The Assertive Cancer Patient

Hair Today

The first time I went bald from chemotherapy was traumatic—I cried, I raged, I agonized over the way people, total strangers, responded to my bald head: with pity. That was late 1998 and early 1999, and I was on chemotherapy with Adriamycin after a mastectomy.

The second time, a year or so later when I had a local recurrence, I had fun with it. I decorated my head with a henna tattoo and flaunted my baldness. That time, the cause was the chemo drug Taxol, which I took for 12 weeks along with radiation to my chest wall.

The third time was about five years ago, during Younger Son's freshman year of high school, and I was back on Taxol, in combination with Herceptin and a couple of other drugs. I wore a wig for the first and only time, as a concession to the sensibilities of my younger son, who did not want to be seen at school with a bald mother.

Note to those who are considering a wig: I hated it. It was hot. It itched. Sometimes it slipped sideways when I was out in public. My best look was wig-plus-hat--then it looked natural and stayed in place.

Every time I went bald, my hair grew back differently. Sometimes it was curly. Sometimes it was a different color. Every time, a surprise.

Since that time, my hair has thinned from yet another chemo drug, oral cytoxan, but didn't disappear entirely.

More recently, I find myself with a full head of wavy hair, as you see in the photo, which was taken yesterday.

I had thrown away most of my hair tools and products during the bald and butch-cut years, so this has required several trips to the drugstore for a new hair dryer and various gels and conditioners. It's all new to me, and kind of fun.

I do miss the ease of the towel-dry-and-go cut that I had in-between periods of baldness, a cut that didn't even require a comb, and I may go back to that ... except for one thing: I notice that men ignore me when my hair is short-short and women seem to be attracted. Hum. No problem with this, except that I'm not gay.

I don't know where the waviness--which goes to loopy curls when I sweat--came from. None of the drugs I'm on now (Avastin, Tykerb, zometa) are supposed to affect the hair.

As far as the color goes, I use one of those spray-in lighteners (that work in the sun or with a hair dryer) on the top layer, and the sides are going a bit gray. So my hair is a mix of about three shades, which I like.

More about hair, and baldness:

Bald, Balder, Baldest

Going Bald I

Going Bald II

Going Bald III

Preparing for a Bald Head

Loose Ends on Bald Heads

@ Jeanne Sather 2008.

Bald, Balder, Baldest

This is for Beth, who will be bald very soon.

I’ve gone bald from chemotherapy at least three times. (Chemo brain, you know. I may have forgotten a time or two.)

The first time was traumatic—I cried, I raged, I agonized over the way people, total strangers, responded to my bald head: with pity. The second time, I had fun with it. I decorated my head with a henna tattoo and flaunted my baldness. The third time, I wore a wig for the first and only time, as a concession to the sensibilities of my then-14-year-old younger son, who did not want to be seen at school with a bald mother.

Right now, I am taking oral Cytoxan, and my hair has thinned, but I am not bald. I don’t have much body hair, though, and my eyebrows and eyelashes are hard to see (the “space alien” look). My eyebrow pencil is my new best friend.

Whether or not you go bald while in chemotherapy treatment depends on the type of chemo you have. There are also individual responses to chemo, and some are quite odd: One of my nurses told me about a woman who lost only half of one eyebrow (in addition to the hair on her head). The other half of the brow stayed firmly in place.

The reason you lose your hair with conventional chemotherapy is that chemo attacks fast-growing cells, including cancer cells and hair follicles. Targeted therapies like Herceptin don’t cause hair loss because they work in a different way.

The photo is of me at about age 2 with my original hair: fine, strawberry blond, and straight as a stick.

Read more:

Going Bald I

Going Bald II

Going Bald III

Preparing for a Bald Head

Loose Ends on Bald Heads

@ Jeanne Sather 2007.

Going Bald I

The first time I was in cancer treatment, back in 1998-1999, I wrote a weekly series called “Jeanne’s Diary” that was originally published on the OnHealth Web site. (It is now on this blog, see Jeanne’s Diary.)

So I have a detailed account of what I thought and felt while going through treatment. A bit too detailed, I sometimes think now. I documented every twitch and sneeze.

It is interesting for me to reread chapters of my diary, because some of the things that were huge issues for me then are non-events now. Losing a breast was one of those issues. Going bald was another.

When I was first diagnosed, I was even more upset about being bald than I was about my mastectomy—at least, that’s what I wrote at the time. I saw a bald head as “a billboard that shouts ‘I have cancer,’” which, of course, is true.

The first time I had chemo, I had Adriamycin (generic: doxorubicin) by IV once a week for 12 weeks. I knew before I started that I would lose my hair, so I went to SuperCuts the week before my first treatment to chop off the chin-length bob I’d worn for years.

At the time of my first treatment, my nurse discussed the side effects with me in detail. These included hair loss: eyebrows, eyelashes, body hair, all of it. (Also pink tears and orange urine.)

I don’t remember losing my eyebrows and eyelashes, but I suppose I did.

Doctors and nurses know a lot about chemo and hair loss. They know enough to predict exactly when your hair is going to fall out. With doxorubicin, I was told, my hair would fall out between treatments three and four.

So after Treatment 3, I went home and buzz-cut my already short hair. I took it from 3 inches down to about a half-inch. I wrote: “It looks pretty good—sort of a Joan of Arc look—except for the back, which is hard to cut evenly over my shoulder.” When I read that now, I catch the whistling-in-the-dark tone: I wish I had the strength of Joan of Arc.

Then, two days before my fourth chemo, I had a meltdown in the shower:

I'm in the shower on Wednesday morning, two days before my fourth chemo treatment. I tug gently on my pubic hair, and clumps come away in my fingers. Now I'm afraid to shampoo my head--I have a couple of appointments that afternoon, and I'd like to have hair for them.

I stand there, wondering whether I dare get my head wet.

Then I realize that my period has started. It's probably the last period I will ever have--chemo makes you sterile and pushes you into early menopause. [This turned out not to be true. My period started and stopped over and over again for years as I went in and out of treatment.] It's one of the things that really upset me when I learned about it. I had always hoped to have one more child.

I'm a mess. But I have to get out of the shower, I guess, so I wash my hair and comb it gingerly. I decide to skip the hair dryer. So far, so good: I still have a full head of hair. I decide a little hair gel won't hurt anything, and dab some on.

Somewhere in one of the books and pamphlets I have on breast cancer is the suggestion that women keep a plastic container in the shower to collect their hair as it starts to fall out. ‘Hair loss is upsetting,’ the book says--that's an understatement. How much money and time do women (and men, for that matter) spend on their hair? Shampoos, special treatments, hairdressers, perms, color, transplants for pattern baldness. We like hair.

Eight days after my body hair began to fall out (yes, I counted), the hair on my head started to go. A gentle tug was all it took, or no tug at all. It didn't fall out in clumps, as I thought it would, but rather a strand at a time, like a dog shedding in spring.

My doctor said it would take a week or two for it all to fall out. This surprised me: I thought it would all go at once. He said it would start growing back as soon as the chemo stops, or possibly sooner. I still don't know how this can be. The hair falls out because chemo kills fast-growing cells, including cancer cells and hair cells. But, in fact, my hair did start growing again while I was still on chemo.

The falling hair was really upsetting. I needed to cry, but I couldn’t. I could feel the tears, right there, but they wouldn't come. Did I feel sorry for myself? You bet.

In the days that followed, hair clogged the drain in the shower, gummed up the soap, and scattered across my pillow. I would run my hand across my head, and a light shower of hair would follow.

Once it was finally all gone, it was a relief, in a way.

I had decided against the expense and hassle of a wig, and I wore hats. See Preparing for a Bald Head for more on that.

@ Jeanne Sather 2007.

Going Bald II

It seems to me, looking back, that I was I was balder the second time around, when I was on Taxol.

I finished my first round of chemotherapy treatments in February of 1999. At the time of my three-month checkup, my hair had grown back. It was still very short, but thicker than before (a nice benefit) and also curly (not so great: it curled like a cocker spaniel’s coat. I wanted loopy ringlets).

Then, five months after finishing chemo the first time, in July of 1999, I had a local recurrence. You can read about that in Jeanne’s Diary.

My doctors recommended chemotherapy with Taxol: four treatments three weeks apart, plus six and a half weeks of daily radiation treatments at the same time.

I did not agonize over the decision to do chemo the second time as I had the first, so the whole thing was much less stressful. I knew the drill. Even knowing that my hair would fall out again was not a big deal.

I ordered a new hat and some headbands. I shaved my head, right down to the skin. And one night, just for fun, a friend and I went out and got a henna "tattoo" of a mandala painted on the side of my head.

The mandala, a circular design that symbolizes totality in Hinduism or Buddhism, was a prayer for me to get through this treatment with as much grace as possible. (I used to have photos of my henna tattoo. If I can find them, I’ll post them.)

The biggest difference between Going Bald I and Going Bald II was my attitude. The first time, I hated those pitying looks; they really upset me. The second time, I was much more in-your-face. I flaunted my bald head with its henna tattoo. I didn’t try to hide it.

I wore large earrings and makeup. And when people gave me “that look,” I stared them down. Inside my head, I was thinking, “Yes, I’ve got cancer, deal with it.”

The message seemed to get through.

@ Jeanne Sather 2007.

Going Bald III

My cancer metastasized to my bones in late 2001, but my first treatment after the metastasis was with the targeted therapy Herceptin, plus hormonal therapy, so I did not lose my hair.

After I’d been on this regimen for a while, I had “disease progression” and had to do chemo a couple of times, in addition to the Herceptin. I know I did Taxol a second time, and I also had Navelbine.

I didn’t lose my hair with the Navelbine, but I did with the Taxol. This was when my younger son Robin was in 9th grade and I was on weekly Taxol for six months. (Plus Avastin toward the end of this series of treatments, because of new research that came out at about that time on how well Taxol and Avastin worked in combination. I was also still getting Herceptin.)

Robin did NOT want to be seen at school or school events with a bald mom (He never cared when he was 8 or 9, but 14 is a different age altogether). I also respected his wish not to be known at school at the kid whose mom had cancer, and we kept it very quiet.

As a result, I wore a wig for the first time. A friend of mine loaned me a human hair wig that could have been made for me: the color was a perfect match, and the style, a straight, chin-length bob, was the way I had worn my hair for years.

I wore the wig with a hat, usually my brown velvet beret, and it looked great.

A wig, especially a natural hair one, is a lot more work than the bald look. You have to wash it, and dry it, and style it, and keep it on a wig stand. And putting it on straight and anchoring it properly takes practice.

But I did enjoy the fact that no one could tell I was doing chemo, yet again.

World's Greatest haircut
When I have hair, I wear it like this. A barber named Chez, who works out of a little retro barbershop on Lower Queen Anne in Seattle, cuts my hair.

@ Jeanne Sather 2007.

Preparing for a Bald Head

Before I lost my hair the first time, I spent weeks getting ready. A friend who was a cancer survivor loaned me six or seven hats and dozens of scarves. She has a whole wall full of hats because her friends gave her a hat and scarf shower when she was going through chemo--a great idea.

I also visited a little shop called Hatterdashery in northeast Seattle. (I’m not sure it’s still there, but here’s a link to another source for hats: Cool Headz Hats.) I dropped by, intending to buy one hat to wear for the holidays, and walked out with four. I gift-wrapped two of them and put them under the tree for myself for Christmas.

On Thanksgiving, I wore my brown velvet beret and a matching velvet sweater. I felt good. (So what if I fell asleep on the couch right after dinner?) The other hat from Hatterdashery, also velvet, had a roll-up brim and was a mixture of blue, green, and purple; the color changed from different angles. It was my favorite hat. I also had the gray fedora my grandfather wore in the 60s. That looked good, too.

Both my doctor and the guy who cut my hair told me that hair grows back thicker and curlier after chemo. This proved to be true: my hair has been thicker since that first series of chemo treatments (when I haven’t been bald yet again). The curliness I didn’t like, but it went away after a few months.

I cut my hair short in preparation for it falling out. First, I had a stylist cut it to a couple of inches. Then, a few weeks later, the day of my third chemo with doxorubicin, I came home and buzz-cut my hair to less than an inch. I needed bigger earrings with this short cut, I decided, and found some from Mexico made of brass and polished them up. They are broad little native faces, wearing bead earrings.

Other times, I have shaved my head right down to the scalp. I prefer that to the wispy look chemo hair has.

I would never have taken electric clippers to my own head before cancer. Cancer has made me bold.

@ Jeanne Sather 2007.

Loose Ends on Bald Heads

Cool Boyfriend
When his girlfriend lost her hair to chemotherapy in 2004, William Rodarmor (right) shaved his head in solidarity.

More Bald Heads
The Makeup Gallery has photos of actresses who have played bald characters, including Emma Thompson in Wit and Meryl Streep in One True Thing.

Cancer Patient Attempts to Sell Bald Head
Last year, a young man in cancer treatment attempted to sell ad space on his bald head on eBay, but was told by eBay to take the ad down.

According to The Cancer Blog, 20-year-old David Mise was trying to raise money to pay some bills.

NoHairDay
This is a very cool project: photos of three women, Debbie Dorsey, Carol Potoff, and Libby Levenson, who became friends while in cancer treatment. Lots of bald shots. Go to: NoHairDay

Be Prepared: Hair With a Mind of Its Own
Now that Liz, who writes As the Tumor Turns, is done with treatment, she's chronicling her hair growth with the Monday Morning Hair report. Last week it was a "freaky little Cupie Doll ridge running along the top of my skull."

Go to her blog to see the photos, or to suggest a style solution.

Bald in the Land of Big Hair
I haven’t read this book—yet—but it looks good. And I love the title.

Buy the book

@ Jeanne Sather 2007.