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| Dignicaps |
Use of
cooling caps or cooling systems during cancer chemotherapy for early stage breast
cancer reduces the hair loss by almost 50% according to two studies published simultaneously
on February 14 in Journal of American Medical Association.
The most dreaded
complication of cancer chemotherapy is hair loss, nearly 50% of patients report
it to be the most traumatic aspect of chemotherapy. Additionally, 8% of patients
who could have benefitted from it refuse to undergo chemotherapy fearing the
hair loss.
Although
Cooling caps and have been in market since some time, but their use was not
backed by scientific studies. The two recent RCTs use different systems for
cooling the scalp, but both show positive results.
The
investigators explain that cooling results in constriction of scalp blood vessels,
reducing the amount of chemotherapeutics delivered to the hair follicles thereby
reducing hair loss.
The article
by Nangia et al. in this issue of JAMA report the result of SCALP trial, a multicenter,
randomized trial testing 182 women with breast cancer receiving chemotherapy
with a taxane, anthracycline, or both. This trial used Orbis Paxman Hair Loss
Prevention System (Paxman Coolers Ltd), which has yet to receive FDA approval
in the United States.[i]
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| Paxman.com |
The Paxman system
comprises of a small compact mobile refrigeration system connected to two lightweight
silicone caps, the inner one is made of silicone and outer one is of neoprene.
The
patient’s scalp is lowered in temperature to approximately 18°C by circulating
a special coolant throughout the cap at -4°C.
Scalp cooling
was carried out for 30 minutes each before and during therapy and 90 minutes
after the therapy is over for each session of chemotherapy infusion.
The study results
showed variable results depending upon type of agent used and clinical expertise
of the treating physician. Hair retention rate was 16% inpatient anthracycline-based
regimen vs. 59% in those on taxane-based regimen.
The second
study by Dr.Hope S. Rugo and colleagues used the DigniCap, approved
by FDA for use in the United States
since 2015.The study used Dean scale to assess hair loss and none of the
patient in the study group received anthracyclines.[ii]
Nearly 66%of
study participants experience 50% less hair loss assessed at 4 weeks after
therapy as compared to 0% in control group.
“Despite difference
in study designs, inclusion criteria and type of device, the results of these
two studies are reassuringly similar: scalp cooling was associated with
prevention of significance hair loss in approximately 50% of patients,” says Dawn
L. Hershman, MD, MS, from the Herbert Irving Comprehensive Cancer Center,
Columbia University Medical Center, New York, New York, in an accompanying
editorial.[iii]
"Identifying
interventions, such as scalp cooling for the prevention of chemotherapy-induced
alopecia, that reduce or eliminate treatment-associated toxic effects will help
ease the distress associated with chemotherapy and may, as a result, improve
outcomes for patients with breast cancer," Dr Hershman concludes.
Fear that
scalp metastasis will not be eradicated because of decline in drug delivery due
to cooling is the number one reason that scalp cooling devices have not
been very popular in the United States. In this study a median follow up of 29.5
months in patients in the scalp cooling group has not demonstrated any evidence
of metastasis.
Link to Nangia study abstract.
Link to Rugo study abstract
Link to Hershman editorial extract.
Two
nonprofits organization in US offer help to women and men undergoing
chemotherapy access and use scalp-cooling technology to help keep their
hair. They are The Rapunzel Project and
The Hair to Stay Foundation. Visit the site by clicking the link for more
information.
DigniCap -
What is Scalp Cooling
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