“Cold Cap” A Staple of Hartford HealthCare’s Breast Cancer Program Allows Patients to Keep Hair and Dignity During Chemo Treatments

October is Breast Cancer Awareness Month. Hearst Connecticut Media Group recently caught up with Hartford HealthCare St. Vincent’s Medical Center in Bridgeport, and spoke with Dr. Richard Zelkowitz, Regional Medical Director, Breast Program, Hartford HealthCare Cancer Institute.

“I grew up in Brooklyn, went to State University of New York City, and attended Brown for my fellowship. My mother had a recurrence of breast cancer, and instead of pursuing a job far away, I came home. In 1989, my siblings made a big circle around my parents’ home in Brooklyn. For employment I looked at Long Island, Westchester, New Jersey and Connecticut. My wife and I ended up in Norwalk. I started to specialize in breast cancer in 1995.

“As time goes on, things change; you look for new challenges. I joined Hartford HealthCare’s Breast Program six months ago. Dr. Brigid Killelea joined me as the surgical director. Hartford HealthCare’s St. Vincent’sMedical Center had a vigorous program. My belief is that you need to be disease-oriented; it’s hard to be a generalist, particularly in oncology. The goal is to really focus on breast health and care. We have a designated breast oncologist, myself, two breast surgeons (and that will soon be growing). We’re very focused, from diagnosis to treatment.”

October being Breast Cancer Awareness Month, what better time to discuss your groundbreaking Cold Cap treatment?

“The Cold Cap is very personal to me, and I’ll tell you why. My mother died of breast cancer in 1990. People’s perception of cancer was different; people were not as overt. No support groups, no hospice. It was a much more private disease that people did not want other people to know about, for whatever reason. Being a teacher, my mother was very focused on getting her treatment, but also on not losing her hair. They did all kinds of things in those days to prevent hair loss. If you talk to men and women about some of the things associated with chemotherapy (and there are certainly more important things than losing your hair), hair loss is always an issue. I’ve lived this, and I never, ever forgot it…I’ve always been a big advocate.

“They had not been doing the Cold Cap at Hartford HealthCare prior to my coming, and I noted how this was a technique I’d like to apply. Again, it’s very personal to me. I was very passionate about it, and that I thought the patients would really appreciate it. And it seems I was correct. The majority of patients using this technology have breast cancer. It could be used with other cancers.”

Besides chemo and radiation, any industry-leading treatments on the horizon?

“The amount of changes that have occurred in the 30 years I’ve been in practice are mind-boggling. We get new drugs all the time; we received at least two this year for HER2+ breast cancer. [When a cancer is HER2-positive, it means that the cancer cells make too much HER2 protein, which can cause tumors to grow more rapidly than with other forms of breast cancer.] What was once one of the more untreatable types is now one of the better prognoses because of these advantages. We continue to offer new options. We’ve always had chemotherapy, we’ve always had hormone therapy; now we have drugs that modify hormone therapy. We have biologic drugs that are targeted, we have immunotherapy.

“This is an area that continues to grow exponentially. We’re now able to focus on a patient’s tumor biology on a more individual level. We have very different tools than when I went into practice 30 years ago.”

Last month we interviewed Dr. Khalid Abbed at Hartford HealthCare’s SpineWellness Center inWestport, who believes in an East-meets-West holistic approach to disease management. Is that applicable with breast cancer?

“We have data that says women experiencing hot flashes during breast cancer treatment respond better to acupuncture than drugs. We’re always open to those modalities, and we want to explore them in a controlled environment. We don’t want patients to take vitamins haphazardly; we want to know what interacts with what. We have data that shows that people who exercise and are in shape have a more favorable prognosis than those who don’t and are obese. It’s a part of everybody’s approach in the major teaching hospitals; it certainly is a component of Hartford HealthCare.”

Nicole Nesmith, 48, of Bridgeport, is a patient of Dr. Zelkowitz currently experiencing a recurrence of breast cancer.

“I met Dr. Zelkowitz in June, and he’s been great. He introduced me to the Cold Cap, which has allowed me to keep my hair, my eyebrows — and my dignity. With my first cancer diagnosis 12 years ago, I lost my hair; I had to wear a wig and I was always afraid the wind would blow it off my head! I was very embarrassed and depressed. Now I’m fighting breast cancer again. But with the Cold Cap, I get to keep my privacy, and I don’t look sick. I can share my illness on my terms. It’s been a godsend! Thank you, Dr. Zelkowitz.”

Dr. Zelkowitz recalled, “I saw Nicole Nesmith when she was diagnosed with her recurrence. I was able to help outline her plan, and we talked over different treatment options. And we talked about how to avoid the loss of her hair. She has wonderful, wonderful energy, and she was enthusiastic to be one of the first patients at Hartford HealthCare St. Vincent’sMedical Center to utilize Cold Cap. And she’s done great with it. It can be unpleasant; you’re putting this ice-cold hat on a person’s scalp. But she’s pretty unflappable. And that’s why I went to medical school … to take care of people like her and have a good outcome. As she is fond of saying, every time she gets chemo, Dr. Z loses more hair (laughs). Humor is the best holistic approach.”

What can we expect from the institute, your department and team in 2021?

“We seek to give every patient a concierge journey. You are not one of the masses; you are an individual. We will give you state-of-the-art care while continuing our research, making the whole situation more tolerable.

“Hartford HealthCare is very patient-focused and very doctor-focused. And they’re open to suggestions on improving patient care — simple things like cloth as opposed to paper gowns, curtains for privacy. Let’s tell patients their results right away, so they aren’t anxiously running to their mailboxes. We promise to turn around biopsy results in 24 hours. This is just about caring. We have such an amazing support team — designated navigators, nutritionists, a genetics program. They couldn’t have paired me with a more superb breast surgeon than Dr. Killalea. Dr. Anthy DeMestihas laid the groundwork for the program. Dr. Chris Iannuzzi and Dr. Deborah Fang are radiologists dedicated to making the experience less burdensome. Our pathologists are top-notch. We all put ourselves in the patient’s shoes.”

This is just one example of how Hartford HealthCare’s St. Vincent’s Medical Center is bringing more specialists and providers to the community. Tune into Hartford HealthCare St. Vincent’s Medical Center’s Facebook Live discussion, where you can ask your questions from COVID to new care coming to the area, Thursday, October 29 at noon. And for more information, log onto hartfordhealthcare.org or call 855-300-6933.

Dr. Richard Zelkowitz, MD