For up to five hours during chemotherapy, a cooling cap pumps a below-freezing coolant into a helmet surrounding Tami Richardson's scalp. The cooling caps also might decrease the biochemical damage done to follicles by whatever chemo does get through. "With scalp cooling, we are lowering the temperature of the scalp, thereby constricting the blood vessels and reducing the flow of blood to the hair follicles, which will help reduce hair loss by limiting the amount of chemo drugs reaching the follicles".
"While further research is needed, the data suggest that when scalp cooling is successful at decreasing hair loss, it could improve the treatment experience for women undergoing adjuvant chemotherapy for early-stage breast cancer". When long-term safety data showed that this scenario was exceedingly rare, it opened the opportunity for scalp cooling to be studied here in the U.S.
Scalp cooling caps are not so popular in the USA only because the device has not been approved by the Food and Drug Administration (FDA).
More than half of women fitted with cooling caps kept their hair during chemotherapy in the world's first randomized clinical trial of the devices, said lead researcher Dr. Julie Nangia.
Patients in the trial who received scalp cooling wore the device for 30 minutes prior to their chemotherapy treatment, for the duration of their treatment, and for 90 minutes following treatment. The DigniCap is set to cool at 3 degrees Celsius (37 degrees Fahrenheit) with a temperature variance of plus or minus 2 degrees.
It was found that those patients who received scalp cooling treatment were 50% less likely to lose their hair as compared to those who didn't receive the special treatment. It also shows that women who use the cooling caps had a better quality of life.
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A trial proved that two-third of the women who wore the cap lost half or less hair than usual.
One of the most traumatic and outwardly visible side effects for many women undergoing chemotherapy treatment for breast cancer is hair loss. It's been a couple of decades since scalp cooling technology has been used in Europe. Hair loss was assessed by a healthcare worker.
Half of the 95 women (50.5 percent) using the Paxman system lost less than half their hair after four rounds of anthracycline and taxane chemotherapy, including five women who had no significant hair loss, as judged by independent observers from photographs.
On the other hand, Nangia's team tested on 142 women in seven medical centers that are randomly assigned at Paxman Scalp Cooling System.
But cooling caps haven't been extensively studied in the US, and womens' experiences with the caps have been hit or miss. "As the cap becomes more widely-used, best practices will be developed to ensure maximum results". Again, all patients without the cap lost their hair, while hair loss was limited or halted in those who used the scalp cooling cap. But the cooling device is not covered by insurance.
While chilling the scalp may seem to carry few risks, Lichtenfeld says there is a theoretical risk that inhibiting the effect of chemotherapy in the scalp could allow metastases to take hold there.