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 The devices work like refrigerators by sending fluid into a special
helmet to cool the scalp before, during and after chemotherapy
treatments. Cooling likely protects the hair by constricting blood
vessels in the scalp and reducing chemical activity.
"I think it’s a very exciting tool, because hair loss is such a
horrible manifestation of chemotherapy," said Dr. Harold Burstein, a
breast cancer specialist at Dana-Farber Cancer Institute and an
associate professor at Harvard Medical School in Boston.
"Whether you’re a mom with young children, a teacher in a classroom
or a corporate lawyer, the visible part of the chemo experience has
really been that hair loss," he told Reuters Health.
Cooling caps are relatively new to the United States but are
established in other countries, according to one of the new studies
published in JAMA.
Barriers to their use in the U.S. included a lack of approval from
the Food and Drug Administration and questions about their safety
and effectiveness.
For the new studies, one team of researchers led by Dr. Hope Rugo of
the University of California, San Francisco Helen Diller Family
Comprehensive Cancer Center and another team led by Dr. Julie Nangia
of the Baylor College of Medicine in Houston tested the
effectiveness of two different cooling caps.
Rugo's team tested a device known as DigniCap on 122 women being
treated for stage one or two breast cancer at five medical centers.
The women wore the cap for 30 minutes before their chemotherapy
treatment, during the treatment and for 90 to 120 minutes after it
ended. Scalp temperature was maintained at 3 degrees Celsius (37
degrees Fahrenheit) during treatment.
Pictures were taken of participants' scalps and hair over the course
of their treatments. The women measured their hair loss based on
those pictures.
Four weeks after their last chemotherapy treatment, about 66 percent
of the women estimated they'd lost less than half of their hair.
The study's results also suggest women using the cooling caps had
better quality of life. A handful of women using the cap reported
mild headaches and only three dropped out due to feeling cold.
Nangia's team reported on 142 women at seven medical centers who
were randomly assigned to the Orbis Paxman Hair Loss Prevention
System or no scalp cooling while receiving chemotherapy for stage
one or two breast cancer.
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As in Rugo's study, the scalp cooling device was worn before, during
and after treatment. Hair loss was assessed by a healthcare worker.
After four chemotherapy treatments, about 51 percent of women using
the cooling device still retained at least half their hair, compared
to none of the women who hadn't used a cooling cap.
Unlike Rugo's study, Nangia's team included women who received
anthracycline-based chemotherapy, in which hair loss is less likely
to be inhibited by cooling caps. About 16 percent of women receiving
that type of chemotherapy while using cooling caps kept at least
half of their hair.
Nangia told Reuters Health that differences in results at the
different medical centers were likely due to improper fitting of the
caps to participants' heads. Cap placement got better as the study
progressed, however.
Also, she cautioned, there will always be some hair loss even with
the cooling caps.
"I would say that most women would have some thinning of up to 30
percent of their hair," said Nangia.
Rugo said women receiving chemotherapy for breast cancer can inquire
about cooling caps, but only one device - the DigniCap - is cleared
by the FDA to be marketed in the U.S.
"I think the biggest issue for patients is the cost and the fact
that you are cold," she told Reuters Health.
“Depending on the location and number of treatments, DigniCap
typically costs between $1500 to $3000 per patient and is not
covered by insurance,” said Rugo.
SOURCE: http://bit.ly/2lcXitI, http://bit.ly/2lcNsb6, http://bit.ly/2ld5fiA
and http://bit.ly/2ld8I0x JAMA, online February 14, 2017.
(This version of the story corrects DigniCap treatment price to
$1,500 to $3,000 per patient in the last paragraph)
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