Purpose: Taxane chemotherapy is commonly used in the management of breast cancer. Hair loss (alopecia) is an expected side effect which may have a significant effect on quality of life. Alopecia is normally temporary but permanent chemotherapy-induced alopecia (pCIA) is increasingly recognised especially following docetaxel chemotherapy. However, the prevalence following docetaxel is not well understood and there is no published literature for paclitaxel chemotherapy. The aim of this study is to investigate the prevalence and patterns of pCIA resulting from both docetaxel and paclitaxel chemotherapy at two tertiary UK cancer centres.
Methods: In collaboration between Clatterbridge Cancer Centre and The Christie NHS Foundation Trusts, a retrospective survey was conducted for breast cancer patients who had received taxane chemotherapy in the neoadjuvant and adjuvant settings. Patients who had concluded chemotherapy at least a year previously were contacted by post and invited to participate by completing a questionnaire and returning it to their treatment centre. Data collected included the incidence and pattern of pCIA using the Savin pictorial hair loss scale, and the methods used by patients to manage it. Fisher's exact test was used to compare pCIA between the docetaxel and paclitaxel cohorts.Results: 383 patients responded to the survey (a 63.3% overall response rate). These comprised 245 patients receiving docetaxel and 138 patients treated with paclitaxel.pCIA was reported by 23.3% of patients receiving docetaxel and 10.1% paclitaxel (p < 0.01). Overall 16.7% of patients in both groups reported the ongoing use of products or appliances such as wigs to camouflage their pCIA. In the docetaxel group, pCIA appeared to be more frequent in post-menopausal women than peri-or premenopausal women (37.8%, 12.3% and 19.6% respectively [Chi-square test p < 0.01]).Also in the docetaxel group, there appeared to be a trend for more severe scalp alopecia when the patient also received an aromatase inhibitor (AI) or tamoxifen and this difference was most marked in those who had received both an AI and tamoxifen as components of their treatment regime (p = 0.04). The use of scalp cooling was How to cite this article: Chan J, Adderley H, Alameddine M, et al. Permanent hair loss associated with taxane chemotherapy use in breast cancer: A retrospective survey at two tertiary UK cancer centres. Eur J Cancer Care.
Purpose. To evaluate the effects of perioperative information for wrist arthroscopy on postoperative pain, return to daily activities, and patient satisfaction. Methods. 34 women and 21 men aged 19 to 54 (mean, 35) years underwent diagnostic wrist arthroscopy to explore the radiocarpal and midcarpal joints. They were randomised to receive specific preoperative information on the procedure (pictures of the wrist joint anatomy, portal entry sites, and the arthroscope) and written instructions on postoperative care (n=28) or only standard preoperative information and verbal instructions on postoperative care (n=27). The visual analogue score (VAS) for pain and the Quick Dash score for return to daily activities of each patient were recorded before and after wrist arthroscopy. Analgesic intake after wrist arthroscopy was recorded. Results. The mean post-arthroscopic VAS from days 2 to 6 was significantly lower in the experimental group than controls. This was reflected by the decrease 2011;19(1):85-8 in analgesic intake. The mean post-arthroscopic Quick Dash score was significantly lower in the experimental group than controls (40 vs. 47, p=0.02), indicating earlier return to daily activities. Conclusion. Patients who received specific preoperative information on the procedure and written instructions on postoperative care experienced less pain, consumed less analgesics, and had an earlier return to daily activities.
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