Advances in Preventing Hair Loss for Cancer Patients Undergoing Chemotherapy

One of the most surprisingly promising approaches, the concept of cooling the scalp to prevent chemotherapy-induced hair loss has been in practice since the 1970s with as simple a procedure as 'ice cubes in a plastic bag'. However, it was relatively unsuccessful as hair loss was prevalent in areas that did not get cold enough and resulted in a patchy hair pattern.

To prevent frostbite and to even out the application, a company called Dignitana developed a proprietary gel cap called the DigniCap that boasts a controlled temperature accurate to +/-2°C. The temperature gradually decreases over 30 minutes and allows the patient's ears to be free for earphones. The technology also has multiple safety mechanisms to prevent incorrect temperature shifts from harming the patient.

A report on msnbc.com detailed the experience of Heather Millar, one of four patients trying the experimental DigniCap. The cap has been used in Europe and some Asian countries but not in the U.S. because of concerns that if cancerous cells were present in the scalp, the chemotherapy would be ineffective in that area. After several treatments, Heather Millar retained the majority of her hair, and with her success, the F.D.A. may approve a clinical trial for 100 people in the near future. For now, investigators are limiting a trial to four patients facing chemotherapy-induced hair loss during their treatment for early stage breast cancer.

Although the concept may be new in the U.S. it has been studied extensively in Europe. Published research from the journal Supportive Care in Cancer in 2003 depicts the initial stages of DigniCap studies. Of 74 patients tested with varying types of cancer, only two had chosen to stop using the cap due to discomfort while total prevention of hair loss was observed in anthracycline treated patients. Additionally, the hair loss in patients being treated with paclitaxel/docetaxel treated was minimal to none. Researchers also found no metastases in the scalp were present 15 months following treatment, alleviating some concerns.

In other parts of the world, a 2009 study from Japan in the Journal of Clinical Oncology involved 255 patients ranging from 25 to 77 years with breast cancer over the course of two years. The study found the 55% of patients had no hair loss and 26% had minimal loss with only 6 patients losing the majority of their hair. They concluded that the DigniCap gel to prevent hair loss was an effective method for those being treated with chemotherapy for breast cancer.

With extreme cases of patients choosing to delay treatment or use less effective methods when hair loss is imminent, addressing the problem of chemotherapy-induced hair loss is not only a critical need to improve quality of patients' quality of life, but also to remove barriers to the best quality of care.