If you or someone you love is currently undergoing cancer treatment, there are options available to help prevent chemo-therapy induced side effects, including hair loss, peripheral nerve damage and mouth sores which can result from certain chemotherapies.
Preventing Hair Loss From Chemotherapy
Chemotherapy-induced hair loss is one of the most reported adverse events experienced by cancer patients and survivors, with an overall incidence of 65%. Up to 88% of women receiving chemo report this as the most disturbing side effect cancer treatment, in part because it is the visible reminder of cancer and its treatment and can affect one’s sense of self and perception of others. Wigs among other head covering options are often subsidized by insurance and there are grants available to those who financial qualify can for work for some patients, but can be uncomfortable and cumbersome for others. Excitingly, in 2015, a new treatment to help prevent this unwanted side effect was approved by the FDA in the United States.
What is Cold-Capping?
Cold capping is a special cap that straps onto the head and attaches to a cooling device that runs cooling liquid through it, and uses cooling technology to divert blood flow from the scalp (and thus chemo) to preserve hair. Roughly ~60% of patients see some hair preservation, though all are likely to experience varying degrees of hair loss. Currently, it’s only approved for use in solid tumor cancers such as breast cancer, not blood cancers like lymphoma unfortunately, because the thinking is that the risk of metastasis to the scalp is higher in blood cancers and cold-capping has been primarily studied in breast cancer patients. Cold-capping works better for people who have thinner hair and average head size to maintain good scalp contact with the cap, which is more challenging with thicker/bushier hair or smaller head. Average cost is around $300-350 per chemo infusion session (so may have to pay for several cycles depending on the regimen of chemo) when I spoke to various companies, and not covered by insurance but there are several grants for those who financially qualify (Sharsheret Foundation has a list of funders here).
Of the brands I looked into, brands such as Dignicap are logistically easier than others. Int he case of dignicap, the mechanism is such that a medical assistant connects cap to a machine with continuous cooling, rather than most other kinds of cold caps that require buying dry ice and your loved one or you filling the cap every few hours. This ends up also being more time efficient as you have to wear the cap for less time since there are no pauses in treatment. One shortcoming of dignicap is the limited availability – at Stanford Hospital for example, it’s only available at Redwood City clinic on weekdays. Interestingly, despite its superiority for the reasons I mention, it’s equivalent in price to other cold-capping options.
What Other Parts of the Body Can Benefit From Cold Therapy?
Preventing Cold Sores
Certain chemotherapy like Adriamycin (a.k.a. Doxorubicin) can cause sores in mouth, and patients are recommended to suck on ice to divert blood flow from oral cavity to reduce risk of cold sores in the mouth. Pedialyte popsicles can be a fun, electrolyte rich way to do this.
Preventing Peripheral Neuropathy
Similar to cold-capping mechanism, cold mittens and socks divert blood flow from hands and feet, but the purpose is to help reduce likelihood of peripheral neuropathy with certain chemotherapy such as taxols. Typically, these need to be worn 15-30 minutes before starting treatment, during treatment and after treatment (similar to cold-capping). Conveniently, these are relatively affordable – e.g. can get a set of cold mittens with 2 sets of ice-packs that can be swapped out for around $40, and socks for around $30 on amazon for example. Typically, patients store the cold mittens and socks in a cooler and swap the ice packs out yourself or have loved one help. You can remove hands if becoming too painful and warm the rest of the body to increase comfort and reduce risk of frostbite.
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Maia Mossé, MD, October, 2023
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