Hair Loss

Trudy · Regular Joined: 24 May 2008 Posts: 48 Location: Hershey PA

How soon does the average person lose their hair after starting chemotherapy? My 84 year old Mom will be starting chemo IV drip of Taxol and Carboplatin. She has NSCLC Stage 4. She also has COPD.
I am almost questioning why go through Chemo...

pbj11 · Site Admin Joined: 12 May 2007 Posts: 1265

Hi Trudy,

Good to "see" you! Hair loss can come as quickly as 10 days to 2 weeks or some people don't lose it at all. (That's rare though.) Some people don't lose their hair for a month or so, but our experience was it was coming out in handfuls by the beginning of the next treatment. It drove my husband crazy and he had it buzzed short to stop being so annoying. It might be a nice idea to have some head coverings or a wig picked out before this starts to happen so your Mom will feel a little better about herself.

Why do chemo at Stage IV? That's such a personal question that each person needs to answer on their own. Sometimes it brings huge amounts of extra time with quality, other times it doesn't and the patient feels worse than without treatment. It all depends on how well each regimen works to reduce the tumors or the spread. Nobody knows how each body will respond to treatment or whether it will work. My husband approached treatment with a "try it and see" attitude and he did pretty well with a lot of treatments and they truly did extend his life by well over a year and a half, than if he had no treatment at all. It's strictly a personal choice. He wanted to fight, that's how he looked at it. I can understand your question, and while I'm glad he did fight and survive longer, I don't know that I'd have made the same choice. He always told me if the shoe were on the other foot, I would, but I guess we don't know unless we were given this diagnosis. Age may also play a role in the decision and I get that too.

It's a very thought provoking question and I don't know if this helped at all. Maybe a sit down with the doctor is in order to see what his take on expectations are for your Mom.

Good luck and God bless,
PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

EFP · Posted: Sat May 31, 2008 11:33 pm Post subject: Re: Hair Loss

Just a note from what's clearly a minority position. I was dx in December 2007 with Stage 4 adenocarcinoma LC, with mets to some lymph nodes and to the pelvis. I've opted for no chemo and no radiation since the average survival benefit I saw figures for just didn't seem worth it (to me). So far I'm doing fine -- just some discomfort from the bone mets but that's handled very nicely by ibuprofen. I am 64 and I can't imagine feeling differently if I were 84. And, FWIW, my 50-something cardiologist volunteered that she would not consider chemo/rad for a moment if she had my diagnosis. Just my 2 cents for a point of view that doesn't seem to get expressed here too often... Good luck, whatever you decide.

Ellen in PA
_________________
64-yr-old woman dx 12/07 Stage 4 NSCLC (adenocarcinoma), with mets to lymph nodes and bones (pelvis, L3). Only symptoms are blood clots, for which am taking Lovenox, and some pain from the bone mets, for which I had radiation to the pelvis and spine. Have opted to do no chemo or chest radiation.

Trudy · Regular Joined: 24 May 2008 Posts: 48 Location: Hershey PA

Hello Ellen,
Thank you so much for your kind and honest words.
I am so sorry that you are walking this path with LC.
I iwll be honest and say I would like it better if my Mother would not have chemo, yet she thinks this is what she must do.
Her doctors made it sound like she had to do this.
Again I am grateful you wrote to me and I will remember you in prayer, keep me posted om how you do.
Thanks you so much.
Trudy

EFP · Posted: Sun Jun 01, 2008 10:50 am Post subject: Re: Hair Loss

Hi Trudy.

Thank YOU for your kind words.

You might want to pin down the drs on exactly *why* they think your mom has to have chemo. For Stage 4 NSCLC it's purely *palliative*, meaning it can only (at best) relieve some discomfort. So the issue is how much discomfort she is having now and whether it is likely to be relieved by chemo. Typical problems that might call for chemo (at Stage 4) are if a tumor is encroaching on a blood vessel or the trachea or something like that. There is apparently *no* research showing that one lives significantly longer with chemo, and individual cases are hard to evaluate since no one knows how long a person would have lived had they done the opposite of what they did. So I would think the issue boils down to your mom's current discomfort level and, if it's more than can be controlled by non-disabling painkillers, how likely it is to be alleviated by chemo. (And it goes without saying that chemo itself always seems to bring some discomfort, even if they get the regimen exactly right on the first try.)

I'm really not trying to talk you out of chemo for your mom -- I just want to make sure you and especially she knows exactly what it could possibly buy her. Again, good luck. You and your mom will be in my thoughts.
_________________
64-yr-old woman dx 12/07 Stage 4 NSCLC (adenocarcinoma), with mets to lymph nodes and bones (pelvis, L3). Only symptoms are blood clots, for which am taking Lovenox, and some pain from the bone mets, for which I had radiation to the pelvis and spine. Have opted to do no chemo or chest radiation.

pbj11 · Site Admin Joined: 12 May 2007 Posts: 1265

EFP,

First, welcome and I'm sorry about your diagnosis. I hate to hear another has joined the ranks of this terrible disease.

By all means, all opinions should be heard here. I don't know if you read my post very carefully, but in my gut I don't think I would choose aggressive therapy either. I've watched two people I adore go through a lot of treatment and the ending was still the same. I formed this opinion when I was in my twenties with my Mom, and having gone through the same thing all over again with my husband, I haven't really changed my mind. All things considered, I'm a wimp! Laughing

Then again, I've never faced a cancer diagnosis either, so who can tell how I'd feel.

I do have to say it was like night and day how my Mom reacted to all the treatment vs. how my husband did. Things have changed dramatically in the last 20+ years for the patient. They are much more comfortable with newer medicines to control the side-effects. Still, Stage IV is considered incurable, but treatable, and I'd have to think very long and hard whether it would be worth it for me if I should ever have this terrible diagnosis. I know that most people do choose the treatment path, but I respect your decision and know in my heart where it is coming from. I was selfish and glad my loved ones chose treatment.

One area that I do disagree with you is in the length of survival you can have with treatment. It all depends on how aggressive the cancer actually is but, in my husband's case, treatment did buy him a lot of extra time and most of it was pretty darn good quality. Some of the newer therapies, like Tarceva alone, actually have extended people's lives by over two years and it's a little pill you take every morning. If you respond to that, then it's a very easy regimen. He had very aggressive cancer, with a heavy tumor burden at diagnosis, so he would not have lasted very long. His length of survival was pretty miraculous and two and a half years is nothing to sneeze at in the area of Stage IV lc with poorly differentiated cells and heavy tumor burden.

You really have to analyze all of the particular variables regarding the specifics of each case. Lung cancer, on a cellular level, is a much tougher customer to fight than many other types of cancer. The less well-differentiated the cell structure of your particular lc, the more sensitive it is to chemo. On the other hand, it also is more aggressive. Well differentiated cells are a little more resistant to, but do respond to chemo and grow more slowly. The specific subtype also is a player. There is at least one more chemo (avastin) that can be used with Adeno (if bloody sputum isn't involved), whereas Squamous cell is not eligible for avastin due to bleeding issues. Although avastin doesn't work for brain mets, those who have them are also excluded because of bleeding issues. Large cell tends to be aggressive. These are all in the NSCLC family. In the SCLC family, limited is considered curable, but extensive is not. Most people experience a huge response to chemo with SCLC, but in extensive it roars back like a lion. SCLC is the most aggressive type of lc. SCLC also has far less types of treatment available.

Tumor burden and where the mets are located also play a huge role in survival. Although my husband had a few bone mets, his was generally confined to the chest. This is a better scenario for survival too. Most oncologists don't have a specialty in lung cancer, so typically aren't aware that overall survival times are increasing through newer therapies. Also, the five year survival statistics have not been updated to reflect the newer therapies. Then, there are those handful of Stage IV people who make up the small percentage that actually see the five year survivor mark and I always think that somebody has to comprise that statistic, so why can't it be you? Or you? LOL That's how we approached it with my husband.

By the way, palliative treatment is just a word that denotes the treatment will not have a curative effect. My husband also was being treated palliatively, but received some of the most aggressive treatment I've ever seen on any cancer board.

Oh dear, I've really gone off a little bit more than I thought I would! Embarassed

My main point, before I digressed, is while your choice is more in the minority category, that doesn't mean we won't be here for you and respect it! God bless you and we're here to support you and give whatever comfort we can while you fight your own battle.

Hugs,
PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

EFP · Posted: Sun Jun 01, 2008 2:20 pm Post subject: Re: Hair Loss

Hi PBJ.

Yes, you are so right that there are all sorts of variables that are relevant when deciding on a course of treatment for LC (including the null course). Sorry for over-simplifying things and thanks for bringing them up.

I'm really intrigued (as you can imagine!) by your figure of a 2-year survival benefit for Tarceva! Is there anything you could point me to to read about this? All I've been able to find is a 2-month difference -- that's all even the company that makes it claims. Of course, they call it significant but that means only that the likelihood of this difference being due to chance in the population studied is less than 1 in 20. For me, two months (or even 6 months...) just doesn't cut it... Wink

Btw, if the patient in this household were my husband instead of me, I'd be grabbing for *any* survival benefit! The nice thing about facing one's own death is that one knows one will not be grieving afterwards. Laughing

Seriously, I don't envy people in your situation and wouldn't trade places with my husband for anything.

Hugs,

Ellen
_________________
64-yr-old woman dx 12/07 Stage 4 NSCLC (adenocarcinoma), with mets to lymph nodes and bones (pelvis, L3). Only symptoms are blood clots, for which am taking Lovenox, and some pain from the bone mets, for which I had radiation to the pelvis and spine. Have opted to do no chemo or chest radiation.

pbj11 · Site Admin Joined: 12 May 2007 Posts: 1265

Ellen,

I couldn't have expressed your last paragraph sentiments better myself! That's why I always told my husband that if the situation were reversed, I wouldn't be seeking treatment! He said I would, but I told him he wouldn't want me to because I'd be such a baby about it. LOL Yes, the part I forgot about is that I'm left here alone now that the fight is over and it really stinks.

May I say you seem to have a great wit and sensibility about you and that will carry you far on this journey.

I can point you to a website that discusses a lot of treatment options in great detail. It is Cancergrace.org and was started by Dr. West, who is an oncologist with a lung cancer specialty out in Washington. If you search the archives, he has all kinds of data for you to spend a long afternoon reading. His original site was onctalk.com, but you can access onctalks archives through the new cancergrace.org site. He's the bees knees. (Oh gosh, I'm dating myself, aren't I?) I can only give you anecdotal information on people I have seen that have had tremendous responses or were held stable for a long time with Tarceva. It all depends on whether the patient has the EGFR mutation or not. Tarceva has only been out on the market for about three years and there are some who have been held stable for over two years. It IS a crap shoot however, but it seems to help in over 40% of the cases. My percentages could be a little fuzzy because my brain is a little fuzzy. I'll be honest and tell you that it did nothing for my husband and was the only therapy that didn't work for him. Naturally, the easy one didn't work. Rolling Eyes

I really like your style Ellen and thoroughly understand your position as you sound a lot like my personal take on the whole thing. I was lucky that my husband didn't feel the same way as I do! Shocked

I've already warned my kids that they better not expect a huge fight out of me when my time comes. I know that sounds odd to others who would be reading, but that's why I understand your position so well Ellen. It takes just as much courage to arrive at your decision as it does to fight. Make no mistake about that!

Feel free to post and ask any questions --- if any of us can answer, we will, otherwise Dr. West's site is the best on the internet for anyone with a lc diagnosis. He answers questions too! It's like having a doctor on-call and he's a very special person.

We're all still here no matter what, even if it's just to give you some humor or prayers. There's a great bunch of very caring people hanging out here.

Hugs,
PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

helensgirl · Posted: Sun Jun 01, 2008 6:03 pm Post subject: Re: Hair Loss

Trudy,
I lost my 80 year-old mom last December from the same diagnosis as yours. She went through the same chemo as they are placing your mom on--then something called Gemzar--which I believe with my heart and any knowledge that I have, is what killed my beautiful mom. I truly believe that if she had not had ANY chemo, she might even be alive today. I hold a lot of anger in my heart towards her onc--and others--b/c the whole thing was like a huge experiment to them...In my mind I think that they should have known that the chemo route was way too trying and hard for an 80 year-old. They made us think she had a chance at long-term, (i.e., 5 years plus), survival with this route. She fought hard for 7 months, through the horridly ridiculous side-effects of chemo, having been given what I think of as false hope for this type of survival, when they could have just given her the best of the time she had left. I also blame myself for not having learned more about it--and known all this myself--so that again, she could have had the best of circumstances with the time that she had. I think if I had it all to do again, we would have gone for pain control, and anti-anxiety meds, and left the rest to nature/God, at her age. I think she would have enjoyed her end-of-life days without feeling so horrid, not eating, and becoming excruciatingly weak and sick. Like I said, she may have even lived longer---she had NO mets outside of the lung when she passed away. Anyway, I hope that I didn't make you depressed, but I just read your post about your mom, and I couldn't NOT say anything...Maybe your mom will react to the chemo in a different way than mine did, but I just had to let you know. Best wishes, and God bless...Kim in NC
_________________
...keeping the faith in n.c.
Helen, my wonderful mom, diagnosed May, 07
fought-stage 4 NSCLC, (adenocarcinoma)
earned her place in Heaven, Dec. 14th, 07

Trudy · Regular Joined: 24 May 2008 Posts: 48 Location: Hershey PA

Wow, I am touched by the response I have received from my subject of hair loss. I SO appreciate everyone sharing their expereinces with me.
Oh if I just could some how know how much time my 84 yr, old mother had, it sure would make the decision of taking the Chemo alot easier.

I honesty am not looking forward to see my Mom go through it. I have lost my father this way and two very close friends. ALL did Chemo, and all got very sick and very weak and never recovered

yet again my beautiful mother feels she has no options but to go through with this,,,,,,,,,,,,,,,,,,

God's Grace will see us through, one moment at a time
Trudy

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