Sarah Forster has been diagnosed with breast cancer and is due to have surgery, chemo and radiotherapy. She asks to talk to Parveen...

“I know it sounds silly given everything that lies ahead of me, but one of the things I’m struggling to come to terms with is losing my hair, which they have said is almost definitely going to happen. What can I do
to prepare for it? I’ve had long hair as long as I can remember – it’s my defining feature...”

Answer

If hair loss is a side-effect of the chemotherapy that Sarah requires, it will start to happen within a couple of weeks of her having her first cycle.

The loss is usually gradual rather than sudden and in most cases the hair grows back after chemotherapy has finished. Sarah may want to think about having her hair cut shorter before starting treatment and sorting out a wig. This could either match her real hair in terms of colour and texture, or be something completely different, depending on how she feels about it.

Sarah will also need some-thing to protect her head from changes in weather when she isn’t wearing a wig; for example, a hat, scarf or turban.

However, it is not just the hair on the head that is affected, as other body hair may also fall out. While some of this is not of huge consequence – most women would be delighted to not have to deal with the removal of underarm and leg hair, and any loss of pubic hair is easily concealed beneath clothing – losing eyelashes and eyebrows can be quite distressing.

Sarah may want to think ahead about how she is going to manage this if it happens – for example, learning how to draw on eyebrows with eye shadow and make-up pencils, and getting to grips with false eyelashes.

The bigger picture

Hair loss is one of the best known side-effects of cancer treatment and is most likely to be caused by chemotherapy. This is because the drugs used target the fastest dividing cells in the body, as this is a feature of cancer cells. However, this is also a characteristic of many other body cells, particularly those of the hair, skin, stomach and blood.

Extend your learning

• Would you know what advice to give someone about how to look after their hair during and after cancer treatment? Find out more at macmillan.org.uk
• The charity Cancer Hair Care has a wealth of information on this topic. Read about what is available at cancerhaircare.com
• Wigs do not come cheap, ranging from £50-£200 for one that is synthetic and will last a few months to several thousand for a real hair wig that will last much longer. In England, patients have to pay for NHS-provided wigs unless they qualify for help with health costs. You can find out more about the groups of patients who may be exempt from charges at: nhs.uk/nhsengland.