How chemo-busting cooling cap can spare cancer sufferers’ hair

MILLIONS of British cancer sufferers could be spared hair loss – the feared yet inevitable side effect of lifesaving chemotherapy – by a silicone ‘cooling cap’ that chills the scalp.

Half of patients who undergo the treatment will preserve their hair, according to the results of a landmark trial announced on Friday at the San Antonio Breast Cancer Symposium in Texas.

A comparison group of patients, who did not have scalp cooling, were also followed during the study and all suffered severe hair loss, known as chemotherapy induced alopecia.

The treatment involves wearing a silicone cap containing chambers filled with a coolant liquid.

Previous concerns that it might increase the likelihood of cancer spreading to the scalp were quashed earlier this year when two large studies reported that the risk was no greater in women who had undergone scalp-cooling than those who had not.

Although hair loss affects all cancer patients, it is a real concern for women. Surveys show that more than 75 per cent of female patients fear this side effect above all others. One study even found that one in ten women would consider reducing chemotherapy or have a less effective treatment to avoid hair loss.

LEAD researcher Dr Julie Rani Nangia, assistant professor of medicine at the Lester and Sue Smith Breast Center in Houston, said: ‘Chemotherapy fights cancer by attacking rapidly dividing tumour cells. However, hair cells also divide rapidly so the drugs target them as well, which is what causes alopecia.

‘Hair is important, especially to women. Hair loss can really affect how a patient feels.

‘If you have a heart attack, you won’t look different, but if you have cancer and lose your hair, everyone knows what you are going through. Some people embrace it, but for others, having something so private made public is embarrassing.

‘Fear of hair loss has been known to make women avoid chemotherapy or try unproven alternative treatments, so it is good that we now have something proven to offer them.’

The success of scalp-cooling is due to the low temperature causing the blood vessels to constrict, reducing circulation to the area.

It is thought that this limits the uptake of toxic chemotherapy drugs by the hair follicles, protecting them from damage.

During the trial, researchers enrolled 182 women with earlystage breast cancer who were due to undergo chemotherapy treatment and randomly assigned them into two groups: those who were to receive scalp-cooling for 30 minutes before chemotherapy, for the entire duration of the treatment and for 90 minutes after, and those who would not get the cooling.

Overall, half (50.5 per cent) of those evaluated in the cooling group kept their hair, compared with no patients in the other group.

Even in those who received anthracycline-based chemotherapy, which is almost always associated with hair loss, a quarter of the women avoided balding.

Hair loss was graded in three stages – one meant no hair loss; two meant up to 50 per cent hair loss; and three meant more than 50 per cent loss. ‘Grade two is considered a success,’ said Dr Nangia. ‘It would appear to be thinning but not obviously. The majority of women on the trial who the treatment worked for suffered about a 30 per cent loss, and hair grows back after treatment ends.’ The device used in the trial was the Orbis Paxman Hair Loss Prevention System, which comprises a refrigeration unit containing a coolant fluid that is circulated through a soft silicone cap. This is covered by a second cap made from neoprene, which is used in wetsuits.

Sensors in the cap help to maintain a scalp temperature of between 18C and 22C, which, said the researchers, was essential for success.

Another device, Dignicap, is also widely used and trials have produced similar results.

‘Prior to this, women were using a device that was essentially an ice pack. As it thawed, the temperature was uneven and this produced very patchy hair loss,’ added Dr Nangia.

Scalp-cooling therapy is available on the NHS, and 90 per cent of hospitals in the UK have access to at least one machine. However, surveys suggest as few as one in ten are aware of the treatment. The device is not suitable for blood cancers such as leukaemia.

There are about 2.5 million cancer patients in Britain, and that number is set to rise to four million by 2030. Breast cancer is the most common type suffered by women.