Taxotere (docetaxel) is a chemotherapy drug that is part of the class known as taxanes. This class also includes Taxol (paclitaxel). Both drugs are mitotic inhibitors, meaning that they interfere with the process of mitosis, or cell division. Although these drugs are intended to target malignant cancer cells, they do affect the reproduction of other cells as well – including hair follicles. This is the reason that cancer patients undergoing chemotherapy suffer hair loss. Patients undergoing chemotherapy with Taxol (paclitaxel) are able to regrow their hair after their course of treatment is completed. However, with Taxotere, the hair loss can be permanent.
Taxotere has been used in the treatment of breast cancer for over twenty years. Dr. Scott Sedlacek is an oncologist that has done a great deal of research into the issue of Taxotere and permanent, irreversible hair loss. According to Dr. Sedlacek, Taxotere is the one drug responsible for irreversible hair loss, even when used in combination with other chemotherapy drugs as is usually the case. What is interesting is that Taxotere affects many cells, such as fingernails and those found on mucous membranes, that regenerate quickly following chemotherapy. The effect on these cells is temporary. However, for reasons that medical science has yet to determine, the effect on hair follicles is permanent.
Taxotere binds to microtubules, which are an integral part of the cell's cytoskeleton. This is comparable to a system of muscles and ligaments, but without bones. If the cell's outer membrane is like a tent, microtubules are the actual poles that give it shape and stability; they prevent the cell from collapsing under external pressure and being damaged from over-expansion from internal pressure. Microtubules can also be compared to trusses and braces used to prop up structures such as bridges. These structures play an important role in the process of mitosis, or cell reproduction. By binding to microtubules, Taxonere causes microtubules to stabilize in such a way that it prevents them from doing their job – thus interfering with mitosis, disabling the cell's reproductive process.
Patients who have suffered permanent, irreversible hair loss as the result of treatments with Taxotere received no warning from manufacturer Sanofi-Aventis about this specific side effect. Many patients were not even told about the less-expensive, equally effective alternative. One advantage of Taxotere over Taxol is that the latter is administered weekly, while the former is given only once every three weeks. For this reason, oncologists argue that Taxotere is more convenient – not only for the patient, but for the clinic.
A few oncologists who are aware of the danger of permanent hair loss argue that patients are far better off having their cancer cured as quickly as possible than preserving their hair. However, there is a serious psychological aspect to this issue: for most cancer survivors, the regrowth of their hair is symbolic of their victory over the illness. When hair fails to grow back, cancer survivors are still perceived as being ill – and often feel as if their recovery has been delayed. According to a study from the Rocky Mountain Cancer Centers in Colorado,
“Such an emotionally devastating long-term toxicity from this combination must be taken into account when deciding on adjuvant chemotherapy programs in women who likely will be cured of their breast cancer.”