Patients going through chemotherapy can save their hair with 'cold cap'
A cancer diagnosis is bad enough. The indignity of losing your hair can add to pain.
Scripps Howard News Service
A cancer diagnosis is bad enough. The indignity of losing your hair can make it worse, patients say.
"It identifies you as being ill," said Pamela Laske, 66, who is going through chemotherapy in Ventura, Calif.
Laske, however, is trying to avoid the hair loss that often accompanies chemotherapy by using a device called a Penguin Cold Cap, distributed by Medical Specialties of California. It's been around since 1990 but has been slow to catch on in the United States.
"It's in its infancy in the U.S., but the cold caps have been used in over 4,000 patients internationally in Europe and Asia," said University of California-San Francisco research assistant Kate Serrurier, who is involved with clinical trials on the cold cap.
The cap is a head covering filled with frozen gel that essentially freezes hair follicles so they don't absorb any of the chemotherapy and die.
"This is more than a superficial concern," Serrurier said "These patients aren't feeling like themselves to begin with. They're being injected with toxins. People around them aren't treating them as who they are because they seem like sick people. It's really powerful for them to be able to keep their hair."
Nursing student Barbra West, who is doing an internship at Los Robles Hospital in Ventura, will give a research presentation on the cold cap in December. She said she hopes her studies will help ease the concerns of some oncologists.
"There is a concern in the oncology community that if there are any hidden (cancer cell) sanctuary sites in the scalp, they might be shielded," West said. "I researched the dickens out of it. It's just 0.6 percent of cancers that have scalp metastases."
For her first cap treatment, Laske, a flight attendant for American Airlines, brought several friends to help. Inside a freezer, 20 cold caps were frozen to minus 25.6 degrees Fahrenheit.
Many caps are needed because they warm up from body heat and must be repeatedly replaced so the hair temperature remains at freezing. It would be the friends' job to replace the caps on Laske's head and keep track of when to change them out.
"It's labor-intensive," said Los Robles chief nursing officer Glenda Cox. "Timing is important. These caps are changed every 20 to 30 minutes."
When it was time to place the first three pound cap on Laske's head, friend Linda Cowan's hands shook a little.
"You're just so nervous,"Cowan said, fitting the cobalt-blue, Fargo-style cap on Laske's head, complete with a chin strap and ear flaps.
Meanwhile, others pulled out the next cap and began massaging it to make sure the gel was evenly distributed. The session lasts about two hours.
It's up to each patient to go online or call to rent cold caps from Medical Specialties. It cost Laske a $600 deposit, then $500 a month for the first three months. After that, the cold caps are $89 a month for as long as her chemotherapy lasts.
A type of cold cap is available on the Internet for less than $100, Cox said, but she cautions chemotherapy patients from buying or using any type of device not vetted and monitored by a physician.
The cold cap is not without discomfort. "It just feels really, really cold. Achy. Like a burn," Laske said.
The cold cap is the subject of one clinical trial at University of California-San Francisco. The other trial is for a similar product called the DigniCap, which is attached to mechanical hoses that circulate continuous cooling, so no freezer is necessary.
"We've had incredibly great results with both devices,"Serrurier said. "We found the main factor in terms of success is the length of the treatment."
The longer the chemotherapy, the less effective the caps, Serrurier said.
The DigniCap trials are being done on 20 patients with breast cancer in Northern California. Right now, the data are being reviewed by an independent, three-person panel.
"It will go to the FDA, and depending on the results, it will then go to a pivotal trial with 100 patients," Serrurier said. "We follow the patients for one year after their last chemo treatment."
The Penguin Cold Caps trial also involves breast cancer patients. Serrurier said UCSF is not endorsing the caps, merely collecting survey data.
Serrurier said the results are promising. She couldn't pin down exactly when they will be published, but she expected some information by spring.
(Kim Lamb Gregory is a reporter for the Ventura County Star in California
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