It's extraordinary what we women are willing to do to achieve great hair - we'll heat it up, stretch it flat, endure an hour clad in tinfoil envelopes, pay hundreds of pounds for that in-demand stylist who might, finally, transform us into a silken-headed goddess. But what about these procedures? Five hours wearing an ice pack on the head, 11 hours having hair sewn on, thousands of pounds to have a custom-made wig. These are the choices (which seems a woefully misguided word) facing women who have had cancer treatment and want to have not great hair, just any hair. I know, I've spent the last year on the odyssey and have made some fascinating, and disturbing, discoveries about women and their hair.
If somebody had said to me a year ago that hair loss is the worst part about having cancer, I would have thought it strange and perhaps a little insulting. The terrifying life and- death stakes of such a serious disease are far too important for something like mere hair to be a consideration. But that is to ignore the deep significance of self-confidence, attractiveness and just feeling like yourself, goddammit. Wherever in the body cancer has occurred, the sudden and brutal sign that you're ill cannot be avoided when you have no hair. Quite simply, it's like wearing a sign round your neck saying, "Yes, I've got cancer."
Before I received the diagnosis that the lump in my breast was indeed cancer, I had very fine, disappointingly straight hair that - apart from regular highlights - was low maintenance. I never gave it much thought - I'd had all those teenage experiments, such as bleaching, cropping, curling, long ago and, with a job and two children to juggle, it was as much as I could manage to wash and comb it before dashing out every morning with damp tendrils getting in the way.
Since so many of us are touched by cancer, I expect that almost everyone reading this will know, either at first or second hand, just how devastating the diagnosis is. I went through the widely recognised stages of grief: denial, anger, questioning, sadness, acceptance. Nine years ago I'd watched a dear friend struggle, fade and finally die, ravaged by a cancer which had been so heartbreaking and painful to witness, I could barely imagine being the person to whom it was happening. But now it was happening to me.
My (male) surgeon was everything you'd expect of an old NHS hand - brisk, busy and realistic to the point of being brutal. He told me I could, if I liked, consider going up a cup size if I went for reconstruction. .. I didn't know whether to hug him or slap him. I had felt thankful for my modest breasts for the first time in my life - because that meant I'd found the lump very early.
Surgeons and oncologists do an amazing job, delivering difficult news at a pace and in a language that patients can understand. What they don't do - don't have time to do - is discuss the psychological effects of cancer. And they are many. For a woman, to have her breasts or ovaries removed is a stripping away of femininity and fertility. Radiotherapy can discolour and roughen up the skin, and scars will restrict what you wear. But it's the hair that's hardest. Of the 72 side-effects of chemotherapy, the vast majority of female patients list hair loss as the most devastating and quote feeling a 'loss of identity'; many go on to develop depression and social phobias.
Certainly having a bad hair day takes on a whole new meaning when the hair itself is falling out. I'd been told, more in hope than expectation, that wearing a 'cold cap' during chemotherapy could prevent that from happening - freezing the follicles could halt the standard reaction to the huge amounts of poison flooding through the body. I forced myself to endure nearly five hours with a peculiar neoprene 'helmet' on my head, attached to a machine that kept its lining icy. Imagine the brainfreeze you get when eating too much ice cream, to the power of a thousand, and without the pleasure of the ice cream part.
On the advice of my stylish and pragmatic hairdresser George, I'd cut my shoulder length hair into a boyish crop before treatment started. That way if it did fall out, it would be less traumatic than for the woman I heard of who thought there was an animal at her feet, only to realise her entire head of long brunette hair had fallen out in a matter of minutes.
Fall out mine did. And once it did, almost everyone in the cancer 'industry' I met told me that the hair always does - it's very rare to find anyone for whom the torturous cold cap works. Hmmmm. I'd started a blog by this point. as I found it easier to pour out my feelings onto a screen than to package them up in brief phone conversations. I also know that even my closest friends and family found it hard to hear my by-turns traumatised and blase descriptions of knives, needles and drugs. It was cathartic to write it all down, and people told me it helped them gain an insight into the months of treatment I endured. But I never read back what I'd written, until now.
This is what I wrote when my hair started to fall out:
So, yesterday I had the real, proper, handfuls-of-hair-coming-out-in-the-shower moment. Conveniently, we had two friends round at the time, and the shower is next to the kitchen where everyone was chatting merrily, and there's a gap above the door, so I was sure they could all hear me crying. It was muffled by the sound of the water and I had my hands over my face, bawling. And throwing lumps of hair down the loo. Eventually, I got John to come in and see and, like that utterly nonsensical moment in Casino Royale when Daniel Craig gets in the shower to comfort Eva Green, he actually got in the shower fully clothed to give me a hug. He might drive me mad but at moments like that, it's hard to fault the man.
My blog quickly became all about the hair. Nausea? There are tablets for that. Weight loss? Well, even cancer has its advantages. Bald head? Help... I posted photographs of myself in a variety of hats and headscarves, and asked friends to vote for the ones that worked, and to tell me honestly which ones made me look like a second world-war refugee.
I shared, with gallows humour, the reaction of an older, male colleague when I had to go into the office for the very first time with a scarf covering my newly bald head. "Oh," he said. "Where's your mop? I thought you were the cleaner." His attempt at levity misfired spectacularly and across the world, my friends groaned. The outpouring of feelings helped, and sharing a photograph of my hairless, eyebrow- and eyelash-less head over the internet seemed much less painful than facing the real world.
I'd promised my son never to be seen without a head covering. When I told him and his nine-year old sister that my hair was likely to fall out, he'd said, "No offence Mum, but I don't want to be seen with you bald." I had to agree - I didn't want to be seen with me bald either... Having my photograph taken for this feature without my scarf was terrifying but, looking back, liberating.
I tried wigs and know that for many women they are an important and empowering solution. But I couldn't find one that came even close to resembling my natural hair texture and colour. Only later, when I met the veteran hairdresser Trevor Sorbie, did I realise that things are changing with wigs. He's turned his back on the fashion element of hair to devote his time and resources to My New Hair, his not-for-profit company that trains hairdressers around the UK to successfully work with wigs. "My aim," he explains, "is for every woman in the UK to be within 45 minutes of a stylist who can make their wig look good. We can give psychological medicine by making her look and feel better."
He suggests taking control of the impending trauma of hair loss by buying and preparing the wig before the hair falls out - wise words. "The word 'wig' is horrible and old fashioned, it makes us think of an old lady with a tea-cosy on her head," he says with a smile. The problem is that wigs are made with a standard (huge) amount of hair stitched into them, usually synthetic. Few of us have that much hair, so it takes a talented hairdresser to thin out and style a wig into something natural. The capacious carrier bag of thank-you cards in his salon is testament to what a difference Sorbie is already making. There are 160 stylists already trained, and he aims for 400, eventually with full integration into the NHS. That's quite a goal.
Meanwhile, I worked the headscarf or beret look each day. I can only compare it, even on the best occasions, to carefully applying eye make-up then plonking glasses over the top. Whatever I put on looked wrong, my entire wardrobe was calibrated for a woman with wispy blonde hair, not a baldie. Skinny jeans and billowing white shirt with high boots, a failsafe party outfit, elicited the quip from my husband, "Well, you look like Captain Jack Sparrow," because I had a silk scarf tied round my head.
I knew that, I hated it, but to curl up on the bed and never go out seemed such an admission of defeat. If I was to beat cancer, I felt I needed to show my best face to the world, to keep on working and being a hands-on mum. I'd never felt less like myself than without hair, but I've never tried harder to fake it.
The exhaustion of - quite literally - keeping up appearances did take its toll and the brave face sometimes slipped.
Another blog moment:
The physical difference is starting to become a bore - after a night at the theatre when I realised belatedly that strangers were looking at me, a lot, it's been hard to shake. I'm one of those people that other people stare at. I'd do it if it was the other way around. And I'm rarely in the presence of strangers these days, either at work or at home, so it was odd.
The feeling was heightened on Thursday, when my brilliant and creative friend Catherine took me to see Lucinda Ellery Britain's leading hair-loss fixer. The salon was full of women having a mesh woven onto whatever little hair they have, to which wefts of 'new' hair are painstakingly stitched on to make it up to a full head of hair that is so natural and realistic you can shower, swim, do everything in it and it won't move for up to two years. The women in the salon all looked quite sad and traumatised, but were clearly doing something about it. And, on the way home, shattered, I realised emphatically that I am one of them, part of it rather than an observer writing a feature about them, or anything like that. Quite sobering.
I got more help from my network of friends than from cancer support networks, which is not to say that they're not brilliant. They just weren't for me. Sarah showing me how to draw on eyebrows with just the right brow pencil was more valuable by far than a class in deep breathing. Looking through old photographs with Nina for laughs was more psychologically uplifting than seeing a counsellor. Deciding to take control of my hair - or rather, hairlessness - was a major factor in getting through the process of cancer. I'd heard about women who had refused treatment because they couldn't face the trauma of going bald. Let's be clear, for almost every single cancer patient hair loss is temporary. Once chemotherapy is over, the hair will grow back, albeit slowly.
It seemed extraordinary to me that anyone might gamble with their ongoing health to avoid a year or so of looking unfeminine, however upsetting that is. The NHS might not have the time or money to make feeling attractive a healthcare priority, but that doesn't mean any of us should settle for feeling 'less than', when boosting self-esteem and femininity is possible. And spending my time researching my hair options was a welcome distraction from feeling tired and fed up. I admit that being lucky enough to have a supportive husband, stoical children and a wide network of long-suffering friends helped enormously.
What I learned is that every woman facing cancer treatment can go into it knowing she can get a wig cut to suit her, and have it ready for when she needs it. (Trevor Sorbie's advice that if energy levels are low, a synthetic wig is better because it's low-maintenance.) She can photograph herself from every angle, with every outfit she possesses, and work out what looks right and what doesn't (that's why digital cameras are so bloody useful). And it might well be worth the financial outlay and commitment to upkeep required to have hair-replacement.
That's what I did, in the end. Once treatment ended, my hair did start to grow back, and for the first time in years I saw my natural colour, newly speckled with grey. It didn't grow back curly, as some chemotherapy patients report (the effect of the follicles being disturbed by the drugs). It was, however, the prospect of another year of not being 'me' that I struggled with. As an insouciant twentysomething, I could carry off a boyish crop - but aged 43, battle weary and with a scarred cleavage, I badly wanted femininity and that elusive, flattering 'softness' around the face...
So, after much soul-searching, I went to Lucinda Ellery the London-based specialist I'd blogged about months before. I had serious reservations about committing to a permanent, high maintenance solution (hair pieces are sewn onto plaits of your own hair in a patented Intralace system™), but after Lucinda herself had patiently listened and advised through several consultations, I felt ready to go ahead with it.
It was, in its way, as traumatic as the day my hair fell out. Watching myself disappear behind a curtain of extensions seemed peculiar, as though I was becoming not myself again, but someone else - a third identity. I had come to, if not love, then accept each step of the cancer journey and it felt somehow fraudulent to disguise myself.
But when I emerged after the hair had been cut into a 'me' shape, and my colleagues, friends and family complimented me (one bloke at work said I looked 27, which was a serious ego boost), I realised how much I missed having the security of hair. Lucinda had been right to encourage me - and she was honest enough to say that if I wanted to take it off after a month or two, then why not? Anything to get me past the hardest part of recovery. It's not when you're lying in bed with painkillers. It's not when you finish treatment and manage to go back to work. It's when you no longer have cancer, but still look like you have cancer. Leaving that behind has been the most liberating moment of all.
Press
ArticlesA cancer diagnosis brings many terrifying consequences - fear, surgery, unpleasant treatments - but losing your hair has a unique power to devastate. Lisa Markwell chronicles her journey to baldness and back.
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