Beating chemo-related hair loss with Scalp Cooling

Posted by in Looking Good, Treatments, Well being | 1 comment

When cancer survivor Lizelle Knott was diagnosed with breast cancer, there was one thing that she just couldn’t accept: losing her hair. Again. At age 16, Lizelle had been diagnosed with Stage IV Lymphoma, and the treatment made all her hair fall out – a devastating experience for a young girl. Now a wife and mother, Lizelle had no choice about fighting cancer a second time – but this time, she made up her mind to hang onto her hair. Like so many who have grieved the loss of their hair, for Lizelle this wasn’t about vanity, it was about privacy. Having the right to decide who gets to know that you are sick, and how they learn about it. With a fifteen month old toddler to consider, Lizelle also wanted to look “normal” for his sake. Psychiatrist Dr Tanveer Baig of the Royal Marsden Hospital in London says that hair loss is the symptom associated with the most distress two months after surgery; as many as 8% of cancer patients say they considered refusing treatment because of expected hair loss. On the other hand, according to Dr Baig, there is increased tolerance for the other side effects of chemotherapy if hair loss can be reduced. Lizelle had heard about a non-invasive treatment which can prevent hair loss during chemotherapy, and decided to try it with the support of her oncologist in East London. The principle is simple: Hair grows from follicles lying just below our scalps. They are energy rich and require a good blood supply. If the scalp can be kept cold enough, growth activity in the follicle is suppressed, reducing blood flow. What’s more, the small blood vessels around the follicles constrict, allowing minimal blood to get through. The first few hours of a chemotherapy treatment is a critical time to protect the hair roots so that hair does not fall out. So how hard can it be, just to keep a cool head for those few hours? In practice, it was far from simple to rescue her crowning glory! The use of Cold Caps to prevent hair loss during chemotherapy was trialled in Europe as long ago as 2000 and is now going through further tests in California and New York. So far, the trials have shown an 81% success rate. As many as 50 000 patients worldwide have tried scalp cooling, yet it’s still not well known nor offered in most cancer treatment centres. Undeterred, Lizelle persisted with the help of resourceful staff at GVI Oncology in East London, who put her in touch with GVI Cape Town (Sandton Oncology Centre in Johannesburg can also help). East London had two Elastogel Hypothermia Caps, and...

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Know your cancer, beat your cancer

Posted by in Blog, Diagnosis, Treatments, Well being | 0 comments

Breast cancer patients tend to be a well informed bunch, who turn up to medical appointments with print outs and well considered questions. However, a recent study in California found that only a small minority of breast cancer patients understood all the key aspects of their tumours. The stage, grade and sensitivity of your tumour determines the type of treatment you will have. Whilst thorough patient education would not necessarily change the outcome of the treatment in a direct way, it is likely to improve the patient’s experience of that treatment as well as her ability to stick with it. All of this key information is available soon after you have your first surgery. Staging indicates the spread of the tumour – how big it has grown as a single clump of cells, and/or how much it has been able to travel to other areas. Sensitivity to Oestrogen (Estrogen in America), to Progesterone and to Epithelial Growth Hormone or HER-2 is a key element of treatment because if cancer cells need these hormones for “fuel” then by blocking the hormones the growth of the cancer cell will also be blocked. Grading refers to the general aggressiveness of a tumour. If it’s made up of cells that are fairly similar to the healthy cells around it, but different to cells in other body organs, that is a low grade, less aggressive cancer. Cells that are more abnormal – more dedicated to being a cancer cell than to the function of the tissue they’re in – are higher grade and more aggressive. Knowing more about your cancer enables you to feel “part of the team” and to take more responsibility for your treatment, as well as to know what questions you want to ask (or not ask). This will ease your stress – you’ll feel much less helpless – and may help you deal with difficult side effects of the treatment such as hormone changes or chemo side effects. For most people today, the idea that “doctor knows best” is no longer enough. We want our doctors to be experts but we want to be knowledgeable as well! For doctors, this means that patient education is an important part of the treatment, time consuming as it may be. Just a treatment is individual – there is no “one size fits all” in breast cancer – so patient education also needs to be individualised. The level of explanation that is helpful for a University professor isn’t likely to be as helpful for a domestic worker, but both women need to be as informed as they can about what’s going on with the cancer and the process of treatment. There’s good news for...

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Memories that heal

Posted by in Blog, Diagnosis, Surgery, Well being | 0 comments

Uluru, also known as Ayers Rock, is a geological feature at the heart of Australia with huge cultural significance to people living there. For indigenous Australians, it is holy ground, representing millenia of history, mythology, and their symbiotic relationship with the land. Every inch of this awe inspiring rock is celebrated, represented, and connected with places far and wide across Australia through the “song-lines” which unite and re-unite people over time. Uluru is the ultimate Memory Space and a focus of healing for the peoples of Australia, both ancient and recent. In Africa we say “Umuntu ngumuntu, ngabantu” which means “a person is a person because of other people”. This finds expression in traditional African values around community and belonging. Psychologically, it is both constraining and liberating to hold this value. As individuals, we could feel smothered by a sense of responsibility for others or the demands of others. Yet, the knowledge that our very individuality is gathered by, with and for others infuses life with meaning and hope. This is especially true when illness, injury or loss shake up our ordinary lives until nothing is “normal” any more. Recently C, a wise and creative patient introduced us to the technique of the “memory space” as a guide and support through the process of cancer diagnosis and medical treatment. The idea was to use a dedicated space in her own home, to represent the experience of being diagnosed with breast cancer and of going through surgery. By inviting people who counted in her world, and who were interested in helping to create this special space, C began to share the burden of having cancer, as well as the hopes she had for the next steps in her journey with cancer. C has kindly given us permission to share this initiative via our website. It is a valuable exercise not only for recently diagnosed cancer patients but for anyone who is facing a personally devastating change or loss – whether that be divorce, illness, emigration or bereavement. Of course, it’s not easy to talk about cancer to others – especially when you’re still trying to get your own head around the news. The story is often shared with a chosen few; who usually try to respond in loving and supportive ways (though see our post on What Not to Say to Someone Who Has Cancer). C’s many years of experience and research in psychotherapy alerted her to the knowledge that more is possible – a deeper experience of Ubuntu and of love. Those invited to the ceremony were encouraged to bring whatever they felt moved to share: a note, a card, a piece of writing or music, a picture, an...

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What not to say…to someone who has cancer

Posted by in Blog, Diagnosis, Well being | 0 comments

It’s hard to know what to say when your friend or relative tells you they have cancer. In that painful moment our tact, good sense, knowledge and insight is put to the test – and so easily fails us.  As Joanna Moorhead of the Daily Mail recently wrote, the most inappropriate comments and messages have, at least, provided some laugh-out-loud moments after she was diagnosed with breast cancer. But with just a little effort, we really can do better. Here’s a guide to What Not To Say, and a few suggestions of better options. 1. Nothing at all. Not saying anything is fine if you have another way to be there for someone who’s hurting. Eye contact, a compassionate smile, a (welcome) gentle hug or hand squeeze, a small act of courtesy or kindness – all so important, and so much better than a verbal blatt. Actions really do speak louder (and often better) than words. Yet even the blattiest, dumbest remark (“My friend died of breast cancer”, “Not another one with cancer, it’s too much”, “Oh no, I can’t lose you”, “What bad luck!”) may be better than silent avoidance, which leaves the person feeling isolated and rejected.  People with cancer know it’s difficult for others -they’ve been through those emotions of shock too – but your absence is noted, and it hurts. It comes across as not caring, even though the truth is that you fear saying the wrong thing. Rather, go for simple sincerity: “I don’t know what to say, that’s terrible news” is absolutely fine. You don’t need sophistication: “That sucks, I’m so sorry” is also quite OK. After that, let your friend or family member’s response guide what happens next. You are part of her life for a reason, so just being yourself is all that’s needed. 2. Meaningless platitudes. If you woke up with stomach flu and spent a couple of days feeling utterly washed out and miserable, would you appreciate a walking, breathing Hallmark card suggesting that you count your blessings and be strong for your family? No, you would not. So why would dealing with a longer term but equally unpleasant illness be different? The fact that someone has cancer (or any other chronic illness) does not mean that he or she is unaware of the many wonderful blessings in life. Quite the reverse, in fact. Yet an ‘attitude of gratitude’ does not do away with pain and suffering, and “being strong” does not require an elaborate pretence that this doesn’t hurt. So dig deep and find a way to be there, alongside the suffering – be one of those blessings instead of talking about them. 3. False optimism. It’s good to get...

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Crowning glory – from PE with love

Posted by in Blog, Looking Good, Well being | 0 comments

“People always ask me how long it takes to do my hair. I don’t know, I’m never there.” ― Dolly Parton When we think of wigs, the picture coming to mind might be something that screams “Diva”. As Dolly herself often says “it takes a lot of money to look this cheap!” Patients undergoing chemotherapy face a dilemma: whether to “go bald” and brave it out with caps and scarves, or cover up with a wig. Tracey Gervais (Wigs@Hair@Tracey’s, Amble In Centre, Main Road, Walmer) understands that helping a woman find the perfect wig is a ministry to her soul. Patients at Bay Breast Care had recommended Tracey, so we got together with her recently.  Here’s what we learned. After running a successful hair salon in Port Elizabeth for 33 years, Tracey was given a golden opportunity last year, to take over a long standing wig-fitting business. She’d always loved wigs, but sharing premises with expert wig fitter Norbert for a year in 2012 really inspired Tracey as she saw the clients come in looking ordinary, and go out with their new wigs “looking fantastic”. Tracey even asked Norbert if she could work alongside to learn from him – but he turned her down, explaining that his approach was always very personal, sensitive and extra-respectful of clients’ privacy so he wouldn’t be comfortable with that – an attitude that made Tracey respect him even more. But when the time came a year later for Norbert to retire, he offered Tracey the business, and she couldn’t have been more honoured that he was putting his trust in her. (We aren’t surprised. Tracey’s caring approach and love for people is obvious). Women undergoing treatment for cancer form the majority of clients, then and now. Tracey says that her clients often fear losing their hair more than breast surgery: “So many women tell me, ‘Maybe my hair won’t fall out’. I ask them, ‘What does your doctor say? That hair loss is a side effect? Then it is going to fall out, so let’s make a plan before it happens”. With chemotherapy, hair usually takes at least a year to return fully – and it may not look the same as before. It could grow out grey if hormone replacements have been stopped, or have a different texture. Keeping it under the wig until you’re ready buys time to decide on a style that works for you in the longer term. “My word is ‘enhance’, because the right wig makes a woman look and feel so much better than she did before, yet it’s still her own look”, says Tracey.  “When a client is so happy and excited to go out with her new wig, well,...

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Vitamin D – are you getting enough?

Posted by in Blog, Prevention, Well being | 0 comments

For some time it’s been known that maintaining adequate levels of Vitamin D helps prevent cancer, especially colo-rectal cancer but also of the breast, pancreas and bladder. Now there’s evidence that women who already have breast cancer can benefit from increased Vitamin D. A major review study reported in the journal Anticancer Research has found that women with high levels of Vitamin D in their blood when diagnosed with breast cancer showed improved survival rates (at average 9 years), compared to women with low Vitamin D levels. The study involved 4443 patients with breast cancer and according to the statistics there is almost no probability that this difference occurred by chance – though further research is needed to see whether more severe illness can lower Vitamin D levels. Improved levels of Vitamin D prevent cancer by helping cells to stick together. When cells are loosely packed they start reproducing at a faster rate and may evolve into cancer cells. The presence of Vitamin D can keep a developing cancer in check by limiting its ability to develop its own blood supply, and/or to invade nearby structures like blood vessels. Dr Cedric Garland of the University of California, San Diego, told Medscape Medical News that up until a fairly late stage of development, cancer cells have intact Vitamin D receptors. He recommends that women undergoing treatment for breast cancer should check their blood levels of Vitamin D, to keep it in the optimal range. And most women could use more Vitamin D. The average American would be in the “low” group whereas the “high” group had nearly twice as much Vitamin D. Moreover, current recommendations for daily consumption are conservative: you would have to take a large amount of Vitamin D on a daily basis before signs of toxicity (such as thirst, nausea, stomach upset or muscle weakness) occur. This would be unlikely unless supplements are added to natural sources. Vitamin D deficiencies by contrast are fairly common, especially in climates where winters are long and cold. Some of the study data came from Canada, but studies in Southern Australia have also found Vitamin D deficiency, so South Africans shouldn’t be complacent about our sunny skies. Here are some ways to keep Vitamin D in good supply: – Sunlight. Make the most of the sun, especially in winter – it’s 100% free! You don’t need to risk getting burned – 20 minutes will do. After that, avoid the hottest part of the day or use sunblock, keeping the sun off your face if you want to protect your youthful good looks. – Oily fish, which comes with a bonus of cholesterol-free protein and heart-healthy fatty acids. A generous serving of...

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