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With Chemotherapy, Cancer Patients Can Save Their Hair: A Simple Method Few Heard Of

Breast cancer patients say the “cold cap” saves their hair. What it is and why not so many people do it, the publication said. USA Today.

Photo: Shutterstock

It took Nikki Cox four years to grow her hair back to its original length after she was diagnosed with breast cancer in 2016.

In those years, 35-year-old Cox from Alikippa, Pennsylvania, remembered her struggle with illness every day when she looked in the mirror, tied a scarf or don an itchy wig.

Cox was just beginning to close this chapter of her life when she was again diagnosed with breast cancer in May 2020.

This time, she was determined to save her hair.

“My hair has been an important part of my healing and mental health,” she said. "I wanted to feel good on the outside knowing what I was going through on the inside."

She decided to try scalp cooling therapy after finding a flyer hidden between a stack of papers she received from her oncologist. By the end of the treatment, Cox retained 90-95% of her hair.

“During the entire treatment period, I have never worn a wig. I've never had to wear a scarf, ”she assured.

Scalp cooling therapy, also known as cold cap, is available to all cancer patients except those battling leukemia or certain other blood-related cancers, but health experts say many people are unaware that such a possibility exists. And for those familiar with the process, the high cost and volatility of coverage can make this option unaffordable.

On the subject: Doctors in the US Cure Cancer of the End-Stage Breast Cancer

Cancer patients, survivors and advocates want to raise awareness of scalp cooling therapy and the effect of hair on a patient's mental and emotional health and recovery. As more people become aware of cold therapy, they hope that more insurance companies will see value in providing coverage or compensation.

“Every time we get an email that says, 'I just got chemotherapy and heard about cold caps - is it too late to save my hair?' Unfortunately, it's too late, ”said Nancy Marshall, co-founder of Rapunzel, a non-profit organization that promotes scalp cooling therapy.

During scalp cooling therapy, the patient wears a special cap attached to the scalp before, during and after chemotherapy sessions to keep it cool and prevent harsh chemicals from entering the hair follicles.

"Chemotherapy works like this: It tries to kill cancer cells and at the same time, some of them kill healthy cells," said Dr. Lynn Jeffers, former president of the American Society of Plastic Surgeons and medical director of the Dignity Health Integrated Breast Center. "If you slow down your hair metabolism with cold, the cells that you slowed down will not respond to chemotherapy to the same extent."

Cox used a Dignitana scalp cooling system. DigniCap has been approved by the Food and Drug Administration (FDA). Studies have shown that it is 67% effective in preserving at least 50% of patients' hair.

"There was a study that confirmed that 8% of women refuse chemotherapy for fear of hair loss," said Dignitana spokeswoman Melissa Borestom. "This is a very frightening statistic, because the most important thing is that you are treating cancer."

Other patients opt for manual scalp cooling offered by companies such as Penguin. In this case, the headgear immersed in dry ice is attached to the patient's head and replaced every 20 minutes by a friend, family member or specialist.

Danielle Lee hired a specialist through Right Arm Inc. when she was diagnosed with breast cancer during the COVID-19 pandemic and was unable to invite friends or family to an infusion center.

“It was a complete support system - having someone there to save my hair and do whatever my boyfriend or my mom would do,” Lee said. "It was not part of my decision, but now, looking back, I understand: it's great that I was not alone."

Cox and Lee have been successful with cold therapy, but health experts warn that hair retention is never guaranteed, especially among patients undergoing the most severe chemotherapy. Moreover, it is a long, laborious and inconvenient process.

But for many women, it's worth it.

“It was very, very good to have control over something,” Lee admitted. "I could not control whether I had cancer, I could not control my life turned upside down, but I could control the process of preserving my hair."

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Cox got married during treatment and wanted to feel like a traditional bride on her wedding day. Her children were younger when she was first diagnosed with breast cancer in 2016, but now they are old enough to understand what the second diagnosis meant for her.

“My family has gone through so much with my diagnosis! And I didn't want them to associate cancer with baldness or death, she said. "I would do my best to look as natural as possible, and that would be the least traumatic for them."

However, scalp cooling therapy is expensive. Patients pay to buy or rent a cooling cap and to use the machine for each chemotherapy session, which can be a dozen times on average, depending on the type and severity of the cancer.

With manual cooling, patients are responsible for the dry ice and also pay for the training costs of a loved one who will change the hood. If they don't have anyone to do the job, a specialist will cost almost $ 300 per session.

Lee said her total bill is $ 80. She plans to receive compensation from her insurance company.

“I may have a chance to get some money back, but even if I don’t do it and I have to go through it again, I would still give this money,” she assured. "It helps maintain dignity."

Some patients said they only paid $ 1800 for the entire service. While insurance companies are improving coverage and compensation, many patients struggle to get them. Overwhelmed by other medical expenses, people are often too tired to bargain with insurance companies and end up giving up.

The Rapunzel Project provides a list of diagnostic codes that patients can report to their insurance company. Codes may help, but Marshall said the coverage is inconsistent.

“It's an ineffective and unnecessarily expensive system,” she says. - Chemotherapy-induced baldness, or chemotherapy-induced alopecia, is a devastating side effect of cancer treatments. Patients deserve financial support to cope with this. ”

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