CHANGES IN SELF-CONCEPT AND BODY-IMAGE DURING ALOPECIA INDUCED CANCER-CHEMOTHERAPY

Alopecia as a result of cancer chemotherapy has been reported to cause changes to the self-concept and body image. In a prospective longitud inal study, self-concept and body image were analysed in 29 patients a fter histological confirmation of gynaecological malignancy, mainly ov arian cancer, who were assigned to receive a complete-alopecia-inducin g PEC combination chemotherapy (cisplatin 50 mg/m(2), epirubicin 60 mg /m(2) and cyclophosphamide 500 mg/m(2) in 1 day every 28 days). The an alysis was performed before the commencement of treatment and repeated when alopecia was complete and after completion of therapy when patie nts had already experienced regrowth of hair, using the Frankfurt self -concept scales (FSKN) and Frankfurt body concept scales (FKKS). Signi ficant differences were observed in the various evaluation scales FSAP (general ability ti solve problems), FSSW (general self-esteem), SGKB (state of health), and SKEF (physical fitness). For all scales the re sults worsened during chemotherapy but did not return to normal or imp rove when patients experienced regrowth of hair. It was found that 73. 3% of the patients did not feel as self-confident as before treatment and that for 46.6% alopecia was the most traumatic side effect of chem otherapy. Since there is no chemotherapeutic regimen or any other effe ctive treatment that can prevent alopecia, either of the following con clusions can be drawn: the observed differences may not be related exc lusively to alopecia, but also associated with coping processes initia ted by chemotherapy and perhaps enhanced by alopecia; or the changes p ersist even after the discontinuation of chemotherapy. Regrowth of hai r and other adaptive processes do not normalize or improve thee improv e the impacted body image and self-concept.