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Ice-free scalp cooling during chemotherapy prevents reduces hair loss for breast cancer patients

Breast cancer patient Laura Carey returned to work one week after beginning chemotherapy, but without a demoralising side-effect indicative of this type of cancer treatment – hair loss.

Carey is among the first breast cancer patients at the Henry Ford Cancer Institute to successfully prevent and reduce hair loss during chemotherapy by using an innovative ice-free cooling cap system, called Paxman.

“I came back to work after chemotherapy treatment and nobody knew my health status,” says Carey, a 51-year-old corporate director at a major health system in Southeast Michigan.

“I can be out with friends and family and they don’t focus on the fact that I’m sick. Even though it’s just the hair that they see, it may give them confidence that I’m still the same, or things are going to be OK.”

“This is not about vanity. It is about women being able to keep their privacy. Using a hat or bandana declares to the community that something is going on with this person, and patients may not want to disclose that. It can be very distressing,” says Haytham Ali, M.D., senior medical oncologist for the Breast Cancer Program at Henry Ford Cancer Institute

Dr. Ali says Carey is a good candidate for the cool cap treatment based on her type of breast cancer, the chemotherapy recommended as part of her treatment plan, and her positive attitude.

Carey has been receiving Taxotere, Herceptin, and carboplatin for early stage, invasive ductal carcinoma.

“With my type of hair and the medication I’m receiving, I was told I could expect the hair loss to occur after 17 days of the first treatment. On those days, I probably lost 20-25 strands of hair,” says Carey. Normal daily hair loss is about 100 strands.

“Hair loss can make a patient not want to do chemotherapy, and that requires me to convince them of the importance of chemotherapy,” says Dr. Ali, who is the driving force behind the scalp hypothermia program at the Henry Ford Cancer Institute.

In the U.S., approximately one in eight women will be diagnosed with breast cancer at some time during their lives.

When chemotherapy is given, many women will experience demoralising hair loss.

That’s because chemotherapy kills fast-growing cancer cells, but it also knocks out fast-growing healthy cells, such as those in the hair follicles.

When chemotherapy treatment ends – after three to six months – women typically begin to see soft fuzz on the scalp.

In the following one to three months, new hair grows at the rate of one-half inch each month.

For women who receive a mastectomy, their self-esteem can be seriously affected by losing a part of their body and losing their hair, says Dr. Ali.

“The cooling cap is psychologically impactful. The positive effects can strengthen a person’s ability to confront the disease.”

Scalp cooling constricts blood vessels and reduces the flow of chemotherapy to the scalp.

Fewer drugs are distributed into the tissue of the scalp, so the hair follicles have less contact with the chemotherapy, says Dr. Ali.

The FDA-approved Paxman scalp cooling system keeps a uniform temperature of 64 degrees on the scalp.

Constantly flowing liquid in the cap picks up heat from the scalp and moves it back into the cart refrigeration system to be cooled.

Before, during, and after chemotherapy treatments, the cooled fluid circulates in a cap on the patient’s head for a total of approximately four hours.

The cap can be used with any type of chemotherapy, but results will vary greatly.

It is most useful with taxanes, saving about 60 percent of hair.

For some drugs, such as Adriamycin and Cyclophosphamide, the likelihood of saving hair is in the 20-percent range.

At Henry Ford, saving 50 percent of hair is considered to be successful.

“We don’t see that happening in the clinical trials. We don’t see a higher level of metastasis or cancer recurrence in the scalp area in general. After I saw robust information from clinical trials and the new technology with the uniform cooling, we started working on it,” says Dr. Ali.

“Our attitude was: We’re going to do this.”

To help women decide about using the cooling cap, the manufacturer provides estimates of hair loss depending on the type of chemotherapy and dosing schedule.

Currently, insurance does not cover the cost of the cooling cap, which is available for purchase online.

“We are working to convince some of our payers to pay for this technology,” says Dr. Ali.

“Right now, our philanthropy money is helping us understand what we need to do, so we can find a way to use this technology for more women.”

Unfortunately, scalp cooling is not available for patients with metastatic cancer.

These patients require ongoing chemotherapy to prevent cancer from travelling to different parts of the body, including the scalp.

Source: Henry Ford Health System

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