Do Quality of Life Measurements Need to Evolve to Reflect the Impact of Hair Loss During Chemo?

Conversation led by Professor Fran Boyle with Dr Steven Isakoff, Dr Amie Jackson, Trisha Marsolini and Isa Pupo Wiss. March 2022

Many controlled trials that have examined the impact that scalp cooling can have on a patient’s quality of life versus those who don’t scalp cool, have found little if any difference in the patient’s experience. For those who are providing supportive care, including scalp cooling, to cancer patients, these findings aren’t representative of what they see in clinic. Is it time to review the scales used to examine quality of life (QoL), and acknowledge that there isn’t a scale which precisely reflects the impact chemotherapy-induced alopecia (CIA) has on self-confidence, physical appearance and mental well-being?

"What success looks like is not your hair looking as nice as it did on the day of the consult, so sometimes that fear of on-going hair loss or that feeling of “is it really working?” is something you want to set expectations well for at the start of the therapy to maximize benefit"

Dr Amie Jackson, MD
Key Discussion Points

– There is plenty of data on the impact of hair loss as a result of chemotherapy, but studies have largely shown little difference in a patient’s quality of life with scalp cooling versus those without

– Quality of life scales have historically successfully tracked patient experience, but are now not measuring the details required to reflect the advances in side effect management

– Accurate quality of life measurements will be different for each patient and accounting for these nuances is challenging