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Scalp Cooling and Hair Loss

Posted 2/21/2013

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  Some of you may be aware of the use of  Penguin Cold Caps/ice caps (www.msc-worldwide.com/ ) reduce hair loss from chemotherapy. The theory is that the cold causes blood vessels in the scalp to constrict, reducing circulation and dissemination of the chemotherapy to the head. If this works, voila, there should be less hair loss. There was an earlier verison of this cap twenty or so years ago and there were two big problems with it: it gave people terrible headaches, and it didn't work very well. It appears that the newer version may be more effective and more comfortable, but the question remains whether this really is a wise choice. If you are going to endure chemotherapy, do you want to limit its' effectiveness? I appreciate that there are women who refuse chemo because of potential hair loss, so this would seem a good solution for them--better the chance of somewhat diminished effectiveness rather than no chemo at all. For the rest of us, it becomes a trickier equation.

  I just came across this article from Support Cancer Care that describes a study in the Netherlands where women receiving taxol every three weeks were given this ice cap treatment after the infusion. It seemed to greatly reduce hair loss and was not unpleasantly uncomfortable. I am guessing that the jury is still out as to whether it makes a difference in the recurrence rate; it will take years to observe these women before such data can be added.

  If you are facing a difficult decision about chemo and hair loss, you may want to read this and to discuss it with your doctor.

Short post-infusion scalp cooling time in the prevention of docetaxel-induced alopecia

C. J. G. van den Hurk &W. P. M. Breed & J.W. R. Nortier

Abstract

Purpose

The patient impact of chemotherapy-induced alopecia (CIA) is high. Scalp cooling is applied to reduce CIA. The potential optimum post-infusion cooling times (PICTs) are currently unknown.

Methods

Scalp cooling was applied in 53 patients receiving docetaxel chemotherapy with 90-min PICT (observationalpart). Also 15 non-scalp-cooled patients were included. If hair preservation was observed in >80 % of the patients, randomisation between 45 and 90-min PICT was planned. Patients reported tolerance of scalp cooling and use of head covering.

Results

 Observational study: 81 % of scalp-cooled patients did not require head covering versus 27 % of non-scalpcooled patients. Randomised study: 79 % of 38 patients with 90-min PICT did not need head covering versus 95 % of 38 patients with 45-min PICT (p00.04). Scalp cooling was very well tolerated (visual analogue scale079).

Conclusion

A 45-min PICTcan be recommended in 3-weekly regimens with a dose of 75 or 100 mg/m2, administeredin 60 min. The shorter PICT is a major advantage in time investment for patients. Patients (women and men) who receive docetaxel, except combined with doxorubicin and cyclophosphamide taxotere, adriamycin and cyclophosphamide (TAC)) should be informed about the protective effect and high tolerability of scalp cooling in avoiding CIA.

http://link.springer.com/article/10.1007%2Fs00520-012-1465-0

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