It may be termed as a side-effect amongst the medical community at best – and a necessary evil at worst – but there’s no denying the distress and trauma that is caused by chemotherapy alopecia. Research published by the United States National Library of Medicine found that almost 50 per cent of women named hair loss as the most traumatic aspect of their chemo treatment and for a lot of women, it could even be the step too far that puts them off getting the treatment they desperately need.
Cooling caps or cancer cold caps have been around since the 1970s but recent news from America’s Food and Drug Administration further raises awareness of this hair loss prevention method that many women are unaware exists.
The announcement from the FDA involves something called the DigniCap Cooling System, which aims to minimise chemotherapy alopecia for patients with solid tumours. The FDA granted marketing authorisation of the DigniCap for use in patients with breast cancer in 2015 – and studies of women with breast cancer who used the cap while undergoing chemotherapy demonstrated that more than 66 per cent of them reported losing less than half of their hair.
It pays to keep a cool head
The DigniCap Cooling System is a computer-controlled system used during chemotherapy. A cap worn on the head circulates liquid to cool the scalp during treatment, and the cap is covered by a second cap made from neoprene to hold the cooling cap in place and insulate against cooling loss.
The goal of scalp-cooling is to constrict the blood vessels in the scalp, in order to reduce the amount of chemotherapy that reaches the cells in the hair follicles. Cold temperature also decreases the activity of the hair follicles and slows down cell division, making them less affected by chemotherapy. And although the FDA took pains to point out that the DigniCap may not work with some chemotherapy regimens, it’s a very hopeful development.
If the cap fits…
To back up these claims, another American study found that the use of scalp cooling was associated with reduced hair loss at four weeks after the last dose of chemotherapy among women undergoing non–anthracycline-based chemotherapy for early-stage breast cancer. According to the results, two-thirds of patients reported hair loss of 50 per cent or less in a scalp cooling group when compared to patients who didn’t use the cap, as well as reporting quality-of-life benefits for the scalp cooling group.
However, there were side-effects, including cold-induced headaches and neck and shoulder discomfort, chills, and pain associated with wearing the cooling cap for an extended period of time. It was also noted that the cap may not be appropriate for patients with cold sensitivity or susceptibility to cold-related injuries. The risk of the chemotherapy drug missing an isolated grouping of cancer cells in the scalp because of the cooling cap is rare, the FDA noted, adding that long-term effects of scalp cooling and risk of scalp metastasis have not been fully studied.
The treatment is used approximately 30 minutes before each chemo session, and at certain points during the recovery period. Most patients report that they can tolerate the feeling of a DigniCap session very well, as – after the initial shock of the temperature decrease – the cap gradually ‘defrosts’ back to room temperature, and the temperature never drops below freezing.