From the Guidelines
Scalp cooling is a highly recommended treatment option for cancer patients undergoing chemotherapy to prevent hair loss, and access to it should be prioritized, especially for those receiving taxane-based chemotherapies 1. To access scalp cooling, patients should first discuss this option with their oncologist before beginning chemotherapy treatment. The treatment involves wearing a specialized cap that cools the scalp to approximately 32°F (0°C) before, during, and after chemotherapy infusions.
- Two main types are available: machine-based systems like the Paxman and DigniCap systems used in medical facilities, and manual cold caps like Penguin Cold Caps that patients can rent.
- Insurance coverage is inconsistent, with costs ranging from $1,500 to $3,000 per treatment course if paying out-of-pocket.
- Some manufacturers offer financial assistance programs, and organizations like The Rapunzel Project and HairToStay provide grants to eligible patients. Scalp cooling works by constricting blood vessels in the scalp, reducing the amount of chemotherapy drugs reaching hair follicles, and slowing cellular metabolism to make hair follicles less susceptible to damage.
- While not effective for all chemotherapy regimens or guaranteed to prevent all hair loss, it's most effective with taxane-based chemotherapies and less effective with anthracycline regimens 1. The latest guidelines from reputable organizations, such as the European Society for Medical Oncology (ESMO) and the National Comprehensive Cancer Network (NCCN), recommend scalp cooling as a preventive measure for chemotherapy-induced alopecia 1.
From the Research
Access to Scalp Cooling
- Access to scalp cooling is an important aspect of cancer treatment, as it can help prevent chemotherapy-induced alopecia (CIA) 2, 3, 4, 5, 6.
- Scalp cooling devices have been shown to be effective in preventing CIA in patients with breast cancer and other solid tumors 3, 5.
- The use of scalp cooling devices has been found to be safe and well-tolerated, with most adverse effects being mild and moderate 3, 5, 6.
- Access to scalp cooling can be improved by establishing reimbursement mechanisms and increasing the availability of devices 6.
- Nurses can play a crucial role in providing access to scalp cooling and educating patients about its benefits and risks 2, 6.
Benefits of Scalp Cooling
- Scalp cooling can prevent CIA in a significant proportion of patients, with success rates ranging from 60% to 77% 3, 5.
- Scalp cooling can also improve hair volume recovery after chemotherapy, even in patients who experience CIA 3.
- The use of scalp cooling devices can reduce the psychological and social impact of CIA on patients 5.
Implementation of Scalp Cooling
- The implementation of scalp cooling requires an integrated effort from physicians, nurses, and other healthcare professionals 2.
- A pragmatic workflow for collaborative efforts from physicians and allied health professionals can help deliver supportive scalp cooling care to patients 2.
- Education and training are essential for healthcare professionals to provide effective scalp cooling care and address patient concerns and expectations 2, 6.