Taxotere Hair Loss Does Additional Harm to Breast Cancer Survivors

Washington, DCIt’s there – like a sub audible hum – underneath Sanofi-Aventis’s decision not to disclose the risk of permanent Taxotere hair loss. It will certainly be there, underpinning the drug manufacturer’s offers to settle the lawsuits according to National Trial Lawyers. The effort to minimize the harm that Taxotere alopecia does to breast cancer survivors, though rarely said aloud, goes a lot like this:

“C’mon. It’s just hair. Aren’t you glad to be alive?”

Permanent baldness can be devastating for women. Hair loss reportedly causes more psychological pain for some breast cancer survivors than the loss of a breast. Yet, evidence suggests that Sanofi-Aventis chose to hide the danger, minimize it, and play it down when it happened. Motivation is anyone’s guess. It’s just hair, and you know how women can be about that.

Studies show that for women more than men, sexuality, attractiveness, and personality are symbolically linked to hair. Hair loss can seriously affect self-esteem and body image. In a study of cancer patients with and without alopecia, those with alopecia had a poorer body image and worsening self-concept after the loss. In other, research about 40 percent of women with alopecia report marital problems as a consequence, and about 63 percent claim to have had career related problems.

Christine tells a more personal story: “I will never forget leaving the dermatologist’s rooms after being told that my lack of hair growth was due to my particular cocktail of chemo drugs, the likely culprit being Taxotere. I was utterly devastated as I felt I had lost my femininity and aged another 20 years, all at once. It was so much worse than losing a breast to cancer, because that could be fixed – I had undergone a reconstruction.” 

The FDA approved Taxotere in 1996. At the time, patient warnings included only information about temporary hair loss. As early as 2009, European labeling for Taxotere warned of cases of permanent alopecia. Studies over a number of years reported permanent alopecia in between 6 and 15 percent of patients. Not until 2015, however, did the FDA update US safety warnings to include the possibility of permanent baldness.

Were Taxotere the only effective drug on the market to treat breast cancer, patients’ decision-making might have been different. However, studies suggest that paclitaxel (marketed as Taxol in the US) is just as effective at combatting cancer. It appears to be less toxic than Taxotere. It’s also a generic and cheaper. The choice for patients has not been about life or death, but between treatments that have more and fewer side effects and may cost less.

But Sanofi-Aventis apparently failed in its obligation to warn patients of the risk of permanent alopecia, perhaps because of a misunderstanding about the importance of hair or perhaps because of unexamined assumptions about the importance of patient’s psychological health.