Cooling caps seem to slow cancer patients’ hair loss
Updated Feb 27, 2019 at 5:14 PM
EXETER - Hair loss is one of the more dreaded side effects of chemotherapy. A technology that is fairly new to the United States shows promise of reducing hair loss due to cancer treatments.
Cooling or cold caps, worn by people as they undergo chemotherapy is not a new concept, said Dr. Kari Rosenkranz, medical director of the Comprehensive Breast Cancer program at Dartmouth-Hitchcock Medical Center and the Norris Cotton Cancer Center.
“They have been around in Europe for a long time, probably for 30 years,” said Rosenkranz. “They have been slow to be adopted in the United States and models have just been approved by the FDA (Food and Drug Administration) in 2015 and 2017.”
“Losing hair, especially for young women represents part of their image,” said YongLi Ji, MD, PhD., an oncologist at Exeter Hospital’s Center for Cancer Care. “Cooling caps have been used for the past couple of years and are now an option for early stage breast cancer patients to prove their efficacy as a treatment supplement. We use them here and try to help patients with the cost as they are not yet covered by many insurances.”
Rosenkranz said patients had been importing the caps from Europe and bringing them with them to use as a part of their treatment.
Ji said some senior nurses have been talking about the caps since the 1990s. She said for now the caps are only approved for patients in early stage breast cancer, those needing a few months of treatment as part of a study to prove the safety of use.
“If ovarian patients ask me about it, I tell them there is no study yet on the use for other cancers,” said Ji. “Many patients for breast cancer have been traveling to Boston for the treatment, not knowing we have it available here. I want them to know about this.”
There are several options for the cooling caps. There are systems that hospitals can purchase, making the caps available to their patients. Both Exeter Hospital and Dartmouth Hitchcock are in process of purchasing a system called Paxman, already in use at Massachusetts General Hospital.
Patients can also rent kits on their own, from providers such as Arctic and Penguin. Ji said both are effective.
The cooling caps work by freezing the hair follicles during chemotherapy. The caps resemble old-style hair dryers used at salons.
“It freezes the scalp and the thought is that the hair follicles do not get the chemotherapy,” said Rosenkranz. “Patients often liken the experience to a really bad ice cream headache. One concern with the caps had been patients would get cancer that metastasizes to the scalp, but that didn’t happen.”
The supplemental treatment is not usually covered by insurance.
“I am hoping they will soon,” said Rosenkranz. “Insurance covers wigs as a prosthetic, so why not this? It can be a significant out-of-pocket expense for the patient.”
As an example, Ji said the cold cap kits could cost a breast cancer patient $500 per treatment. By the end of their treatment, that might translate into $2,000 out-of-pocket.
“I have been writing my patients a letter for their insurance,” said Ji. “Sometimes, a few insurances have decided to cover up to 80 percent of the cost.”
Cooling caps are not a guarantee that there will be no hair loss. Rosenkranz said the success is variable, depending on the patient, and on the type of chemotherapy the patient needs to receive.
“Some patients will have no hair loss, and for others it might be negligible,” said Ji. “Some patients have such a small loss that their family and friends do not really notice. Even with some, hair may grow back faster, because the hair follicle does not get the chemo.”
To learn more about the various systems, visit the Rapunzel Project at http://rapunzelproject.org/ColdCaps.aspx.
The Rapunzel Project is a non-profit organization dedicated to helping chemotherapy patients keep their hair during treatment. Ji said the site offers some ideas on financial assistance.