Do you counsel patients on the (very small) risk of permanent hair loss with docetaxel?

I have to admit that I didn't recognize permanent hair loss with docetaxel until the legal commercials - the same ones your patients are seeing that are prompting their questions. After careful reflection and discussion with my nursing staff, we can identify 2 patients over 17 years who have not had full regrowth of hair after docetaxel. Bottom line -it does happen but is exceedingly rare. That is exactly what we tell patients

How well the cold caps work with docetaxel isn't clear at this point.

I think if a patient brings it up, it should be addressed and explain that it is quite rare. There are many unusual complications, some potentially serious, but because they are exceedingly rare, we wouldn't want to list all of them and risk patients running away from potentially life-saving treatments.

On the other hand, there are certain toxicities that matter more to certain patients. I had a patient who worked as a chef and as I was going through chemotherapy toxicities with her, she started crying when I mentioned that her taste will change. This was very significant to her and we had to rebalance the formula. Another patient who did not want to use a taxane because she did not want to risk any neuropathy-she was a piano player. That w...