Heart failure explained; why chemo causes hair loss
: My father was just diagnosed with congestive heart failure. How can he still be alive if his heart has failed? — Phil P., Little Rock, Arkansas
A: In congestive heart failure, blood flowing out of the heart to the rest of your body slows down and blood that returns to the heart after it’s made the circuit through your veins gets backed up. That increases pressure in the veins, which in turn causes water to accumulate in the body’s tissues. You get swelling of the ankles and legs, and liquid can accumulate in the lungs, making breathing difficult (that can cause pulmonary edema). The kidneys may struggle to do their job.
It’s most often caused by coronary artery disease, such as atherosclerosis, high blood pressure, heart attack, faulty valves or atrial fibrillation. But a diagnosis of CHF doesn’t mean the heart is going to stop working immediately. We probably should call it “heart failing” instead of “heart failure” because there are many ways to slow, and in some cases reverse, CHF.
Unfortunately, many folks don’t take advantage of their treatment options. A recent study looked at 161 patients with heart problems: 111 were regarded to be at risk for transplant, LVAD (left ventricular assist device) or death. Yet only about 40 of the 161 thought that they were at high risk for serious health issues.
And 63 per cent indicated they would decline one or more simpler forms of life-sustaining therapy, such as dialysis. The result: just over a year later, 33 of the 161 patients had died; 13 had transplants and 15 had LVAD implants.
A diagnosis with CHF doesn’t mean it’s time to give up. Lifestyle changes such as quitting smoking, giving up red meat, managing stress, eating more fruits and vegetables, shedding excess pounds, regular slow walking and increasing physical activity as your doctor says is safe can improve quality of life and help you live longer. Medicines for coronary artery disease, high blood pressure, high LDL cholesterol and diabetes can help ease or even reverse the problem, too.
So encourage your dad to stay positive and get information about CHF support programs at his local hospital.
Q: Why does chemotherapy cause hair loss in some people and not in others? I am bald as a cue ball! — JoAnne P., Vail, Col.
A: Chemotherapy-induced alopecia (hair loss), or CIA, is the most common side effect of chemotherapy. It happens because the chemical agents that target fast-replicating cancer cells also KO the fast-replicating cells of the hair follicle. You could say that when you lose your hair during chemo, the chemotherapy is doing what it’s supposed to. It’s kind of a shotgun approach, but it works.
CIA doesn’t happen to everyone who undergoes chemotherapy, and it’s important to know this. About eight per cent of women refuse treatment because they can’t deal with the idea of losing their hair.
A lot depends on the type of cancer being treated, the type of treatment being administered and whether you’re getting a single drug or a combination of drugs.
Researchers are hard at work looking at subgroups of women who haven’t lost their hair during chemo to figure out why they didn’t. They’re hoping that their research will help everyone avoid CIA: the psychological stress and the quality-of-life problems that hair loss triggers are significant.
That’s why those cooling caps we’ve written about before are such a great option. The cap preserves the hair follicle by restricting blood flow to the small blood vessels of the scalp during chemo treatment. That keeps the chemo away from those fastreplicating cells and slows their replication, too. The caps are effective 50 to 65 per cent of the time. Ask your doc if it’s a good option for you.
And remember, when you have CIA, your hair will grow back eventually, though sometimes it takes several months after you end your treatment. Mehmet oz, M.D. is host of “The Dr. oz Show,” and Mike roizen, M.D. is Chief Wellness officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. oz and Dr. roizen at youdocsdaily@sharecare.com.