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Psychosocial interventions to support breast cancer patients affected by treatment-related hair loss

Pilkington, Melissa


Melissa Pilkington


The psychosocial impact of cancer treatment is wide-ranging, including changes to appearance, such as hair loss. To date, there is limited published research on the provision of psychosocial support for chemotherapy-induced hair loss. It was important to explore what psychosocial interventions are currently available for patients, whether they have been evaluated and whether they are meeting patients’ needs in order to inform the best possible provision of care for women in this situation in the future.

The first objective was to conduct a systematic review of the available evidence of the effectiveness of psychosocial interventions to support people affected by hair loss (Study 1). A systematic search yielded eight studies, reporting on five different interventions. Characteristics of the successful interventions included: intervention delivery soon after hair loss, information provision, individual based intervention; and an opportunity for individuals to express their concerns. However, since a number of interventions currently available for breast cancer patients have not yet been evaluated, it is unknown whether they offer any benefit. One intervention currently freely available to breast cancer patients, but which has not yet been evaluated, is Breast Cancer Care’s HeadStrong service. HeadStrong is a volunteer-led service offering information and support in the use of head camouflage. A mixed methods approach was used to evaluate the HeadStrong service, employing parallel qualitative and quantitative approaches. In Study 2 25 semi-structured interviews were conducted to explore women’s experiences of this service. Thematic analysis identified three main themes: facing the challenges of hair loss, receiving support for treatment-related hair loss and meeting unmet needs. A quantitative approach was adopted in Study 3. The findings suggested the HeadStrong intervention can be important and helpful for breast cancer patients affected by hair loss, but it does not necessarily meet all their needs. It was highlighted that there is still potential to develop a range of interventions for this patient group. The final study in this programme of research (Study 4) considered the feasibility of an expressive writing intervention to support this patient group. Although the expressive writing was found to be appealing to some, based on the small sample size no definitive conclusions could be made.

In conclusion, support needs vary between individuals and throughout their cancer journey; not all patients want the same support with hair loss. It is imperative that patients are equipped with strategies to help them to manage all aspects of hair loss, rather than relying on one strategy, such as camouflage.


Pilkington, M. (in press). Psychosocial interventions to support breast cancer patients affected by treatment-related hair loss. (Thesis). University of the West of England

Thesis Type Thesis
Acceptance Date Feb 9, 2016
Keywords Breast cancer, hair loss, psychosocial, intervention


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