UCSF physicians are combating a devastating side effect of chemotherapy with an innovative new program--"Hair to Stay"--to evaluate devices that could reduce scalp hair loss in breast cancer patients.
One feasibility study on a scalp cooling system, the first significant inquiry of its kind in the United States, will test the safety and effectiveness of a device already widely used overseas called the "DigniCap." The FDA recently approved a pilot study of the Swedish cool cap, which continuously cools a patient's scalp during treatment using a circulating coolant inside a gel cap. The first patients are being enrolled at the UCSF Helen Diller Family Comprehensive Cancer Center and at Wake Forest University Medical Center.
"Devices that prevent hair loss have the potential to make a huge difference to our patients," said Laura Esserman, MD, MBA
, co-leader of the Breast Oncology Program at the center and director of the UCSF Carol Franc Buck Breast Care Center. "If we can avoid hair loss, then our patients can avoid one of the most emotionally difficult and dreaded side effects of chemotherapy."
The cool cap process is a relatively simple and low-cost solution. By cooling the scalp, blood vessels surrounding the hair roots contract, resulting in a significant reduction of cytotoxins to the follicle. With reduced blood flow, less chemotherapy is available for cell uptake, while at the same time the lower temperature results in less absorption of the chemicals.
UCSF breast cancer patients ineligible for the FDA DigniCap trial have other scalp-cooling options. As part of another study evaluating patient experience, the university has purchased a freezer for cold caps, allowing patients to bring in their own caps and keep them cooled during chemotherapy. Currently, patients who provide caps go through as many as a dozen during a treatment session--the caps heat up in as little as 20 minutes.
Chemotherapy-caused hair loss takes a profound physical and psychological toll on cancer patients and is considered one of the most feared and traumatic side effects of cancer treatment.
"Almost all standard chemotherapy treatments for early stage breast cancer cause hair loss," said Hope S. Rugo, MD
, principal investigator for the study and director of Breast Oncology and Clinical Trials Education at the UCSF Helen Diller Family Comprehensive Cancer Center.
Read more at Elizabeth Fernandez, UCSF News Office