Chemo side effects, Tamoxifen dosage

[gail23]

I am 50 yrs old and have recently finished 4 cycles of AC and 2 of Taxol following a mastectomy. The oncologist only did 2 Taxol treatments because of side effects I was experiencing from it. I have now started taking 20mg of Tamoxifen once a day. I have several questions on side effects from the chemo to date and what might occur with the Tamoxifen.
I am concerned that my hair does not seem to be growing back. It is mostly thin short stubble at this time with some big bald spots in the front where the hair line appears to have receded greatly. When I visitied my family Dr. recently she said with some people the hair loss is permanent. In what percentage of the patients is the hair loss permanent?  Did I do or not do something to cause it? Is there  anything I can do to make it better - it is going to be difficult to adapt to wearing a hat 24/7 on a permanent basis.
Also can you tell me anything about when the different dosages of Tamoxifen are appropriate, i.e. 10mg vs. 20mg and if you are on a larger dose does that for instance double the risks of the blood clotting and other side effects associated with Tamoxifen? And does the possibility of the Tamoxifen side effects diminish with time or are you at the same (or greater) level of risk for the whole 5 yrs you are on it?
Thanks for any information you can provide.

[gail23]

I hear what you're saying but hair styles are like all styles, what may look OK on one person can look disasterous on another. I have very poor facial qualities and the baldness just accentuates that fact and makes me even more self-conscious. It just is not flattering at all. I am not an out going person and my immediate work group is all male with the exception of 1 and I am dreading the reception I will receive (or avoidance) and am fearful of losing my position because I will not be able to get up to speed with the 'guys' on all the technology and product changes I missed while on medical leave. However, it is comforting to know that under the right circumstances there is support in the work place and a positive outcome for some of us. Thanks for sharing.

[Belleview Teacher]

I completed chemo in the middle of April this year.  Today was my first day back to work without my wig.  I am so glad I finally took the plunge to go natural even though my hair is only about 1.5 inches long at this point.  I teach high school and was nervous about the students' reactions.  I received many compliments today on my "new" hairstyle.  Since I am 58, the hair that came in was almost all white with a little grey.  I went to my hairdresser last Friday and she colored it blonde.  She also evened it out and showed me how to deal with my verrrrry curly hair (I was at a loss because prior to chemo my hair had always been straight).  I love my new look and plan to get my ears double pierced within the next few days.  I am looking forward to my whole new look.  Please try to treat your hair loss and your new look afterwards as a new beginning for the old you.  That's what I'm trying to do. This is certainly not what we survivors would have chosen for ourselves, but we need to make the best of all God has given us.  Good luck and don't worry!

[gail23]

Thanks to all for your responses and God Bless.

[dammie]

Try to be patient (easier said than done).   I finished chemo 2/04 and was also concerned about my hair coming back.  Today, it is about 3 inches long and thick with some wave (I have always had straight hair).  I do know some women in my support group had given their head "one final buzz" to even it out as it grew in.  I was told not to use a hair dryer, just to gently towel dry it.  I also used a conditioner to make it feel softer and some gel to help shape it as it comes in.  I understand the anxiety that you are feeling, just try to give it some time and look at all the positives of how far you have come.  Good luck and God Bless.

[seven7]

My Chemo ended Nov. 2002.  I still wear a wig.  My hair is much too thin to get a perm qnd try to fix it. I have decided that I may never get a full head of hair.  But I am glad i received the chemo, radiation and am taking tamoxifen.

I am 70 years old but I still have a lot of living to do, and I believe I would be dead by now  if I had not done the Chemo.

Mine was a stage III agressive cancer.  No sign of it returning yet!  Thank God!        Don't worry too much about your hair.

[pitcrew]

i started getting my hair back 2 months after I finished Chemo. it came back quicker in some areas then others and by 3 months after chemo I had about 1/4" of hair in most areas. It's been almost 10 months since my last treatment and my hair os about 3 or 4 inches long and VERY curly. But at least its hair. My eyelashes have continued to grow and fall out. I've lost them 3 times since I finished Chemo.

[CCF-RN,MSN-rf]

Dear Gail23:  Hair loss is not usually permanent but it may not be as full as it once was.  This can sometimes be compounded with thinning that women experience as a result of hormone changes (some women have some receding hair line issues associated with menopause).  You did not do anything to cause this or make it worse.  It takes time.  New hair can be fragile, so treat it gently.

You do not mention whether you are post menopausal.  If so, many doctors are using aromatase inhibitors such as Arimidex rather than tamoxifen in the adjuvant setting because there is evidence that it may be more effective and has a better side effect profile.  If you are premenopausal, then tamoxifen is appropriate and there is no evidence to support that a dose higher than 20mg per day is of any additional benefit.