Metronomic therapy reduces the toxic effects of chemotherapy to a bare minimum. And it has a priceless perk, especially for women: your hair doesn't fall out.
It might sound like a recent innovation, but metronomic therapy has been around for some time already. While traditional chemotherapy is administered intravenously at high doses and in a hospital setting, metronomic therapy is taken by mouth, at lower doses, and at home, either every day or twice-thrice a week.
The advantages are mainly due to the reduced systemic toxicity of the drugs, which are also less expensive. Taken this way, chemotherapy not only has a direct pharmacological effect against cancer cells, it also modifies their microenvironment by inhibiting the neoangiogenic process which facilitates tumor proliferation and metastasization. The efficacy of metronomic therapy has hitherto been proven in some types of breast, lung and pediatric cancers and lymphomas. It has even proved effective in some tumors resistant to common chemotherapy.
Not only is it effective, its toxicity profile is significantly better, it modulates the immune response, it has lower side effects – less than 1% of patients will suffer from alopecia and less than 5% will have neurological side effects – and it can even lead to improved survival in advanced stages. Not to mention the incredible economic advantage of treatment at home and the advantage for those patients who live far from hospitals or cancer centers.
But the main point is how less toxic it is compared to conventional chemo. Chemotherapy usually works by destroying cancer cells, but it also damages healthy cells due to toxic side effects. The most commonly damaged healthy cells are the rapidly proliferating ones, like hair follicles. It might seem strange, but of all the toxic side effects of chemotherapy, the cutaneous ones have the strongest impact on the patient's quality of life: the resulting blemishes can have important repercussions on the patient's social life, relationships, and psyche.
The aesthetic factor is so strong 8% of female patients refuse treatment because they fear hair loss, and opt for less effective therapies instead. The incidence of chemotherapy-induced alopecia varies depending on the drug, its dose, the frequency and method of administration. For many women suffering from breast cancer, alopecia even has a stronger psychological impact than mas-tectomy, and is by far the least tolerated of chemo's side effects.
Since hair follicle cells proliferate continuously, they are easy targets of chemotherapy, leading to hair thinning and falling out altogether. The moment hair starts falling out in clumps is for many women the most dramatic event of the whole disease. This usually occurs between the first and the eighth week of therapy and is generally reversible.
Metronomic therapy isn't the only method to avoid alopecia: galenic formulae prescribed by a dermatologist or cooling caps which reduce the amount of drug reaching the scalp by vasocon-stricting the scalp's capillaries are other solutions. However, even in case alopecia does set it, one can rest assured than in most cases the hair will grow back within a month or two from the last treatment.
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