Published On: Thu, Apr 13th, 2017

Ice caps worn during chemo help prevent hair loss in cancer patients

whatisscalpcooling-w1200NEW YORK – In most parts of the world, hair loss is considered an inevitable part of chemotherapy, and one of the most emotionally distressing aspects of cancer treatment.

But advances in scalp-cooling technology, already in use in Europe to help chemotherapy patients keep their hair, may help the practice gain ground in the United States and elsewhere.

The New York Times reported on two recent studies published in the Journal of the American Medical Association (JAMA) — one from the University of California, San Francisco (UCSF), and one from Baylor College of Medicine in Houston — which confirmed that women with early-stage breast cancer who underwent scalp-cooling treatments were significantly more likely to keep some of their hair throughout chemotherapy.

In both studies, each carried out at multiple medical centres, researchers used similar automated cooling systems, in which a tightly fitted cap is placed on the patient’s head before and during each chemotherapy session and for at least 90 minutes afterward. An attached machine circulates a liquid coolant through the cap.

According to the report, the continual cooling constricts blood vessels in the scalp, reducing blood flow to the area, and slows the metabolism of hair follicle cells, limiting the effects of chemotherapy on hair.

The technology is said to offer advantages over earlier cooling caps, which were not connected to a cooling machine and typically required the use of several caps that needed to be kept frozen and manually switched every half-hour during chemotherapy sessions.

Patients, mostly women, were quoted as saying that the caps were generally well tolerated, with minimal adverse effects. Most said they weren’t bothered by the cold once the cap had been on for several minutes.

The results were impressive, with more than half of the women with early-stage breast cancer who wore cooling caps keeping at least half their hair, and about five percent keeping all their hair.

Hair retention was said to vary depending on the types and duration of cancer drugs used, and it did not work for everyone.

The UCSF study, involved 122 women with stage 1 or stage 2 breast cancer and employed a device called DigniCap, made by the Swedish company Dignitana, which partially funded the study.

The device received clearance from the US Food and Drug Administration (FDA) in December 2015 and is currently the only FDA-cleared scalp-cooling system.

Five percent of patients who wore the cap had no hair loss, and 36 percent lost 25 percent or less of their hair by the end of their adjuvant chemotherapy. The women who did not receive scalp-cooling treatment lost most or all of their hair.

In the second study, from Baylor College, researchers evaluated 142 women with stage 1 or stage 2 breast cancer who were receiving a broader range of chemotherapy. The women in the scalp-cooling group used a device created in England called the Paxman Scalp Cooling System, which is awaiting FDA clearance, with similar results.

In the study, which was partially funded by Paxman, 50 percent of women who were treated with the scalp-cooling device retained more than 50 percent of their hair, “so it was quite effective,” said Dr Julie Nangia, an assistant professor of medicine at Baylor and the study’s lead author.

Researchers in both studies noted that the scalp-cooling technique is more effective for patients who are receiving certain types of chemotherapy that do not incorporate a cancer drug called anthracycline.

Scalp cooling is used only in patients with solid tumours, including breast cancer, and may not be appropriate for patients with blood cancers.

Although the studies included only patients with early-stage cancers, Dr Rugo said she recommends scalp cooling to her patients with more advanced cancers.

Photo: A patient using a scalp-cooling device. (Credit: http://eptca.com)

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