Details
Category: Volume 06 Issue 10 October 2018
Hits: 2201

Title: Psychosocial implications of Hair loss following Chemotherapy Intervening with completion of Adjuvant Therapy for Breast Cancer

Authors: Chandan Roy Choudhury, Anis Bandopadhyay, Priyanka Mandal

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i10.143

Abstract

Context: Hair loss has been the most feared side effect of chemotherapy for women and it may be more distressing than the loss of her breast.2Depression, shame and loss of confidence2 and anxiety4 also have been associated with alopecia in women with breast cancer, and as many as 8% may be at risk of refusing chemotherapy because of this fear.

Aims: To assess the patient’s awareness regarding the side effects of chemotherapy and surgery for breast cancer , perception of study subjects regarding chemotherapy induced hair loss as a psychosocial burden and to measure the relative burden of depression and anxiety  

Settings and Design: The study was an observational, descriptive and institution based cross sectional study. A predesigned, pretested and semi-structured schedule along with HADS was used for interviewing the consenting breast cancer patients who had already received at least one cycle of chemotherapy.

Results: Majority of the respondents are more concerned about the chemotherapy related side effects than the consequences of surgery. About 88.9% of the patients had inhibition of sexual activities while almost half of the study population felt the need to hide their cancer to avoid being stigmatized. 36.6% had thought about discontinuing treatment due to chemotherapy induced hair loss while majority (77.8%) felt the need to address chemotherapy induced hair loss and considered cosmetic grooming and counseling as a treatment option.

Conclusions: Sudden diagnosis of breast cancer in a female patient is a traumatic experience and may lead to depression. However the effect of the treatment like removal of the breast or hair loss and other side effects of chemotherapy may have an influence over the recovery from breast cancer and further research is required to understand the severity of the situation.

References

  1. http://www.breastcancerindia.net/statistics/stat_global.html
  2. Moorey, S. S. (2007).Breast cancer and body image. New York: Routledge.
  3. Ganz PA. Why and how to study the fate of cancer survivors: Observations from the clinic and the research laboratory. EurJCancer. 2003;39:213641
  4. Hesketh, P.J., Batchelor, D., Golant, M., Lyman, G.H., Rhodes, N., and Yardley, D. Chemotherapy-induced alopecia: Psychosocial impact and therapeutic approaches. Support Care Cancer. 2004; 12: 543–549
  5. de Boer-Dennert, M., de Wit, R., Schmitz, P.I., Djontono, J., Beurden, V., Stoter, G. et al. Patient perceptions of the side-effects of chemotherapy: the influence of 5HT3 antagonists. Br J Cancer. 1997; 76: 1055–106
  6. Baxley, K.O., Erdman, L.K., Henry, E.B., and Roof, B.J. Alopecia: Effect on cancer patients’ body image. Cancer Nurs. 1984; 7: 499–503
  7. Münstedt, K., Manthey, N., Sachsse, S., and Vahrson, H. Changes in self-concept and body image during alopecia induced cancer chemotherapy. Support Care Cancer. 1997; 5: 139–143
  8. Chandra PS1, Chaturvedi SK, Kumar A, Kumar S,  Subbakrishna DK,  Channabasavanna SM, Anantha N. Awareness of diagnosis and psychiatric morbidity among cancer patients--a study from South India. J PsychosomRes. 1998 Sep;45(3):257-61
  9. Beatty, L., Oxlad, M., Koczwara, B., & Wade, T. D. (2008). The psychosocial concerns and needs of women recently diagnosed with breast cancer: A qualitative study of patient, nurse, and volunteer perspective. Health Expectations, 11, 331-342.
  1. Benjamin B1, Ziginskas D, Harman J, Meakin T. Pulsed electrostatic fields (ETG) to reduce hair loss in women undergoing chemotherapy for breast carcinoma: a pilot P sychoon-cology. 2002 May-Jun;11(3):244-8.
  2. Harcourt, D., & Frith, H. (2008). Women’s experiences of an altered appearance during chemotherapy. Journal of Health Psychology, 13, 597- 606
  1. Ng CG, Mohamed S, Kaur K, Sulaiman AH, Zainal NZ, Taib NA, et al. (2017) Perceived distress and its association with depression and anxiety in breast cancer patients. PLoS ONE 12(3): e0172975.
  1. Berterö C1, Chamberlain Wilmoth M. Breast cancer diagnosis and its treatment affecting the self: a meta-synthesis. Cancer Nurs.2007 May-Jun;30(3):194-202
  1. Badger, T., Segrin, C., Dorros, S. M., Meek, P., & Lopez, A.M. (2007). Depression and anxiety in women with breast cancer and their partners. Nursing Research, 56(1),44-53.
  2. Coates A, Abraham S, Kaye SB et al. On the receiving end patient perception of the side-effects of cancer chemotherapy. Eur J Cancer Clin Oncol 1983;19(2):203–208.
  3. Carelle N, Piotto E, Bellanger A, Germanaud J,Thuillier A, Khayat D. Changing patient perceptions of the side effects of cancer chemotherapy. Cancer 2002;95(1):155–163.
  4. Rosman S. Cancer and stigma: experience of patients with chemotherapy-induced alopecia. Patient Educ Couns 2004;52(3):333–339
  5. Maunsell E, Brisson C, Dubois L, Lauzier S, Fraser A.Work problems after breast cancer: an exploratory qualitative study. Psycho-Oncology 1999;8(6):467–473.
  6. Freedman TG. Social and cultural dimensions of hair loss in women treated for breast cancer. Cancer Nurs1994;17 (4):334–341.
  7. Srivastava V, Ansari MA, Kumar A, et al. Study of Anxiety and Depression among Breast Cancer Patients from North India. Clin Psychiatry. 2016, 2:1

Corresponding Author

Chandan Roy Choudhury

Medical College Hospital, 88 College Street, Kolkata -700073, India