WASHINGTON — Hair loss is one of chemotherapy’s most despised side effects, not because of vanity but because it fuels stigma—revealing to the world an illness that many would rather keep private.
Now U.S. researchers are about to put an experimental hair-preserving treatment to a rigorous test: To see if strapping on a cap so cold it numbs the scalp during chemotherapy really works well enough to be used widely in this country, as it is in Europe and Canada.
The first time Miriam Lipton had breast cancer, her thick locks fell out two weeks after starting chemotherapy. But when the disease struck again, she used a cold cap during treatment and kept much of her hair, making her fight for survival seem a bit easier.
“I didn’t necessarily want to walk around the grocery store answering questions about my cancer,” recalled Lipton, 45, of San Francisco. “If you look OK on the outside, it can help you feel, ‘OK, this is manageable, I can get through this.’”
Near-freezing temperatures are supposed to reduce blood flow in the scalp, making it harder for cancer-fighting drugs to reach and harm hair follicles. But while several types of cold caps are sold around the world, the Food and Drug Administration hasn’t approved their use in the U.S.
Scalp cooling is an idea that’s been around for decades, but it never caught on here in part because of a concern: Could the cold prevent chemotherapy from reaching any stray cancer cells lurking in the scalp?
To Dr. Hope Rugo of the University of California, San Francisco, the impact of hair loss has been overlooked, even belittled, by health providers. She’s had patients delay crucial treatment to avoid it, and others whose businesses suffered when clients saw they were sick and shied away.
With more people surviving cancer, “we need to make this experience as tolerable as possible, so there’s the least baggage at the end,” Rugo said.
“Quite frankly, it’s the first or second question out of most patients’ mouths when I tell them I recommend chemotherapy. It’s not, ‘Is this going to cure me? It’s, ‘Am I going to lose my hair?’” adds Dr. Susan Melin of North Carolina’s Wake Forest Baptist Medical Center.
Later this summer, Rugo and Melin, along with researchers at a few other hospitals in New York and California, will begin enrolling 110 early-stage breast cancer patients in a study of the DigniCap brand of scalp cooling. Participants’ hair will be photographed for experts to assess, and they’ll be compared with a small group of similarly ill patients who get chemo alone.