Humanism in Healthcare: Hair Loss in Cancer Patients
Cancer care reflects the inequities in America’s socio-economic system and further divides the classes ability to access medical care. Controversies exist in cancer care insurance coverage because treatments and medications are costly. Patients who are denied by their insurance companies treatment options or prescriptions bear an undue burden. In effect, patients are often deeply in debt due to the care or can’t afford their care at all. Denial of medical treatments and prescriptions, specifically preventative care for hair loss, is an area that emphasizes this inequality.
Anti-cancer therapies create hair loss in a majority of patients. Hair loss, or alopecia, is common in those who are undergoing cytotoxic chemotherapy. The hair loss occurs because there is a reduction of hair cells that make hair. The time it takes for a patient to lose hair also may affect the time it takes for patients to regrow hair, if they are even able to regrow hair after treatments. Further complicating regrowth is if a patient has an infection on the scalp due to chemotherapy or alopecia. Scarring from infections may inhibit hair regrowth. Often, patients are not warned of this possibility and are upset when they find their hair will not be able to regrow. The psychosocial impact of hair loss is demonstrated mostly in women and children.
After speaking with several breast cancer patients, many stated that the loss of their hair is traumatizing.A few said they would reject chemotherapy so they may keep their hair. The women I spoke with also worried about the loss of eyebrows and eyelashes. Some women felt the side effects of chemotherapy were worse than the chemotherapy itself.
The fact is, patients have an option to help prevent alopecia, but most insurance companies don’t cover the option. The Federal Drug Agency (FDA) has approved a scalp cooling system that helps prevent or minimize hair loss. The technology is available in several cancer care sites across the United States but the cost can be prohibitive. At Moffitt Cancer Center in Tampa, FL the technology is available at $400 per session. If the average number of chemotherapy sessions is 8, then the total out of pocket cost is $3,200. For some, the cost is worth the chance to keep all or most of their hair, but for others the cost is prohibitive.
Cancer is stigmatizing. The side effects of chemotherapy negate a patient’s ability to keep their illness private. A person shouldn’t be denied access to a preventative treatment which could improve self-confidence, decrease depression, and allow a sense of privacy because of their socio-economic status. Insurance companies include health and wellness treatments, including acupuncture and yoga because of physical and mental health benefits. Alopecia as a result of chemotherapy reminds patients of their disease, affects social interactions, and impacts how the patient feels about their body. Scalp cooling treatments provide mental health benefits that can be measured by a patient’s quality of life during and after receiving chemotherapy. The standard of cancer care defined by insurance companies and medical organizations needs to encompass all aspects of a patient’s cancer experience by covering helpful treatments, such as scalp cooling. Providing preventative care which affects a patient physically and emotionally does not create an undue burden on society, it enhances a person’s ability to interact in society.