.

All of our consultation rooms are private and are equipped with the best salon hair styling equipment available.  A team member will explain the process of when hair loss will begin and most importantly when your natural hair will regrow.

At RNHW, we carry an extensive line of human hair and synthetic wigs and hairpieces for your chemotherapy hair loss solutions.  We also have many turbans, scarves and hats in stock to suit your fashion style.  Do you have questions?  Call a RNHW  team member, or schedule a free consultation at 713-623-4247.

Look Good, Feel Better!

Our world-renowned hair stylist and cosmetologist, Ricky Knowles, will be teaching women undergoing cancer treatment tips and beauty techniques to manage the effects of chemotherapy and radiation on October 14th at MD Anderson - Clear Lake and on October 16th at Memorial Hermann - The Medical Center.

The Look Good...Feel Better program is offered in partnership with the American Cancer Society and is free of charge.

Ricky will teach attendees make up enhancement techniques, educate women about wigs, hairpieces and skin care and show them how to wear head scarves and turbans.  The presentation will be hands-on with plenty of time for questions.  Each woman gets a free makeup kit to use during and after the workshop.

If you or a loved one is undergoing cancer treatment, register for the free seminar and get an opportunity to visit one-on-one with Ricky and learn his secrets to Looking Good, and Feeling Better! For more information, or to register for one of these events, call the American Cancer Society Houston Office at (713) 266-2877.

Women with Breast Cancer Benefit from Personal Website Sharing

Developing and using a personal website to chronicle their experience and communicate with others improves psychological and cancer-specific adjustment in women being treated for breast cancer, according to research published online Aug. 12 in the Journal of Clinical Oncology.

Annette L. Stanton, Ph.D., of the University of California at Los Angeles, and colleagues randomly assigned 88 women diagnosed with breast cancer to participation in Project Connect Online or a waiting-list control group. The intervention consisted of a three-hour workshop to create a personal website and a follow-up call to encourage its use.

The researchers found that, six months later, women in the intervention group showed significant benefit in depressive symptoms, positive mood, and life appreciation compared with women in the control group. No benefit was observed in negative mood, perceived strengthened relationships, or intrusive thoughts. Among women participating in the online intervention, those who were currently undergoing treatment for cancer showed significantly greater benefit in depressive symptoms and positive mood than those not receiving treatment.

"To our knowledge, ours is the first research to evaluate an intervention to teach patients with cancer personal website development," the authors write. "Findings suggest the promise of an intervention to facilitate the ability of women diagnosed with breast cancer to chronicle their experience and communicate with their social network via the Internet."

Tamoxifen Halves Breast Cancer Risk in High-Risk Women

Tamoxifen halves breast cancer risk in high-risk women A global study of women with inherited mutations in BRCA1 or BRCA2 found that tamoxifen could halve the risk for breast cancer in the contralateral (opposite-side) breast in these high-risk women.

Tamoxifen has been used for decades to treat breast cancer and has recently been shown to prevent breast cancers in many women. Until now, there has been limited information about whether it reduces breast cancer risk for women who are at the very highest level of risk with BRCA1 or BRCA2.

This study, led by the University of Melbourne and the Peter MacCallum Cancer Centre in Australia, involved about 2,500 women from Europe, North America, and Australia who have inherited mutations in BRCA1 or BRCA2 and who have been diagnosed with breast cancer since 1970. About one-third of these women were placed on tamoxifen.

Tamoxifen was taken by 24% of the 1,583 BRCA1 and by 52% of the BRCA2 mutation carriers after their first breast cancer diagnosis. Over 20,104 person-years of observation, 520 contralateral breast cancers occurred. The statistical analysis of 657 BRCA1 and 426 BRCA2 mutation carriers with 100 contralateral breast cancers found an adjusted hazard ratio estimate of 0.58 for BRCA1 carriers and 0.48 for BRCA2 carriers. This study was published in the Journal of Clinical Oncology.

"In the past, the only way of reducing breast cancer risk for these high-risk women was to do invasive surgery to remove their breasts and/or ovaries. For women who choose not to undergo such surgery, or who would prefer to delay surgery until they are older, tamoxifen could now be a viable alternative," said the lead author, Kelly-Anne Phillips, MD, of the Peter MacCallum Cancer Centre. Her previous research had found that only one in five Australian women with a mutation in BRCA1 or BRCA2 chose to undergo bilateral mastectomy to prevent cancer.

Co-author John Hopper, PhD, of the University of Melbourne, said, "In light of our findings, it is clear that women who have a mutation in BRCA1 or BRCA2 should review their management plan with their specialist and re-discuss the options available to them to lower that risk."