Hair in Breast Cancer

Hair in Breast Cancer

The term bad hair day was invented for women. Hair has occupied an inflated place in our
lives since we were little girls, out of all proportion to so much other stuff and certainly out
of all proportion to what preoccupies men. (Even sex? Yes!) When we were growing up,
was hair more important than breasts? I would say yes, though some may argue the two
are on a par with each other. How many hours in your life have you spent on your hair—
cutting, setting, blow-drying, straightening, curling, crying? Well, to braids, bangs, and
barrettes, add bald! If you have chemotherapy, your hair is almost sure to go. Now in the
grand scheme of things this may not be such a big deal. Kill the cancer, lose the hair. That
doesn’t sound like a bad trade-off to the rational mind. But when have we ever been
rational about hair? It is okay. You are allowed to be irrational about this one because the
hair thing is a big deal.

That wretched chemotherapy is a miraculous cocktail of drugs that zeros in on rapidly
dividing cells that are growing out of control. But it doesn’t distinguish between the bad
cells (the cancer) and the good cells—like hair. You have probably thought many times in
your life that your hair is out of control. Well, it kind of is. The cells that make up your hair
strands are among the fastest-growing cells in your body. You are right: your hair at the
cellular level is out of control, and those cells get zapped just like the cancer.

I have tried to imagine myself looking different throughout my life. When I had waistlength
hair, I wanted to get rid of it. When it was shoulder length, I had a perm. When it
grew out, I wanted to cut it right away. But baldness? That had never entered the equation.

You never imagined it either, did you?

So what to do? I have some good news. When you are diagnosed with cancer, you really
don’t have much control over anything. You think you do, but honestly you don’t.

However, I discovered one thing I could control. After talking to friends I decided to shave
my hair off before it fell out. For some, waking up with clumps of hair on the pillow is a
traumatic experience. In addition to the trauma of diagnosis and treatment, you are faced
with a hair 911 that must be dealt with right away. I was not going to take that route. There
is enough to handle without trying to muscle your way into the salon for an emergency hair
appointment.

Here’s what you, too, can do: shave it off. I could tell that some around me were a little
taken aback. First step? Talk to someone else who has been through this. Get
recommendations for hairdressers who have experience dealing with cancer patients.

Believe me, they will hold your hand through this process in every way. I had a consult
with the wonderful Hans, a gentle soul with the perfect manner who was a Washington
institution among women who had gone through what I was going through. I was to
discover later that he also volunteered in a program to help women cope with their changed
looks during cancer therapy. After that consult, at which I tried on a number of wigs, I
made an appointment. Hans encouraged me to bring people along and turn it into a party.
So that’s what we did. My husband and children, my sister and my girlfriends, sparkling
cider and cupcakes in tow, forty-eight hours after my first chemo session I had all my hair
shaved off.

I will not deny that the minute he took the razor to my head I was freaking out inside.

My teenage daughters looked on bravely, but I knew it was tough for everyone. Don’t
worry. It moves fast. Your friends are there with you, and before you know it, the hair is
gone. Give yourself permission to cry at this precise moment. You’ve cried for lesser hair
misdemeanors, and watching in the mirror as your hair is being shaved off is akin to
watching a federal crime being committed. But, I thought, I have a pretty nicely shaped
head! This revelation doesn’t stop you crying, or your daughters or your sister crying, but it
does make you hold your head up a little higher. Make sure you have great earrings on and
you are made up. If you have already chosen a wig, have your hairdresser trim it to fit your
new bald pate. Voilà! Extreme makeover, cancer style.

Of course I was riddled with doubt. What if I had acted too soon? What if my hair
wasn’t going to fall out? In fact it didn’t, and I was full of righteous indignation. I had
stubble that was kind of growing almost immediately after I had shaved my head. “I’m a
hard-ass,” I told my oncologist. “It hasn’t fallen out yet. Maybe I shouldn’t have shaved
it.”
“It will,” she said, and she was right. A few days later my stubble rubbed off on my
hands in the shower. The floor looked a little like the sink does after my husband shaves,
with tell-tale stubble around. It was still a profound shock, and I cried inconsolably in the
shower. But I was grateful I wasn’t pulling out clumps of my shoulder-length hair (and
clogging up the drain).

Now how about the hair not on your head? That depends on the chemotherapy drugs
you are on. Chances are some or all of it will go. Believe it or not, it’s not as traumatic as it
could be. No eyebrows? Very bad (see “L Is for Looks”). Leg hair? Well, no waxing for
the duration of my treatment, so not so bad. The same for underarm hair. For those of us
who have inherited the hirsute characteristics of our ancestors, this was some very
welcome news.

What happens to your hair is important. There were many times when I was up in the
middle of the night and saw a scary thing in the mirror: a bald me with no eyebrows and
sallow skin and a face so puffed up from steroids that I looked like a billiard ball or
Nosferatu (see “L Is for Looks” again). But I’m here to tell you it passes and your hair
grows back really quickly once you have completed your treatment.

In the Hindu faith, there is a tradition to perform a mundan on a child’s first birthday.
The head is completely shaved to rid the child of all the negativity of previous lives, the
undesirable traits of previous incarnations, so that the child can start anew. I didn’t have
one of those when I was one year old, so I approached my haircutting as a mundan
ceremony forty-seven years delayed—the first step on the road to new, post-cancer
beginnings.