Cold cap may prevent hair loss in cancer patients

ATLANTA -- Paula Rice looks and feels healthy and she has a full head of hair, yet she is halfway through 12 rounds of chemotherapy treatment for breast cancer.

Rice says she has saved her hair by using a European contraption called the Penguin Cold Cap. Before each chemo treatment, family members seal her head in the cap, which is frozen to -31 degrees Celsius. That's about -24 degrees Fahrenheit.

What does it feel like? "It feels like a brain freeze, like if you drink a Slurpee. That's how it feels," Rice laughed.

Every 20 minutes, Rice's husband, sister and son help to remove the cap and replace it with a freshly frozen one. She starts the cold cap therapy 20 minutes before chemo treatment begins, and wears it throughout the one-hour treatment and for several hours afterward.

After six rounds of chemo at Piedmont hospital, Rice has experienced zero hair loss. European studies have shown the cap is effective in about 80 percent of cases but Rice says it's crucial that application instruction be followed to the letter. She said in any area of the scalp where the cap is not tight enough, hair loss may result.

"The way it works is it constricts the blood flow to the scalp so the chemotherapy doesn't get into the hair follicle and you don't lose your hair," explained Rice's Oncologist Dr. Perry Ballard. He said he often recommends the cold cap for his patients who are concerned about hair loss and are willing to spend the approximately $2,000 for caps, dry ice and related equipment.

Ballard said the Penguin Cold Cap has been an important hair loss prevention tool among European cancer patients for about 15 years but is still considered experimental in the U.S. because it is not yet FDA approved.

"It has been very important to many of my patients in terms of their recovery from breast cancer. It has improved their overall sense of well being and their psychological health," he said.

Ballard said while some physicians are concerned that patients may be at risk for scalp cancer because the chemo drugs are not reaching their scalps, he thinks breast cancer spreading to the scalp is extremely unlikely. "We just haven't seen that happen," he said.

Ballard is hoping clinical trials being conducted in California and New York will eventually lead to FDA approval and possibly, insurance reimbursement for patients. Currently most health insurers will reimburse patients for thousands of dollars in expenses for wigs, but not the cold cap therapy, which can prevent hair loss in the first place.

Many patients say being bald was one of cancer's most distressing side effects.

"For some reason, the potential for hair loss seemed to be one of the most devastating parts of everything," said breast cancer survivor Sharla Kahn.

Kahn, along with survivors Jody Goldstein and Laura Schwartz have all used the caps successfully within the past year, though Kahn and Goldstein did experience a small amount of a hair loss. All three are working to spread awareness of cold cap therapy

"I was basically able to put my hair in a ponytail and go right on after the cancer," said Goldstein.

Schwartz is a two-time survivor who lost her hair the first time around.

"It is devastating as a woman to be bald," she said.

Schwartz said part of the reason she used the cap during her second course of chemotherapy was to preserve a sense of normalcy for her two young children.

"My daughter said, Mommy, do you have a light version of cancer? 'I said what do you mean?' and she said you don't look sick!"

"To me, that was worth it right there." she said.


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