How Hair Loss Affects Women With Breast Cancer

For some, losing their hair was more traumatic than losing their breasts.

From the questionable highlights we have as teenagers to the sleek cuts we opt for as adults, our hair provides us with a way to tell the world: this is who I am.

So what happens when a key part of female identity is taken away from women

A new study from The University of Nottingham highlights the importance of hair loss to women with breast cancer.

Dr Diane Trusson from the School of Sociology and Social Policy at the university interviewed 24 women about their experiences of being treated for early breast cancer.

She found that hair was a prominent topic, even for those who did not lose their hair.

"Women who had chemotherapy as part of their treatment often described hair loss as even more traumatic than losing their breast(s)," she said. 

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The study, ‘The Role of Hair Loss in Cancer’, which has been published online in journal Cancer Nursing, found that loss of hair, not only from the head, but also body hair and eyebrows, affected women's sense of identity and the way that they were viewed by other people. For example, one woman said that she was mistaken for a man.

Dr Trusson said: "Appearing in public with a bald head was an immediate indicator that they had cancer, consequently they had to decide if and how to disguise their hair loss to control information about their health.

"Often they wore a wig in order to protect other people such as their children, or in the case of a teacher, to protect her pupils from seeing her hair loss."

An unexpected finding during the research was that some of the women who did not have chemotherapy and therefore did not lose their hair, also reported some distressing experiences.

They often described feeling guilty that they had not suffered to the same extent as other women even if they had lost their breast(s) and sometimes wondered if people did not believe that they had cancer because they had kept their hair. 

“In one case a woman described how she was bullied when she returned to work after having a mastectomy because she was unable to lift and carry as part of her duties,” said Dr Trusson.

"She wondered if people may have treated her more sympathetically if she had lost her hair because, unlike breast surgery, hair loss would have been a visible sign of her cancer treatment."

The study argues that visibility of cancer treatment is key to the way that people relate to others, whether this is in a positive or negative way.

Dr Trusson adds: "Patients should be provided with support and information from nurses and practitioners to prepare them for the impact on self-perception and social interactions when facing hair loss.

"Patients should also be warned about the possible implications of not conforming to the cancer stereotype.

"There also needs to be greater education among the wider population about the possible side effects of cancer treatments, which may prevent women feeling stigmatised while already undergoing a stressful experience." 

Breast Cancer Signs And Treatment
What Are The Symptoms?(01 of10)
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"A new painless, firm breast lump with irregular margins is a potential symptom of breast cancer," says Dr. Sandhya Pruthi, a breast cancer researcher at the Mayo Clinic. "The cancer diagnosis is confirmed following a biopsy of the lump." She notes that usually, women who are newly diagnosed with breast cancer are healthy and don't feel sick at all. (credit:LarsZahnerPhotography via Getty Images)
Other Symptoms(02 of10)
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Another potential symptom/sign of breast cancer, Pruthi notes, is a new onset of persistent redness on the skin overtop the breast with an orange peel appearance. This would also need a biopsy to confirm a diagnosis of breast cancer. (credit:Image Source via Getty Images)
Metastatic Cancer Symptoms(03 of10)
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"If the cancer is very advanced (metastatic) then the symptoms may also include weight loss, bone pain, headaches, nausea and persistent cough," Pruthi says. (credit:pamela burley via Getty Images)
What Are The Risk Factors?(04 of10)
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Some commonly associated risk factors, Pruthi says, are menstruation before age 11, menstruation after age 54, a first pregnancy after age 35 and a family history of relatives diagnosed with breast or ovarian cancer. (credit:AP Photo/M. Spencer Green)
Are There Any Lifestyle Risk Factors?(05 of10)
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"There is evidence in the literature that obesity after menopause, lack of regular exercise, consuming greater than more or more alcoholic beverages daily, and a high fat diet can all be associated with a higher breast cancer risk," Pruthi notes. But, she points out, "women need to know that any woman can get breast cancer even in the absence of any of these risk factors." (credit:Adrian Samson via Getty Images)
Can I Eat Anything To Prevent It?(06 of10)
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There are no specific types of diets, Pruthi says, but rather women are encouraged to eat fruits, vegetables, fibre, and minimize their alcohol and fat intake, as well as get regular exercise. (credit:lola1960 via Getty Images)
How Do Doctors Determine Treatment?(07 of10)
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"The most current treatment of breast cancer has taken on a individualized approach and is dependent on the biology or aggressive features of the breast cancer," Pruthi explains. "Breast cancer is a heterogeneous disease and this means that are many sub-types and different degrees of aggressiveness. So staging, which typically takes into account common prognostic features such as tumour size and if lymph nodes are involved, are no longer the only factors doctors use to determine treatment options." (credit:Christopher Futcher via Getty Images)
So What Do They Look At?(08 of10)
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"Today the biology of the tumour is also characterized by molecular markers (also known as predictive markers) such as if the estrogen or progesterone receptor is positive or negative and if the HER 2 protein is positive or negative," she says. "This helps decide who will benefit from a specific chemotherapy regimen, hormonal medications known as antiestrogens or who may need both chemotherapy and hormonal treatment." (credit:BluePlanetEarth via Getty Images)
What About Preventative Mastectomies?(09 of10)
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"Preventive mastectomy is an option for women at very high risk for developing breast cancer because they are BRCA 1 or 2 gene positive or if someone has hereditary predisposition to getting breast cancer but chooses not to have the genetic testing done," Pruthi says. "It is prudent that women who are considering this surgery know their family history in detail. Based on the moderate or strong family history, your doctor would recommend you meet with a genetic counselor to go over the family pedigree and help decide who should test for the breast cancer gene, when to test and how to interpret the genetic test results before proceeding with this preventive surgery." (credit:Jesús Jaime Mota via Getty Images)
Are Other Preventative Treatments Available?(10 of10)
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"High risk women who have had precancerous breast biopsies or strong family history may also be eligible to take preventive medications such as tamoxifen, raloxifene or exemestane to reduce breast cancer risk," Pruthi adds. (credit:art-4-art via Getty Images)

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