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Scalp cooling can help breast cancer patients retain hair

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Scalp cooling can lessen some chemotherapy-induced hair loss in certain breast cancer patients, according to US researchers.

They found the majority of patients – women with stage 1 or 2 breast cancer – who underwent scalp cooling, retained more than half of their hair after completing chemotherapy.

“The data suggest that when scalp cooling is successful at decreasing hair loss”

Hope Rugo

The study, published in the Journal of the American Medical Association, tracked patients over five years.

Scalp cooling has been used in more than 30 countries as a way to potentially prevent hair loss in patients receiving chemotherapy, noted the researchers.

Two types of cooling caps are typically used – frozen caps that need to be replaced every half hour or cooling systems that continually circulate coolants into a cap during the chemotherapy session.

Scalp cooling is thought to reduce hair loss due to reduced delivery of chemotherapy to the scalp and hair follicle, said the study authors.

The cold temperatures also are thought to slow the hair follicle cell division, making the cell less susceptible to the damaging effects of chemotherapy.

The US researchers investigated the effectiveness of one device – the DigniCap scalp cooling system manufactured by the Swedish public company Dignitana AB, which partly funded the research.

The study involved 122 women with stage 1 or stage 2 breast cancer, all of whom received non-anthracycline adjuvant chemotherapy, which generally causes severe hair loss.

Of the participants, 101 were enrolled in scalp cooling while 16 others acted as a control.

Scalp cooling began 30 minutes prior to each chemotherapy cycle and involved a close fitting of the silicone cap on the patient’s head, followed by an insulating neoprene cap.

The silicone cap was then gradually cooled. The DigniCap is set to cool at 3 degrees Celsius with a temperature variance of plus or minus 2 degrees.

Of those who underwent scalp cooling, 66.3% retained half or more of their hair, said the authors, led by researchers from the University of California, San Francisco.

All the control group lost their hair. In addition, three of five quality of life measures were significantly better for women who underwent scalp-cooling, including feeling more physically attractive.

University of California, San Francisco

Scalp cooling can help breast cancer patients retain hair

Hope Rugo

Lead study author Dr Hope Rugo said: “Hair loss is almost universal among breast cancer patients receiving adjuvant chemotherapy and is one of the most distressing of adverse side effects.

“We found that scalp cooling during commonly used chemotherapy regimens was well tolerated and was associated with significantly less hair loss, as well as improvement in several quality-of-life indicators,” she said.

“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,” she added.

The researchers noted that many of the patients reported mild headaches or scalp pain associated with the scalp cooling, and two patients discontinued the intervention due to feeling cold.

However, they said there had been no evidence of scalp metastases in any patient after around 30 months of follow up. All patient follow up will continue for a total of five years.

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Readers' comments (1)

  • Scalp cooling has been known to prevent hair loss during chemotherapy for over 40 years now. I was involved in a study T the Royal Marsden Hospital the results of which were published in both the BMJ (1981) and Cancer Nursing (1982). Both before and since there have been a number of similar studies with inconsistent redults. We argued that the cap temperature (it had to be cold enough) and whether or not there was biochemical impairment of liver function were predictors of success. The interesting aspects of this study are the length of follow up, the findings about scalp metastases which were a key concern, and the use of quality of life measures.

    Given that scalp cooling is still offered - at least it was in the chemptherapy day unithere in CAMbridge, what would be intersting and useful would be routine collectoin of data to provide a larger dataset over an even longer period of time.

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