One of the most upsetting side effects of treatment for cancer is hair loss. It is a visible and constant reminder of the disease and can have a dramatic effect on patients’ confidence. For many women their hair is bound up with their self-image and hair loss can make people feel vulnerable, exposed and anxious about other people’s reactions. HeadStrong offers each patient a personal hour long session run by two volunteers, giving clients the chance to talk about their concerns regarding hair loss and body image in a safe and confidential environment. The volunteers are carefully selected and have completed and passed a two day training course run by Breast Cancer Care to ensure they have the knowledge and skills necessary to run HeadStrong sessions. During the training they learn about cancer treatments and their effects on the body, and receive advice on listening to and empathising with cancer patients. Many of the volunteers have also been personally affected by breast cancer and understand just how sensitive and difficult losing your hair can be. Each client is able to try on a range of hats, scarves and hairpieces, learn how to wear different styles and gain information on where to buy headwear to suit different hair types. They can choose a scarf which they will practice with and take home at the end of the session. They are also given the latest information on preventing and reducing hair loss and learn practical tips on how to look after their hair and scalp before, during and after treatment. By providing in-depth and tailored advice, HeadStrong empowers patients to regain control over their appearance and helps to improve their self-esteem. The need for support Being diagnosed with breast cancer can be very stressful and may invoke a range of emotions including fear, depression and anger. A large proportion of patients report feeling distressed about their body image during this time, and research has shown that the effect on self-esteem is most devastating amongst younger women. Hair loss can make people feel vulnerable, exposed and anxious about other people’s reactions. This in turn can cause withdrawal which intensifies the sense of isolation they may already be feeling. Women need support to adjust to their altered image following treatment for cancer, helping them to feel comfortable with their bodies again. There is very little provision made by the NHS or other organisations to help patients deal with the personal and emotional consequences of losing their hair from cancer treatment, and this is also exacerbated by the lack of consistent practical support available. The expansion of HeadStrong We would like to continue to develop this popular service, provide structured support for our current volunteers and recruit and train more volunteers from diverse cultural backgrounds, providing support for hard-to-reach groups. As more health care professionals signpost patients to HeadStrong, we hope to meet the demand for support by increasing the number of clients we are able to support. Over the past five years, HeadStrong has rapidly expanded and consistently receives excellent evaluation from clients: when we surveyed clients at the end of 2008/09 over 99.5% were satisfied with the service. Many of our schemes are operating at near maximum capacity. Given the clear need for this service, we want to continue extending our provision to reach more people throughout the UK. Our aim is to establish a HeadStrong service in every chemotherapy clinic in the UK where there is demand, and in selected non-hospital locations as well. To work towards this aim we are hoping to open at least five new HeadStrong centres over the coming year in areas where there is no similar service available.