Sara Davidoff, RN, left, with patient Joanna Ng, who has routinely worn a cold cap to prevent hair loss during chemotherapy treatments.
Joanna Ng was determined not to lose her hair after she began receiving chemotherapy treatments for breast cancer last spring.
“I cut my hair short a long time ago, and it took so long to grow back I vowed I would never do it again if I could help it. But mostly, I didn’t want my family to see any hair loss,” says Ms. Ng, 27, who works for a global brokerage firm.
As a patient at the Dubin Breast Center of the Tisch Cancer Institute, Ms. Ng learned about an increasingly popular therapy known as cold cap or scalp cooling, which has been shown to preserve hair in approximately 70 percent of patients. Fortunately for Ms. Ng, the Dubin Breast Center, located at The Mount Sinai Hospital, was expanding its cold cap program and helped cover the cost of the therapy through a philanthropic grant from the Marisa Acocella Marchetto Foundation.
According to Ms. Ng’s physician, Julie Fasano, MD, Assistant Professor, Medicine (Hematology and Medical Oncology), Icahn School of Medicine at Mount Sinai, “Breast cancer is a life-transforming diagnosis, and the anticipated side effect of chemotherapy-induced hair loss can be overwhelming. Cold caps can help patients dramatically reduce hair loss.”
Still, she says, by working to constrict blood vessels beneath the scalp so that chemotherapeutic agents cannot reach hair follicles, the unintended consequence may be that the medicine is prevented from attacking the cancer cells. “Multiple trials in Europe show this is not the case, but I’m very open with my patients about it,” says Dr. Fasano.
The decision to use cold cap therapy “takes 100 percent commitment from the patient and must begin on the first day of chemotherapy,” says Raina Caridi, Administrative Director of the Dubin Breast Center, who manages the cold cap program. “It can cause headaches and chills.”
Ms. Ng used a brand known as Penguin Cold Cap, where pliable caps that are filled with a gel that is chilled to around -40 degrees Fahrenheit are strapped tightly around the head leaving no room for air pockets. Because these caps must be applied 50 minutes or so before infusion and remain in place for two to four hours afterward, a long day of chemo is made even longer. Additionally, the cold caps must be replaced every half-hour to maintain a constant temperature.
With the support of her mother and a professional “capper” whom she hired to assist with the roughly 14 cap changes she needed each session, Ms. Ng was able to persevere despite the inconvenience.
At the Dubin Breast Center, the caps are stored in a special biomedical freezer that was donated by the Rapunzel Project, a nonprofit organization dedicated to helping chemotherapy patients keep their hair during treatment.
“My hair loss has been very minimal, and most people say they honestly can’t tell that anything is wrong,” says Ms. Ng. “I’ve had some thinning at the ears, but if anything, it seems as if I am following the trend of shaving the sides of my head.”
To ensure success, Ms. Ng’s hair care regimen remained restricted for a few months following chemotherapy as well, when she had minimal washing, little to no combing, and was not able to use hair ties or clips.
This fall, the Dubin Breast Center, and the breast cancer treatment centers at Mount Sinai Beth Israel and Mount Sinai West, will roll out a new cold cap system from Dignitana, a Swedish medical technology company that markets a continuous scalp cooling
system that recently received approval from the U.S. Food and
Drug Administration.