In JAMA Editorial, NewYork-Presbyterian Oncologist Urges Cancer Providers to Offer Scalp-Cooling Caps for Hair Loss

Feb 16, 2017

New York

New clinical trials have shown that a scalp-cooling cap can reduce chemotherapy-induced hair loss in breast cancer patients, and Columbia University and NewYork-Presbyterian oncologist Dawn Hershman, MD, says the time is right for U.S. providers to offer the treatment to their patients.

In an editorial published in the Feb. 14 issue of JAMA, Dr. Hershman writes that hair loss is “one of the strongest deterrents for a woman who is deciding whether to undergo chemotherapy. Interventions, such as scalp cooling, that reduce treatment-associated toxic effect may help ease the distress associated with chemotherapy and improve outcomes for patients.”

The treatment is available in Europe and is increasingly offered at many institutions in the U.S., including NewYork-Presbyterian/Weill Cornell Medical Center. A recent study, featuring researchers at NewYork-Presbyterian and Weill Cornell Medicine, and published in the same issue of JAMA, found that 66.3 percent of patients who enrolled in scalp cooling retained half or more of their hair.

Chemotherapy is a mainstay of breast cancer therapy and reduces the risk of death by up to 35 percent. But according to one study, 8 percent of women diagnosed with breast cancer may be at risk of avoiding chemotherapy because of their fear of losing their hair.

“The medical community has gone to great lengths to reduce the risk of side effects – such as nausea, fever, early menopause, and even infertility – that may interfere with the initiation or continuation of breast cancer chemotherapy,” says Dr. Hershman. “But when it comes to preventing significant hair loss, we have made very little progress.”

Scalp cooling is thought to prevent hair loss by reducing blood flow—and the resulting flow of chemotherapy drugs—to the hair follicles. Patients wear a cooling cap during chemotherapy sessions and for 90 minutes after treatment.

Scalp cooling is not yet covered by insurance, but Dr. Hershman is hopeful that regulators will view the potential benefits as more than cosmetic.

“Reassuring patients that symptoms can be controlled may help persuade them to initiate treatment, and may lead to improvements in quality of life and survival,” she says.

Dr. Hershman is professor of medicine at Columbia University’s College of Physicians & Surgeons, Leader of the Breast Cancer Program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Medical Center, and professor of epidemiology at the Mailman School of Public Health.

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