Just about everyone has been touched by cancer, and during our lifetimes many cancers have become survivable thanks to the hard work of our scientific community. Early diagnosis and aggressive treatment give many cancer patients a fighting chance, but they can also be extremely physically and emotionally taxing. When you talk with someone who is beginning treatment for cancer, you’ll often hear a deep sense of dread, which is completely understandable.
But the source of that dread might surprise some people. Often, they are more anxious about the prospect of losing their hair due to the chemotherapy than they are about the cancer itself. The hair loss seems to be symbolic to a lot of cancer patients – stripping them of a source of self-confidence and perhaps signaling how delicate we all are.
However, scientists are gaining a greater understanding of how this type of hair loss might be prevented in the future.
Researchers from the University of Manchester, led by Dr. Talveen Purba of the Center for Dermatology Research, School of Biological Sciences, recently published the article, “CDK4/6 inhibition mitigates stem cell damage in a novel model for taxane‐induced alopecia,” in the journal EMBO Molecular Medicine. Their research examined how a class of drugs called CDK4/6 inhibitors can protect hair follicles from the damaging effects of taxanes, which is the term used to describe the family of commonly used and highly effective drugs used to treat many types of cancer.
Before we get into the research findings, let’s explain why chemo causes hair to fall out. Chemotherapy targets all rapidly dividing cells. It doesn’t distinguish between healthy cells and cancer cells, it just attacks all cells that are rapidly dividing. As you might expect, hair follicle cells are very active. In fact, the cells of the bulb divide every one to three days. That behavior is a lot like cancer cells, so the hair cells get hit and within a couple weeks cancer patients undergoing chemo start losing their hair.
The hair might come out in little bits or in big clumps, but it’s always difficult and disheartening. The chemo often makes you feel sick and the hair loss makes you look sick.
Dr. Purba and his team carefully examined what was happening at the molecular level that causes hair follicle cells to respond to taxanes by falling out.
“We found that the specialized dividing cells at the base of the hair follicle that are critical for producing hair itself, and the stem cells from which they arise, are most vulnerable to taxanes,” he said the article, “Scientists discover new breakthrough in cancer hair-loss treatment,” published by the University of Manchester. “Therefore, we must protect these cells most from undesired chemotherapy effects – but so that the cancer does not profit from it.”
That’s obviously a critically important point. If it’s a choice between losing your hair and surviving cancer versus keeping your hair but having a greater risk of the cancer treatment failing, the choice is certainly to do everything possible to survive cancer. But what if it’s not an either/or choice? What if you could undergo chemotherapy, keep your hair and survive cancer?
That was the focus of Dr. Purba’s research. They started with a theory: what would happen if, prior to chemotherapy, they temporarily delivered a different drug to basically inoculate the hair follicle cells from the harmful effects of taxanes. They tested a class of drugs called CDK4/6 inhibitors and what they found is that their approach appears to work.
“When we bathed organ-cultured human scalp hair follicles in CDK4/6 inhibitors, the hair follicles were much less susceptible to the damaging effects of taxanes,” said Dr. Purba.
As is often the case, the more we learn the more we discover how much we still don’t know. For instance, Dr. Purba acknowledges that researchers still don’t understand why some patients lose hair during chemo while others do not. Similarly, some patients experience permanent hair loss after chemo, which is still a mystery, and the University of Manchester researchers don’t know if their discovery could be effective at regrowing hair for those patients.
“We need time to further develop approaches like this to not only prevent hair loss, but promote hair follicle regeneration in patients who have already lost their hair due to chemotherapy,” Dr. Purba said.
One of the exciting aspects of this research is that CDK4/6 inhibitors are not new or untested. They are already medically approved as targeted cancer therapies. This might mean that regulators such as the FDA might be willing to accelerate the usual timeline for clinical trials. Instead of talking about a potential treatment taking decades to develop, we may be talking years.
Congratulations to Dr. Purba and his team! We at Arocha Hair Restoration will keep you updated as this exciting work in the U.K. continues to advance.