Chemotherapy-induced alopecia in African American women: A literature review demonstrates a knowledge gap

Hrin, Matthew L.; McMichael, Amy J.

doi:10.1016/j.jaad.2021.06.858

Cited by 5 publications

(5 citation statements)

References 4 publications

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“…There is extremely limited published literature on effectiveness of cold capping in other racial or ethnic populations, with those that do exist reporting results only from machine-based cooling systems. There is one report of similar results for Asian hair type vs. Caucasian [ 32 , 33 ], but most of the limited reports suggest potentially less effectiveness [ 34 , 35 ], with hair loss and/or alopecia-related distress actually increasing with cold capping for some groups, particularly African Americans [ 36 , 37 , 38 ]. Our data, while gathered from a small group of patients, may support slightly lower effectiveness in non-Caucasian patients independent of chemotherapy regimen, as none of the African American or Asian patients received doxorubicin-containing regimens.…”

Section: Discussionmentioning

confidence: 99%

Retrospective evaluation of Penguin Cold Caps for chemotherapy-induced alopecia

Weaver,

Pershing,

Golden

et al. 2024

Support Care Cancer

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Background Scalp cooling is an increasingly recognized non-pharmacologic approach to minimize chemotherapy-induced alopecia (CIA). Several commercially available machine-based and manual scalp cooling systems are available; however, literature reports of effectiveness are highly variable. The purpose of this study was to determine real-world tolerability and subjective effectiveness of a manual cold capping system in minimizing CIA across a variety of patient race and hair types. This study was a single-institution review of outcomes from manual cold capping. Methods We identified retrospective cohort of adult patients who presented to discuss cold capping between January 14, 2019, and March 31, 2022. Data collected from medical records included demographics, decision to pursue/continue cold capping, diagnoses, chemotherapy regimens, hair characteristics (length, thickness, coarseness, type), and subjective perception of percentage of hair retained. Those with successful vs. unsuccessful cold capping (≥ 50% vs. < 50% of hair retained) were compared based on the patient-level factors of interest. Findings A total of 100 patients initiated cold capping during the study period, and 95% of them completed cold capping. The majority of patients who started cold capping completed it. The median-reported percentage of hair maintained was 75%, and 82/89 (92.1% of patients) had favorable results, defined as ≥ 50% of hair retained. The only patient-level factor associated with favorable response was chemotherapy regimen, with fewer patients receiving doxorubicin-containing regimens having successful hair retention compared to other chemotherapy types (71.4% successful results vs. 95.7% for those receiving paclitaxel-containing regimens and 96.6% for those receiving docetaxel-containing regimens (p = 0.018). There was no difference in success based on patient race/ethnicity or hair characteristics. Interpretation The overall effectiveness (92.1%) in this study is consistent to higher than many literature reports. One possible reason for the high success in our cohort is compliance with cold capping protocols, meaning applying the cap in the appropriate manner and wearing the cap for the prescribed durations, which may impact effectiveness.

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Section: Discussionmentioning

confidence: 99%

Retrospective evaluation of Penguin Cold Caps for chemotherapy-induced alopecia

Weaver,

Pershing,

Golden

et al. 2024

Support Care Cancer

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“… 4 Though there is limited data regarding chemotherapy toxicities in skin of color (SoC) patients in particular, some recent studies have found that unique considerations and tailored patient education for hair care are required for this subset of patients undergoing chemotherapy. 7 , 8 To our knowledge, this study is the first to pilot an educational intervention for dermatologic toxicities of chemotherapy that includes information specifically for skin of color patients.…”

Section: Discussionmentioning

confidence: 99%

Dermatologic toxicities of chemotherapy: an educational intervention for skin of color women with breast cancer

Ahmad

Saeed

Olamiju

et al. 2023

International Journal of Women’s Dermatology

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Background: Minority patients are more likely to require dose adjustments for chemotherapy, with cultural barriers and access to medical care cited as contributory factors. Objective: We sought to pilot an educational intervention, in the form of a pamphlet, to evaluate the effectiveness of this tool in teaching skin of color (SoC) patients about potential dermatologic toxicities of chemotherapy that are relevant to their skin type. Methods: At a chemotherapy infusion center, SoC patients ( n = 26) who were receiving chemotherapy for breast cancer voluntarily consented to read an educational pamphlet and complete a series of survey questions before and after this educational intervention. Results: Most participants identified as female (96%), African American/Black (81%), and non-Hispanic (85%); all respondents had obtained at least a high school degree. Survey responses revealed a significant increase in knowledge about the potential dermatologic effects of cancer treatment after this intervention. Notably, 100% of participants either agreed or strongly agreed that they would like to see other doctors use this educational tool as a form of patient education, that they would recommend this pamphlet to other patients who are starting cancer treatment, and that the pamphlet was easy to understand. Limitations: Limitations of this study include small sample size and single-institution recruitment, which may limit generalizability. Furthermore, this study only included patients who are proficient in English. Conclusion: This study pilots an effective educational tool that addresses dermatologic toxicities of chemotherapy that are relevant to SoC patients. Further multi-institutional studies with larger sample sizes and translation to other languages can overcome the limitations of this pilot study.

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“…Although most of the data on CIA include predominantly White cohorts, there is a paucity of research regarding the specific impact of CIA among Black women, who are disproportionately affected by more aggressive disease in which chemotherapy (particularly neoadjuvant chemotherapy) is more likely to be administered 12–17 . One literature review only showed four studies specifically characterizing CIA outcomes among African American women, with data suggesting that this group may be at higher risk of diffuse, permanent alopecia and may achieve poor results in hair preservation interventions 18 . A qualitative study of 38 Black survivors of breast cancer revealed disturbing implications of CIA, such as hair loss being perceived by participants as more traumatic than the loss of breast tissue and experiencing physiological side effects of illness stemming from the loss of patients' hair, 11 sentiments also echoed by patients in other CIA studies 9,19,20 .…”

Section: Figurementioning

confidence: 99%

“…[12][13][14][15][16][17] One literature review only showed four studies specifically characterizing CIA outcomes among African American women, with data suggesting that this group may be at higher risk of diffuse, permanent alopecia and may achieve poor results in hair preservation interventions. 18 A qualitative study of 38 Black survivors of breast cancer revealed disturbing implications of CIA, such as hair loss being perceived by participants as more traumatic than the loss of breast tissue and experiencing physiological side effects of illness stemming from the loss of patients' hair, 11 sentiments also echoed by patients in other CIA studies. 9,19,20 Perhaps distinctive to Black women were the concerns about the inability to wear wigs that were not designed for Black hair color or textures, with the author highlighting the need for practitioners to better understand such unique psychological effects of CIA on Black women.…”

mentioning

confidence: 99%