Radiotherapy to the brain always causes some hair loss. If you are having treatment to a particular part of your head, your hair only falls out in that area. You might also have some hair loss on the opposite side of the head, where the radiotherapy beams pass through. This area is called the exit site.
Whether or not your hair grows back depends on the type of radiotherapy you're having. For example, if you're having whole brain radiotherapy to treat your symptoms it's likely that your hair will grow back. Whereas treatment to try to cure cancer uses a high dose of radiation and so permanent hair loss is much more common.
If your hair does grow back it may not be quite as thick as before and in some people can be patchy.
Hair washing tips
During your treatment, you need to wash your hair carefully so that you don't make the area sore. Use only warm or cool water.
Be gentle with your hair and use a non perfumed shampoo or baby shampoo.
It is best not to use a hair dryer but to gently dry your hair with a soft towel. Or you can let your hair dry naturally.
Let your radiographer know if your skin gets sore and they can advise you on how to care for it.
You might like to cover your head with a soft hat or scarf to protect the exposed skin and keep your head warm.
The video shows you the different types of hats and scarves you can wear when you have hair loss.
Ann: Sheena who lost her hair during her chemotherapy will now show you some of the different types of headwear. Hello Sheena.
Sheena: Hello, I wore wigs as well as lots of alternatives. There are many different alternatives to wigs. The stretchy tube is simple, easy and quick to put on. It’s comfortable, light and breathable and there are no uncomfortable seams. And it’s easy to wash. They come in lots and lots of different colours which is really nice so you can match different outfits very easily. You can get them from lots of different high street stores which is very useful.
I use to keep one of these by my front door. So if anyone rang on my front doorbell and I didn’t have my wig on or have my headscarf on I could just pick this up very quickly and just pop it on. It is important to just make sure you adjust it so that it follows your natural hairline. And then that was it. I was ready to go and answer the door. If I then wanted to go out I could then just tuck it in at the back and if I wanted to I could just put an ordinary outdoor hat on top and that would be me ready to go. The other nice thing about that is that if you perhaps were out and somebody invites you in for a coffee, you don’t want to go in wearing an outdoor hat you, so can just slip the outdoor hat off. Make sure you hold your fingers to keep it in place and you have got head covering.
Depending on the shape of your face you might want to create a bit more width and one of the ways to do that is to add another one of these stretchy tubes on top. They are quite versatile. And actually just pop it on, very simple. You can do a little bit of adjusting if you want to, and then it’s created a little bit more width. If you want to create a bit more height if you just un tuck the back bit you can just rearrange it... and tuck the front part under there and that creates a bit more height.
The other thing you can do is to add different scarves and accessories. You can even take... you know this would be quite a good scarf you could just wrap it... around... and it gives you quite a nice elegant look, so you can change it to whatever suits your personality, your wardrobe and what you are doing.
The other important thing if you are talking about scarves is looking at the size um and texture of what they are. This one is a bit too small... that sort of size. It won’t provide enough coverage so when you tie it you’ll find you’ve got sort of gaps and won’t be a good size. The sort of size you are looking for is this sort of one, you can see it’s quite big that’s the sort ideal size of head scarf. This is cotton so it’s got a little bit of grip it’s not going to slide. The problem is this is a really beautiful scarf but this is silk. The trouble with silk is that if you tie it, you think it is secure it tends to slip so it is much better to choose a fabric with just that little bit of grip.
If you want to tie a headscarf it is important to start with something quite simple. You don’t want to start with anything too complicated. You form it into a triangle first, if you create a little turn over it gives you a little bit more height which is quite nice because what you are trying to re create is that sort of volume around your face and that’s what the scarves and the tubes do.
And then it goes round the back and use one of these stretchy bands but without any metal because otherwise it might catch your headscarf and ruin the fabric. Treat it a bit like tying a ponytail. Double the elastic over and you can pull out as much of the fabric as you like at the back. And again with all these scarves the other thing you can do of course is accessorise them. So we can choose something perhaps to just add a little bit of extra... this would work, this would work again. And again you can either tie bows or you can wrap the ends in whatever you feel comfortable doing. If you just lose the ends behind.
So the other thing you can think about is perhaps putting a nice summer hat on top. And again you have got the layer underneath so if you want to stop anywhere you can take the hat off but you can just add another. Quite an elegant look. Also another thing is it is quite important sometimes to avoid the sun and this provides you with a nice shade over your face.
The other option are these crinkle cotton ones. Now these are quite nice, they are quite long. And because it is crinkle cotton it will grip quite nicely. So again what you are doing is off- setting this, so we have got one end longer than the other. So if you just scrumple the ends, cross them over at the back and then that’s secured it. Then if you give it a little bit of a twist and go over the top. And then secure it. If you can try and tie a reef knot at the side it gives a flatter knot which is a nicer look. And then what you can do is either leave the ties loose or you can tie a bow and again you can lose the ends... and wrap the one round the back there. And they do these in a wide range of different colours and designs. So if you are trying to co-ordinate an outfit it is quite easy to find something that will actually work for that.
If you want to go for hats, one of the things you might need to do is to measure your head to get your hat size. It is a very simple way of measuring. You just need to take tape measure, the middle of your forehead, round the back and there is a little bump on the back of your head. You are measuring over that little bump. And then you just take the measurement and mine is 55, I think 55 to 56 is about a standard size. That’s centimetres. In old money it’s 21 to 21 1/2 inches.
The high street tend to sell them as standard sort of sizes. So, if you have a smaller head or a larger head you might need to look elsewhere. If it is too big you’ll tend to look swamped in it. If it is too small you’ll feel it is quite insecure and you’ll feel like it is slipping off all the time. So it is important to get the right sort of size. Something like this would be good because you are looking at... something that provides enough coverage. So you need to have something that is going to cover...to the sides and also down to the nape of the neck. And you can see here it has quite pretty detail on this one. And another one... I quite like this one, this is another... nice breathable fabric, no sort of seams to be uncomfortable and again you can see it has got quite a nice detail to the side.
Whatever you choose to wear remember you can experiment with different colours and patterns depending on your outfit and what you will be doing that particular day.
Some people prefer to wear a wig until their hair grows back. You can get a wig on the NHS or buy one privately. Speak to your radiotherapy staff who can advise you on any wigs, hats or scarves they sell in the hospital.
You might want to cut your hair short before the treatment starts. This can make the change less dramatic and easier to cope with. But speak to your doctor beforehand to check how much hair you might lose.
Radiotherapy can cause many different side effects, such as tiredness. The side effects you get will depend on the area you're having treatment to but there are some general side effects you might experience regardless of where your cancer is. This video is about the side effects you might have when having radiotherapy to the brain.
On screen text: Severe tiredness (somnolence)
Mary: You know, when you say you're tired, it's not like being tired. It's like you lose all of your energy and you just do something simple like having a shower and it's like you have to lie down or you have to rest.
Martin (radiographer): After completing brain radiotherapy, you may experience severe tiredness known as somnolence. This can occur about six weeks after treatment finishes.
Mary: That fatigue really hit me and it went on for a while afterwards as well. It didn't get worse. It just stayed.
Martin (radiographer): Symptoms of somnolence include extreme tiredness and slowed mental processing. To help you cope we would recommend listening to your body and trying not to overdo things but if you can do light exercise to help maintain your energy levels.
Mary: I just took a rest if I needed to and I had to learn not to be so hard on myself. But there is little things that you can do that I felt helped anyways. That little bit of exercise. Just going for them small walks. They really do help you and even if it is just walking around your house or just walking around the block, getting outside, just getting a bit of fresh air that really, really did help me.
On screen text:
- Rest and have short naps when you need to
- Drink plenty of water
- Eat a balanced diet
- Do some gentle exercise
- Try to get some fresh air
On screen text: Feeling or being sick
Mary: After the first two or three days of the radiotherapy, I started getting really bad nausea. As the radiotherapy went on, it was just kind of a constant. Every time I'd have it, I'd feel sick afterwards.
Martin (radiographer): If you do experience sickness, then speak with your team. They can prescribe medications to help with that.
Mary: I did ask my oncologist. I'll just explain to him that I'm feeling sick from this. Please, can I get something? And then they did. They prescribed me these anti sickness medication so that did help me a lot. You don't want to eat anything, but you have to. If you're going to keep your strength up, anything that aggravates your stomach or aggravates the nausea, don't go near that but if you don't eat even though you feel sick and you feel nauseous, then you're going to feel even worse.
On screen text:
- Ask your doctor about anti sickness medication
- Your doctor might prescribe you steroids to help with your sickness
- Relaxation techniques such as mindfulness and visualisation can help
- Certain food might make it worse, such as fried food
- Eat a few hours before treatment rather than just before
- Try sipping water or fizzy drinks throughout the day
On screen text: Hair loss
Martin (radiographer): Having radiotherapy to your head can cause hair loss in the area that we're treating. It's unlikely to be all over the head, more likely to be in patches.
Mary: 2 to 3 weeks after the radiotherapy I was brushing my hair and loads came out on the brush. I knew it was going to happen, but it was just hard when it happened.
Martin (radiographer): In many cases, the hair will grow back about two months after treatment finishes. The texture and the colour may be different to before.
Mary: Mine did grow back and there's a lot of grey in it so I have to dye it, this is not my original colour. It's very slow growing back. I would say use quite a sensitive shampoo, a baby shampoo. Use that for sensitive skin in your head.
Martin (radiographer): Protect the head from the sun and the wind and avoid using hair colour, hair dryer or straighteners to style your hair. If you experience substantial hair loss, then speak with your team who can give you information about wigs and hair coverings.
Mary: I got some really cool head scarves. There is some really nice ones out there.
On screen text:
- Be gentle with your hair
- Use a non-perfumed shampoo or baby shampoo
- Avoid using heat on your hair such as a hairdryer or hair straighteners
- Let hair dry naturally or gently pat dry with a soft towel
- Your radiographer can advise you on how to care for sore skin
- Speak to your radiographer about hair coverings and wigs
On screen text: Your symptoms might get worse
Martin (radiographer): Radiotherapy to the brain can cause swelling in the area that we're treating. If you already had symptoms before starting treatment, this swelling may make the symptoms worse. After you've finished treatment, the swelling may continue for a few more weeks, but then you should recover quite quickly.
On screen text:
- Your symptoms may get worse during treatment
- This might include headaches, sickness, fits, numbness and weakness in your hands and feet
- You might need steroids to help reduce the swelling
If you're experiencing a side effect that hasn't been covered in this video, you can find more information on the Cancer Research UK website.
On screen text: For more information go to: cruk.org/radiotherapy/side-effects