Bald and beautiful? Quality of Life and Chemotherapy-Induced Alopecia

Document Type

Poster Session

Publication Date

6-2017

Digital Object Identifier (DOI)

https://doi.org/10.1016/j.ygyno.2017.03.117

Abstract

Objectives: To better understand how ovarian and uterine cancer patients perceive the effects of chemotherapy-induced alopecia on their quality of life.

Methods: Longitudinal qualitative interviews averaging 120 minutes total per patient were performed over an 8-month period. Participants were interviewed at least twice over the course of chemotherapy. Thematic analysis was performed across transcript data.

Results: Fifty-three longitudinal interviews were conducted with 17 ovarian and 8 uterine cancer patients (n = 25) treated with carboplatin and paclitaxel. Eighty percent were Caucasian, with an age range of 39–83 years and mean of 62 years. The majority (96%) associated chemotherapy-induced alopecia with loss of control. The majority (68%) explicitly viewed their head shave as a form of positive action and a way of having some control over a largely powerless situation. Almost half (44%) initially reported age as having a significant influence over how they view alopecia, yet only 1 patient maintained this opinion throughout the 6 cycles of chemotherapy. The 40% who shifted away from their initial perceptions of age as a significant influence reported coping with alopecia as more related to maintaining prediagnosis perceptions of self. Most patients (88%) described alopecia as highly emotional and hindering daily activities, yet they were reluctant to directly associate it with quality of life (only 0.04% expressed that alopecia directly affected quality of life). On a 5-point Likert quality-of-life scale, patients associated low numbers with specific negative experiences (e.g., “I’m upset I can no longer take walks,” or “I will not attend church without my hair”) and high numbers with overall health status (e.g., “Completing chemo puts me at a 5, but I’m a 4.5 until my hair returns”).

Conclusions: Our data show hair loss signals a loss of control over patients’ experiences with cancer and its treatment, which negatively affects quality of life. Future studies of chemotherapy-induced alopecia should incorporate patient preferences and develop an instrument to test prediagnosis perceptions of self specifically related to hair loss as they may have implications for improved patient quality of life.

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Citation / Publisher Attribution

Gynecologic Oncology, v. 145, Suppl. 1, 46

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