Cold caps are being tested on
patients going through chemotherapy in hopes that it will prevent hair loss.
The
first time Miriam Lipton had breast cancer, her thick locks
fell out two weeks after starting chemotherapy. The second time breast cancer
struck, Lipton gave her scalp a deep chill and kept much of her hair — making
her fight for survival seem a bit easier.
Hair loss is one of chemotherapy’s most despised side effects, not because of
vanity but because it fuels stigma, revealing to the world an illness that many
would rather keep private.
“I
didn’t necessarily want to walk around the grocery store answering questions
about my cancer,” recalled Lipton, 45, of San Francisco. “If you look OK on the
outside, it can help you feel, ‘OK, this is manageable, I can get through
this.’”
Now
U.S. researchers are about to put an experimental
hair-preserving treatment
to a rigorous test: To see if strapping on a cap so cold it numbs the scalp
during chemo, like Lipton did, really works well enough to be used widely in
this country, as it is in Europe and Canada.
Near-freezing
temperatures are supposed to reduce blood flow in the scalp, making it harder
for cancer-fighting drugs to reach and harm hair follicles. But while several
types of cold caps are sold around the world, the Food and Drug Administration
hasn’t approved their use in the US.
To Dr.
Hope Rugo of the University of California, San Francisco, the impact of hair
loss has been overlooked, even belittled, by health providers. She’s had
patients delay crucial
treatment to avoid it,
and others whose businesses suffered when clients saw they were sick and shied
away.
Later
this summer, Rugo and Melin, along with researchers at a few other hospitals in
New York and California, will begin enrolling 110 early stage breast cancer
patients in a study of the DigniCap brand of scalp cooling. The tight-fitting,
insulated cap is attached to a cooling machine to stay around a shivery 41
degrees as patients undergo chemo. Participants’ hair will be photographed for
experts to assess, and they’ll be compared with a small group of similarly ill
patients who get chemo alone.
Patients
haul a collection of caps to chemo sessions on dry ice, or store them in
special freezers provided by about 50 hospitals. It’s deliberately separate
from doctors’ and nurses’ care — typically, patients bring a friend to help
them switch caps every 20 to 30 minutes when one loses its chill.
“I know
I’m sick, but I don’t want to
look it,” said Vanessa Thomas, 57, of Baltimore, who is using the
Penguin caps at the recommendation of her doctor at MedStar Harbor Hospital.
Halfway through her breast cancer treatment, Thomas says her hair feels only a
little thinner.
Hair-preserving
approaches need good testing, adds Dr. Laura Esserman, a UCSF breast cancer
specialist.
“If it
matters to our patients, it should matter to us,” she said. “It’s really not
more complicated than that.”
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