Coping with cancer is hard enough. How do tell your toddler that mommy’s hair is falling out because of chemotherapy? Harder still, how do you explain this to a classroom full of curious toddlers?
“One of our breast cancer patients undergoing chemotherapy has several children under age three. She was very involved volunteering as a room mother and didn’t want cancer to keep her out of the classroom. She pursued scalp cooling therapy to help prevent hair loss, not only for her own well-being, but for the children’s well-being,” says Lauren Gallegos, BSN, RN, CPHON. Ms. Gallegos is director of Clinical Practices for Infusion Services at Sylvester Comprehensive Cancer Center.
How does scalp cooling therapy work?
Hair loss is one of the most dreaded aspects of chemotherapy. Unfortunately, the treatment doesn’t discriminate between malignant and healthy cells. Hair cells are especially susceptible to chemotherapy medicine since they tend to grow and divide rapidly.
Many patients now have an ally against hair loss, thanks to an innovative therapy. In 2017, Sylvester began offering DigniCap® scalp cooling therapy at its Miami, Plantation, Lennar and Deerfield campuses.
During each chemotherapy infusion session and for one to three hours after, patients wear a cap attached to a machine that automatically lowers their scalp temperature. This restricts blood vessels under the scalp, limiting the amount of medicine that reaches the hair follicles. This chilling process also restricts hair follicle activity and slows down cell division. Combined, these effects help reduce hair loss.
Patients also have the option of using manual cold cap therapy. “Patients rent the caps directly from a vendor. Like scalp cooling, they wear the caps during chemotherapy. This method requires storing caps in a freezer, then changing them periodically throughout the chemotherapy session. It is not FDA-cleared and requires much more effort than the mechanical version of scalp cooling, which is automatically cooled,” Gallegos says.
If you’re a candidate for scalp cooling, a Sylvester nurse will show you how to enroll. Once you’re in the Infusion Services area, an infusion nurse will provide additional instruction and support. Additional support services available to Sylvester patients include psychosocial and nutritional counseling, complementary therapies, wig services and many other resources.
Who benefits from this therapy?
The therapy was originally approved for patients with breast cancer; research studies also focused on those patients. In 2017, however, the Food and Drug Administration (FDA) cleared scalp cooling for patients with other solid malignant tumors, including prostate, uterine, ovarian and lung cancer. For this reason, many male patients can now use this therapy. Your oncologist can help determine if you would benefit from scalp cooling. In some cases, patients must go through a few therapy sessions before knowing if it will work.
The goal of scalp cooling therapy is to help patients keep 50% or more of their hair, but overall shedding still occurs. “The efficacy of this therapy depends on the type of chemotherapy drug the patient receives,” Gallegos says. The therapy is more effective if patients follow the manufacturer’s hair care recommendations.
This means avoiding:
- Permanent processing
- Hair dye
- Blow drying
- Hot curlers
- Flat irons
- Tight ponytails
- Shampooing more than twice a week
Gallegos suggests that patients interested in this therapy read the manufacturer’s FAQs page. The company also has nurses who answer questions by phone. “Review the information, then talk to your oncologist. I always empower patients to educate themselves."
Does it hurt?
Some patients feel cold or lightheaded, get a headache or experience some scalp pain.
Will insurance cover the cost?
Not all insurers cover the therapy, so it’s best to ask your insurer. The manufacturer can also guide patients to financial assistance programs. Patients who are covered pay the manufacturer directly, then file for a reimbursement from their insurance company.
Thanks to Sylvester’s commitment to bring patients the latest therapies, one of the most disheartening aspects of chemotherapy is now treatable in many cases. At long last, patients coping with cancer have found help in making the treatment process a little easier.
Nancy Moreland is a regular contributor to UMiami Health News. She has written for several major health care systems and the Centers for Disease Control and Prevention. Her writing also appears in the Chicago Tribune.