Cancer Patients Keep their Hair With Chemo Cold Cap

Hair loss, it’s one of the most obvious signs of cancer treatment. Many of the drugs used in chemotherapy for diseases like breast cancer cause all or the most of the patient’s hair to fall out, but as one woman found out, a cool new therapy currently being studied is changing that.

When Cheryl cook got breast cancer her doctor recommended chemotherapy, and told her what to expect.

“Because of the drug that I’d been taking’, I would lose my hair before the second treatment,” Cheryl Cook, told Ivanhoe.

So, she started researching ways to stop that.

“Just simply typed in the search box ‘How do you keep your hair during chemo’,” Cheryl said.

Cheryl discovered a clinical trial testing an investigational system designed to prevent chemo-induced hair loss.

“I am literally hooked up to machine that acts like an air conditioner and it reduces the scalp to 42 degrees,” Cheryl said.

A coolant circulates through a silicone cap, causing blood flow to hair follicles to constrict. There are some concerns doing that could create a place for cancer cells to hide during chemo treatments, but studies in Europe and Asia, where the cap is widely available, show it’s safe and effective.

“It cools the scalp down and by doing that, prevents the chemotherapy from actually getting into the hair follicles and causing hair loss,” Susan Melin, M.D., an associate professor of the division of hematology and oncology at Wake Forest Baptist Medical Center, explained.

Cheryl wore the cap during every one of her chemo treatments. Color, perms, and blow drying were off limits.

“It was very easy for me to manage and I was glad to,” Cheryl said.

For the 20 study participants with stage one breast cancer, the treatment paid off. Most patients kept enough hair that they didn’t need a wig or head covering.

“I had pretty much decided you know, I’m going to lose my hair when I got the news, but the fact that I didn’t, you just feel better,” Cheryl said.

Knocking out cancer and keeping her hair for Cheryl, it just doesn’t get any cooler.

Wake Forest Baptist Medical Center and the University of California, San Francisco are the only two centers in the U.S. involved in the particular cold cap study. The next step is a larger study with at least one-hundred patients. The cold cap is available to cancer patients in Europe and Asia. Right now, it’s only approved for investigational use in the U.S.

Research Summary

BACKGROUND: The chemo cold cap is soft, elastic, covered by a thermo insulate that is used to cool the scalps metabolism and blood flow, to protect the hair follicles from chemo drugs. Hair loss is an inevitable side effect of chemotherapy and it is not a medical issue. Hair loss occurs because chemotherapy targets all rapidly diving cells, healthy cells as well as cancer. Hair follicles, the structures in the skin filled with tiny blood vessels that make hair, are some of the fastest-growing cells in the body. When healthy, hair follicles divide every 23 to 72 hours, but as the chemo does its work against cancer cells, it also destroys hair cells. Within a few weeks of starting chemo, patients may lose some or all of their hair. Drug induced alopecia occurs in over 80 percent of patients and represents a major psychological fall back for patients. The cold cap treatments have been successfully used in Europe, New Zealand the United Kingdom for years. Now backed by clinical studies the U.S is beginning to look at cold caps for hair retention. ( ; (

EFFICACY: In a clinical trial that involved 98 patients, 93 females and 5 males, divided into metastatic breast cancer, advanced ovarian cancer and advanced pancreatic cancer; the cap was placed as a tightly as possibly by applying a wet single-use mobcap on the patient's hair. The temperature of the cap had to be around 13 degrees Fahrenheit. Adherence to the scalp was improved by bandages. Cotton protected the nap, brows and ears. Chemotherapy was started 15 minutes after putting the cap on; the cap was changed 30 minutes after the beginning of the infusion, and the second cap was worn for one hour. Alopecia was assessed according to the World Health Organization. Success was defined as WHO grade less than or equal to two alopecia and no need to wear a wig, according to patient's decision. Failure was defined as the fact that the patient wore a wig whatever the grade of alopecia.

All patients but one was evaluable for the results, because they refused chemotherapy. Of the patients, 83 were successful responders to the cap as they had a WHO grade 0 or grade 1 alopecia. Only 14 patients were evaluated as a failure because seven of them refused to continue with the cold cap, and the other seven had to wear a wig.

The conclusion was the cold cap is an effective technique for the prevention of Docetaxel-induced alopecia.

(European Journal of Cancer, 1997)

APPLICATION: Most doctors are willing to use the cold cap treatment, however there are many who have not heard of the treatment and will need research and clinical information.

There is a service now offering cold caps, however insurance does not cover the cost. Through Advance Cold Cap Services, patients can order their cold caps that arrives in a cooler that is packed with dry ice in special compartments that allows effective cooling. The dry ice is not accessible to the user, so they never have to handle it or touch it. Six cryogel caps arrive frozen and easy to access. The cooler remains at a temperature at or below -50 degrees Fahrenheit and can do so for up to 5 days. They can be refrozen and cycled for repeated applications during treatment. The cost for the treatment is $249.

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