A Cap that Stops Hair Loss During Chemotherapy

Wigs and scarfs could become relics of a bygone era of breast cancer treatment. In what promises to be a major breakthrough for cancer patients, trials at teaching hospitals in the U.S. are currently underway of two versions of a cap that cools the scalp, shielding hair follicles from damaging effects of chemotherapy. Breast cancer websites and chat rooms are abuzz with stories of women who have completed chemotherapy treatments with their hair intact as a result of using cold caps. Several women with success stories were featured on Good Morning America this week in the following segment.

The caps must be worn during chemo treatments and for up to an hour afterwards. The two types in wide circulation are the Penquin Cold Cap and the Dignicap. The former, made in New Zealand, uses ice to cool the cap, which requires a facility with a special freezer and has to be changed every 30 minutes. The Dignicap, made in Sweden, uses a cooling gel that is constantly resupplied by a machine hooked up to the cap. In theory, freezing the follicles reduces blood flow to the scalp and thus reduces the amount of chemotherapy available for uptake into cells. Less absorption of chemotherapy into the cells surrounding the hair follicles protects them from damage.The Dignicap cold cap from Sweden.

So far, most of the evidence to support the use of cold caps is anecdotal (meaning scattered reports of success with no double-blind, placebo controlled studies are published showing efficacy.) But women who have used the cold caps with success are understandably vocal and passionate about getting the word out. According to GMA, the following medical centers have tests underway (several using freezers donated by The Rapunzel Project founded by two breast cancer survivors.)

•  Beaumont Hospital, Royal Oak, Mich. 
• Minnesota Oncology, Minneapolis office 
• Minnesota Oncology, St. Paul office 
• University of California, San Francisco Medical Center, San Francisco
• New York-Presbyterian Hospital/Weill Cornell Medical College, New York 
• Fairview Southdale Oncology Center, Edina, Minn. (coming soon) 
• Washington Oncology Hematology Center, Washington (coming soon) 

Dr. Merrell's Take: Early reports seem very promising for improving quality of life for women undergoing chemotherapy for breast cancer (or anyone receiving chemo for cancers below the head.) Since the devices work primarily by reducing the blood flow that carries chemo to the scalp it is important to check with your oncologist that your cancer is not a type that can spread to the scalp (prostate cancer is one.) Also, it's important to first rule out using it with brain cancer or for a cancer that could have spread to the brain, as we do not yet know what effects the caps might have beyond the scalp on chemotherapy targeted to the head and brain.