After months of battling cancer, Princess Kate is now showing off her full head of hair. An atypical sight after chemotherapy. An expert explains.
Munich – It seems as if Princess Kate has won her battle against cancer. After her horror diagnosis following abdominal surgery in March 2024, she returned to Instagram at the beginning of September with a groundbreaking video message. The chemotherapy is now over, she announced. “I can’t even put into words how relieved I am.”
The 42-year-old seems to have coped well with the aggressive treatment, at least that’s how it looks on the outside. As in one of her rare public appearances in July, the Duchess of Cambridge also appears in the Instagram video with a full head of hair. And that’s despite the fact that hair loss is one of the most common side effects of chemotherapy.
Chemotherapy prevents cell division – both malignant and healthy cells
However, the effect of chemotherapy can vary from person to person, as the German Cancer Aid on its homepage. The non-profit organization provides information about the most common side effects, but emphasizes that patients “experience these to varying degrees.” In addition to nausea, vomiting, anemia, frequent infections and loss of the sense of taste, which King Charles also suffered from, the most important side effect is hair loss, also known as alopecia, which is psychologically stressful. This is caused by the way the medication administered during treatment works.
These are cell poisons that fight cancer by specifically preventing cell division. Cancer cells grow and multiply much faster than healthy tissue, which is why the drug primarily attacks these cells. However, healthy cells that divide frequently are also damaged. These include hair root and skin cells in particular.
Hair loss depends mainly on the type of cancer drug
Karin Jordan, spokesperson for the Working Group on Supportive Measures in Oncology in the German Cancer Society, explains in response to a request from IPPEN.MEDIA: “Of course, there are many different forms of antineoplastic therapy. Depending on the type of cancer, different drugs are used.”
She is chief physician of the Clinic for Hematology, Oncology and Palliative Medicine in Potsdam and has the Patient guidelines for supportive therapy for the German Cancer Aid. This guideline states: “Whether hair loss occurs depends primarily on the type of cancer drug, but also on the dosage and the method of administration – as a tablet or via a vein.”
“Chemo to swallow” usually causes little to no hair loss
The drug capecitabine, which is used in classic chemotherapy, is considered gentle on the hair, as Jordan explains. Unlike most conventional drugs, it is not administered as an infusion, but as a tablet. This “chemo to swallow” is a further development of the substance 5-fluorouracil, which has been used in cancer therapy since 1958 and also affects the division phase of cells.
Despite this effect, the drug causes, according to the German Medical Journal little to no hair loss. However, the usual side effects of treatment, such as nausea, loss of appetite or fatigue, also occur frequently with capecitabine. The active ingredient is approved in Europe for colon cancer, metastatic colon cancer, advanced stomach cancer and locally advanced breast cancer.
“Even newer forms of treatment, such as immunotherapy or therapy with certain antibody drug conjugates, make the side effect of hair loss rather rare,” says the oncology expert. Immunotherapy does not attack the cancer cells, but strengthens the body’s own immune system to eliminate cancer cells independently. The antibody drug conjugate (ADC) combines chemotherapy and targeted cancer treatment with antibodies. “However, these forms of therapy must always be used at the right time and for the right type of cancer,” says the expert.
Cold can also help against hair loss during chemotherapy
Jordan emphasizes that many of the side effects of chemotherapy can now be alleviated or even completely prevented through supportive measures. However, there are currently no medications that can prevent hair loss. However, Jordan and Co.’s patient guidelines state: “To prevent severe hair loss, your doctor can offer to cool your scalp with special cooling caps for a few minutes before, during and after the medication is administered.”
The cold causes the blood vessels to contract and less blood, and therefore less chemotherapy medication, flows through the scalp. The hair roots also reduce their metabolism and absorb less of the medication. The patient guidelines also list measures that the patient can take themselves. To protect the scalp, those affected should not wash their hair too often, only use lukewarm water and, ideally, avoid blow-drying.
After the treatment, the hair usually grows back within a few weeks to months. The new hair is often thicker and curlier than before. The color may be slightly different from the original, say the experts. (rku)
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