Radiation adjustment can stop hair loss

 

Adjusting the application of radiation technology could prevent hair loss in patients treated for brain tumors, researchers reported Wednesday.

Hair loss is one of the more socially and emotionally devastating quality-of-life issues involved in cancer treatment.

"This is a quality of life issue," Dr. Todd Scarbrough, a radiation oncologist at Melbourne Internal Medicine Associates in Florida, told United Press International. "Whole-brain radiation is generally used for palliation when cancer metastasizes. With standard treatment, patients almost always lose all their hair. With our technique most of them keep it."

The standard treatment for brain metastases involves a two-field opposed lateral beams of radiation energy, Scarbrough explained at the annual meeting of the American Society for Radiology and Oncology.

"In addition to irradiating the cancer in hopes of killing it or stopping its spread, the standard two-field treatment also irradiates the scalp, and results in most case in 100 percent alopecia -- hair loss."

Scarbrough said hair loss, even to patients with grim diagnoses of metastatic cancer, remains one of the toughest consequences of cancer treatment.

"Hair loss is not just important to women," he said. "Men too are deeply affected by losing their hair."

He said loss of hair can impact social events, and can be embarrassing, because it marks the individual as a cancer patient, even to those who do not know them.

Instead of using the two-beam treatment, Scarbrough offers his patients a multi-field, computer-controlled conformal beam arrangement that can focus more radiotherapy on the areas where the lesions are located and limit radiation exposure to the scalp.

He began using intensity-modulated radiation therapy this year and has tried it on 14 patients. Of those patients, six suffered no hair loss during their treatment.

"The others had what I call subjective mild hair loss," said Scarbrough, who holds faculty positions at the University of Miami School of Public Health in Florida and at the University of Texas Health Science Center in San Antonio. "There is no standardized scale for defining hair loss."

"Use of intensity modulated radiation therapy is much more expensive than standard whole brain radiation," noted Dr. Theodore Lawrence, professor and chair of radiation oncology at the University of Michigan in Ann Arbor.

"It may be difficult to sell to patients the idea that they might be able to protect their hair with a procedure that is both more expensive than the standard and unproven," Lawrence told UPI.

He said the physics behind the concept is sound and there should be less of a dose of radiation to the scalp. Nevertheless, Lawrence said the treatment needs to be compared in a randomized trial to determine its true effectiveness.

Scarbrough said if insurers cover the expense of palliation treatment for a person with late stage cancer, the companies will often pick up the cost of using the more expensive treatment. Not surprising, he said, patients prefer the treatment that will preserve their hair.