Manual scalp cooling in early-stage breast cancer case report: Value of caretaker training and patient experience to optimize efficacy and patient selection

Rezayee, Manaz; Moxon, Nicole; Mellinger, Staci L.; Seino, Amanda Y.; Fredrich, Nicole; Kelly, Tracy L.; Mulligan, Susan; Uche, Ijeoma; Urba, Walter J.; Conlin, Alison; Ruzich, Janet; Page, David B.

doi:10.1016/j.cpccr.2021.100096

Cited by 1 publication

(6 citation statements)

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“…Although not a life-threatening side effect, it is a constant reminder to the patients and others that they have cancer [ 26 ]. Indeed, a small percentage of women may choose not to treat their breast cancer with chemotherapy due to the side effect of alopecia [ 7 – 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Effectiveness of machine-based and manual cooling systems is highly variable. While overall it seems that more than half of all participants using scalp cooling have positive results, there are estimates as low as 8% and as high as 94% having a successful result from machine-based systems and 20 to 94% having success with manual systems [ 9 , 11 , 22 , 23 ]. With variable literature-reported effectiveness of cold capping in reducing chemotherapy-induced alopecia, the purpose of this study was to explore the real-world effectiveness in our local setting over the first 3 years of the program, including impact of cold capping with ethnic/racial hair types.…”

Section: Discussionmentioning

confidence: 99%

“…Even so, the overall effectiveness (92.1%) in this study is consistent to higher than many literature reports. One possible reason for the high success in our cohort is compliance with cold capping protocols, meaning applying the cap in the appropriate manner and wearing the cap for the prescribed durations, which may impact effectiveness [ 9 ]. This interpretation is speculative because we cannot determine full compliance due to the retrospective nature of the study.…”

Section: Discussionmentioning

confidence: 99%

“…Many methods to save hair have been tested, but scalp cooling has been the most effective in reducing CIA [ 7 ]. Scalp cooling is a non-medicinal approach to minimize CIA, whereby ice packs or cooling caps are placed on the scalp for up to an hour before, during, and up to 7 h after each chemotherapy session, depending on the chemotherapy regimen and cooling system [ 9 ]. The cold results in local vasoconstriction, which potentially minimizes the amount of cytotoxic drug that reaches the cells of the hair follicles [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Use of Penguin Caps has an overall 20–90% success rate, defined as hair loss < 50%, across several trials evaluating success in breast cancer [ 9 , 11 , 22 , 23 ] and 79% success in a limited evaluation in cancer types [ 23 ]. The range of success rate is due, in part to measures of success (patient-reported vs. objective measures) and regimens used, with better success in non-anthracycline-based, shorter regimens [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Retrospective evaluation of Penguin Cold Caps for chemotherapy-induced alopecia

Weaver,

Pershing,

Golden

et al. 2024

Support Care Cancer

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Background Scalp cooling is an increasingly recognized non-pharmacologic approach to minimize chemotherapy-induced alopecia (CIA). Several commercially available machine-based and manual scalp cooling systems are available; however, literature reports of effectiveness are highly variable. The purpose of this study was to determine real-world tolerability and subjective effectiveness of a manual cold capping system in minimizing CIA across a variety of patient race and hair types. This study was a single-institution review of outcomes from manual cold capping. Methods We identified retrospective cohort of adult patients who presented to discuss cold capping between January 14, 2019, and March 31, 2022. Data collected from medical records included demographics, decision to pursue/continue cold capping, diagnoses, chemotherapy regimens, hair characteristics (length, thickness, coarseness, type), and subjective perception of percentage of hair retained. Those with successful vs. unsuccessful cold capping (≥ 50% vs. < 50% of hair retained) were compared based on the patient-level factors of interest. Findings A total of 100 patients initiated cold capping during the study period, and 95% of them completed cold capping. The majority of patients who started cold capping completed it. The median-reported percentage of hair maintained was 75%, and 82/89 (92.1% of patients) had favorable results, defined as ≥ 50% of hair retained. The only patient-level factor associated with favorable response was chemotherapy regimen, with fewer patients receiving doxorubicin-containing regimens having successful hair retention compared to other chemotherapy types (71.4% successful results vs. 95.7% for those receiving paclitaxel-containing regimens and 96.6% for those receiving docetaxel-containing regimens (p = 0.018). There was no difference in success based on patient race/ethnicity or hair characteristics. Interpretation The overall effectiveness (92.1%) in this study is consistent to higher than many literature reports. One possible reason for the high success in our cohort is compliance with cold capping protocols, meaning applying the cap in the appropriate manner and wearing the cap for the prescribed durations, which may impact effectiveness.

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Section: Discussionmentioning

confidence: 99%