Hair Loss and Cancer – Chemotherapy Does Not Need to Lead to Hair Loss Anymore

Hair Loss and cancer – as if the dreaded disease isn’t bad enough it usually comes with the added burden of hair loss. So when the news hit the world of a new device that helps cancer patients keep their hair during chemotherapy, cancer patients everywhere felt there might be a small amount of relief to everything they already have to deal with.

DigniCap is the name of the device that is supposed to revolutionize hair loss during chemotherapy. It is a scalp cooling system that offers patients the possibility of keeping all or most of their hair during chemotherapy. According to DigniCap, the cooling system was approved by the FDA for use in the U.S. in December 2015.

Modern medicine has come a long way when it comes to handling the side effects of chemotherapy, making many aspects of the treatment manageable for the patients. But hair loss has been one of the side effects that for a long time was unavoidable. Many patients going through chemotherapy has said that they do not like the fact that hair loss makes it so obvious to others that they are are sick.

Dr. Saranya Chumsri, an oncologist specializing in breast cancer at the Mayo Clinic in Jacksonville, a clinic that now offers their patients DigniCap, said in an interview for the local paper that many patients do not want to be reminded they have cancer.

“Even though they, most of the time, feel really well, the fact that they don’t have hair reminds them every single day that they have cancer and are on chemotherapy. With the DigniCap system, just the fact they can keep their hair makes a whole world of difference,” said Dr Chumsri.

 

How Dignicap Works When Dealing with Cancer and Hair Loss

The DigniCap scalp cooling system is a tight-fitting silicone cooling cap. The cap is placed directly on the head of the person. And an outer cap is placed on the first silicone cap, and insulates and secures it.

The cap is connected to a cooler, where liquid coolant circulates throughout the silicone cap, delivering cooling to all areas of the scalp. Before the patients put on the cap, they wet their hair, and sometimes, when the treatment is done, they can actually find ice crystals in their hair. The temperature of the scalp is lowered and the scalp is kept cold, and because of that, less chemotherapy makes it to the scalp.

These are the factors that reduce the risk of hair loss. What determines how long the patients will be attached to the DigniCap, is the treatment that they are getting. But it usually last from four to seven hours.

Dignicap and hair loss
More and more clinics are integrating Dignicap as part of the post-cancer treatment.

Still Unattainable for Most People

Even though DigniCap is revolutionizing the battle of cancer and hair loss, it is still a tool that is mainly for those who can afford it. Using DigniCap is not cheap. In fact, it costs about $400 for each treatment.

Other problems that have been reported are that some of the patients get a headache from the cap, and that the strap on the cap can give some patients irritations on the chin. Nonetheless, more and more clinics are integrating DigniCap as part of their post-cancer treatment, making it a great development when it comes to cancer and hair loss.

William Cronin, the Chief Executive Officer of Dignitana Inc, the company that produces DigniCap, says in an article that he is honored to make a real difference for cancer patients who fear losing their hair to chemotherapy.

“As more and more centers like the Mayo Clinic integrate new innovations like the DigniCap system into their cancer care regimens, we move closer and closer to the day when that fear is a thing of the past,” he comments.

 

Scalp Cooling: A Way To Combat Hair-Loss During Chemotherapy

Scalp Cooling: A Way To Combat Hair-Loss During Chemotherapy

A trademark side effect of cancer is hair loss, but that may no longer have to be the case. The effectiveness of scalp cooling, a method to prevent chemotherapy induced hair loss, has been outlined in several recent studies conducted at University of California, San Francisco and University of Baylor College of Medicine.

What is Scalp Cooling?

According to an article by the American Cancer Society, “Cooling Caps to Reduce Hair Loss”, scalp hypothermia, or scalp cooling, is a method of cooling the scalp with ice packs or cooling caps during, before and after each chemotherapy treatment to reduce the effects of chemotherapy on hair loss cells. We have previously written about how this treatment is already widely used in Europe and is gaining ground in the U.S.

How Does it Work?

Chemotherapy uses cytostatic drugs, or drugs that prevent cell growth and division, to stop cancer cells from rapidly dividing by attacking the body’s cells. While chemotherapy attacks cancer cells, it also attacks healthy cells, such as hair cells, which will result in hair loss.

In an article released by Cornell Weill Medical, “Scalp Cooling Can Help Some Breast Cancer Patients Retain Hair”, Dr. Hope S. Rugo, a UCSF professor that led the study, explains the theory behind scalp cooling. Dr. Rugo says the cold temperatures slow hair follicle cell division, and therefore creates a less susceptible environment for the damaging effects of chemotherapy.

Blood vessels dilate when the body is exposed to heat and constrict when the body is exposed to cold. When the body becomes too hot, the blood vessels will dilate so that the blood can flow closer to the surface of the skin so heat can be released from the body. When the body is exposed to cold the blood vessels will constrict to conserve heat in the body.

According to the aforementioned American Cancer Society article, when cooling constricts the blood vessels in the scalp, the amount of chemotherapy that is able to reach the cells of the hair follicles reduces; therefore, the effect of chemotherapy on the follicle cells reduces and as a result there is less hair loss from the scalp.

How Effective is it?

According to a study in JAMA by the University of California, San Francisco, scalp cooling has proved to be an effective method to combat chemotherapy induced hair loss. The study aimed to answer whether or not scalp cooling associated with a lower risk of hair loss when used by women receiving chemotherapy for early-stage breast cancer. There were 122 patients in the study receiving non anthacycline-based chemotherapy and 50% or less was found in 66.3% of the patients using scalp-cooling group vs. hair loss of 50% or less was found in 0% of patients in the control group after four weeks of chemotherapy.

Baylor College of Medicine conducted a similar study with 182 breast cancer patients receiving chemotherapy with a taxane, anthracycline, or both. This study found that the women who underwent scalp cooling were significantly more likely to have less than 50% hair loss compared with no scalp cooling.

Nutrafol | Woman using cooling cap from DigniCap
DigniCap has made a cooling cap that has been cleared by the FDA.

Who Makes Cooling Caps?

There are a variety of different ways in which scalp cooling is practiced, ranging from simple bags of crushed ice to continually cooling machines that are placed on the head. Some companies that create these cold caps are ChemoCap, Elasto-Gel and Penguin Cap. Paxman, a UK company, created a technologically advanced scalp cooling system that circulates a non-viscous coolant through the helmet to keep the scalp cool. We have previously written about the product DigniCap, made by Swedish  company Dignitana. While the technology isn’t widely obtainable in the United States, DigniCap, an FDA cleared device, is available in the United States. Around 50 medical centers across 17 states have access to DigniCap but the expensive device, which costs between $1,500-$3,000 per patient is not covered by most insurance. While this is expensive, a non-profit organization called HairToStay offers subsidies for patients that cannot afford the technology.

DigniCap, the Cooling Cap That Protects Your Hair During Chemotherapy

Nutrafol | DigniCap

For most people, hair loss is  what we expect during chemotherapy. But the new patented product DigniCap changes that. The new method of cooling the scalp during and after chemotherapy has a proven effect on hair growth.

Losing Hair During Chemotherapy

Most people lose some or all of their hair when going through chemotherapy. It can be a traumatizing experience, as much of our identity is in our hair. And about one in eight American women will develop breast cancer at some point in their lives. Breast cancer is the most commonly diagnosed cancer among women. Researchers estimate that some 252,710 women will diagnosed with this disease in 2017.

“We have this huge growing population of breast cancer survivors, and many of them are very traumatized by their treatment,” said Dr. Hope S. Rugo. Rugo is the director of breast oncology and clinical trials education at University of California, San Francisco. The school is working on developing different ways of tackling this problem, one of them being scalp-cooling.

Nutrafol | DigniCap
DigniCap is currently the only scalp-cooling device that has been cleared by the FDA.

Studies Using the DigniCap

The method of cooling the scalp in order to keep hair growth alive is old. However, with new technique available today it works better and is easier. Swedish company Dignitana produces the device that is called the DigniCap. This device was used in a cold cap study from the University of California, San Francisco.

The study involved 122 women with early stage breast cancer. Among the women who received treatment with the cold cap, 66.3 percent kept 50 percent of their hair. In the control group, that did not wear a cool cap, the number was zero. For the scalp-cooling group, three out of five quality-of-life measures were also “significantly better” a month after ending treatment.

How the Device Works

The DigniCap is the only scalp-cooling device that has currently been cleared by the Food and Drug Administration. “Managing the side effects of chemotherapy is a critical component to overall health and recovery,” said William Maisel from the FDA’s Center for Devices and Radiological Health. Our hair is a big part of our identity and losing it can cause emotional trauma. The DigniCap is a safe way of preventing or easing hair loss. As it does not involve any medication or surgery, it is safe from side effects.

The Cap

The cap consists of an inner and an outer cap, and works much like a refrigerator, and are filled with a cooling liquid. Temperature sensors built into the cap regulates how often the liquid circulates. When our head gets cooled off, blood vessels in the scalp constrict. When blood flow to the hair follicles slow down, the metabolism of the follicles also slows down.

This is a breakthrough for cancer treatment, as some women will even refuse to undergo chemotherapy treatment in order to save their hair. Dr. Julie Nangia, who is an assistant professor of medicine at Baylor College of Medicine, said that they “are at a higher risk for relapse and if the cancer comes back, we can’t cure it.” Now, with the option of the DigniCap, it could encourage these women to accept a treatment that could save their life.

Dealing with Cancer and Hair Loss, Part 3

Cancer and Hair Loss

Cancer and Hair Loss are traumatic experiences that combined makes a tough battle. This is the third part in a series of three where Anne Sarte tells about her journey.

Dealing with Cancer and Hair Loss Part 3

The barber who had shaved the last vestiges of my pre-cancer hair had already left for the evening and I was trying to get accustomed to walking around the house bald. So this is how it feels, I thought. I wish I could say I felt all my hair standing on end, but I had no hair! The sensation came from the pores on my scalp that became ultra-sensitive to the air around me.

When I lay on my pillow that night, the top of my head felt really cold. I used to always have the airconditioner on every time I went to sleep, but that night, I could feel the cold seep through my scalp. I thought I had a fever so I got a beanie and put it over my head the rest of the night. Sleep was elusive that first night because the beanie kept slipping off my head as I turned on my pillow.

Everything, including the scarves I used to cover my head during the daytime, had a hard time staying on. My scalp seemed to take on a slippery feel much like a crystal ball. During the one time that I wore a wig when I went out, I felt my scalp was on fire because the wig was so hot! That was the last time I wore that nasty headpiece and finally decided to go au naturel.

I really cannot understand how Dwayne Johnson, Andre Agassi, or Michael Jordan – who are on the list of the hottest bald men of all time – can go around in public without any problem, while people who go bald because of cancer cause others to feel so uncomfortable. And for most people with this disease, cancer and hair loss go together, so there is not much to do about it.

This double standard had to stop and I thought of doing something about it. I got my smartphone and took a couple of selfies when no one was looking and surprised everyone on Facebook the next day with my clean-shaven pate. Before that time, only my family and a couple of friends knew that I was diagnosed with cancer so when the rest of the world got in on my secret, I received a mixture of reactions from everyone on my list.

To this day, I remain extremely grateful to family and friends who, despite their initial surprise, poured out their love, support and prayers. They sent me messages on my Facebook wall and in my inbox. Some sent me books to read and lots of food to eat. While many were generous in their encouragement and support, some became stoic and did not know what to say. It seemed as if my coming out bald in a public space was an affront to them and someone even told me to take my photo down.

Cancer and Hair Loss
Some cancer patients wear wigs or scarves, while some feel more comfortable going natural.

It is true that challenges bring out the best or worst in people, and life events show you who your real family and friends are. That period was the moment of truth – when I started to see the true colors of the people around me and it was both enlightening and liberating at the same time. Before my illness – and before you could see it on me – I was slim and fit, on top of my game, and was doing the rounds of international real estate and financial services.

When I fell ill and was undergoing chemo sessions, I became weak and very sickly because my immune system had buckled down. I had lost a breast and all my hair, yes, but I was, and still am, the same person inside.

I don’t think anyone’s self-worth should be defined by how one looks, or may appear to look like, at a particular time. After all, beauty, like time, is fleeting but the true essence of a person is found deep within.

In my battle against cancer, I learned seven important lessons that I always go back to until this day:

  1. The greatest investment you can make in your life is the time you spend with your loved ones, for you do not have forever to be with them.
  1. The second great investment that we always neglect is our health – we work so hard for money and comforts when we are young, but we spend so much to get our health back when we grow old.
  1. The people who stick by you in good times and in bad are the only people you really need in your life – the rest are just like driftwood, waiting to be washed over again to another shore.
  1. We learn to value people or things only when we lose them. I appreciated my body more when I lost my health. I learned the value of my hair when I felt cold and bare. I realized that every function of my body that I took for granted before was important to my well-being. I became aware of the full worth of every single day that I was alive, and was thankful for each moment with my loved ones.
  1. Do not give anyone permission to pull you down. Each one of us leads unique lives, and no one should ever be allowed to mess with yours.
  1. My hair mirrored my life. Setbacks were temporary. I learned that even as it went through the entire catagen phase of slowing down and breaking at the roots, it had to go through the telogen process of being wiped out much like a purging of the bad things in my life. It was an inconvenient necessity but it made me look forward to experiencing a rebirth and moving on to its anagen stage when everything starts anew.

For my physical body to heal, I also had to heal myself emotionally, mentally, and spiritually. I had to forgive myself and others for past mistakes, let go of the negativities in life, and surrender myself to the one true God who created me.


Text by Anne Sarte

This was the last part in a series of three.

Photo credits: cea + via Flickr

liz west via Flickr

 

Dealing with Cancer and Hair Loss, Part 2

Cancer and hair loss

For many people with cancer, hair loss is a necessary evil. In the previous text, Anne Sarte shared her story of how she was fighting hair loss during her cancer treatment. Here is the continuation of her series of articles on cancer and hair loss.

Cancer and Hair Loss Part 2

During that late afternoon when my dad invited a barber over so I could have a haircut in the privacy of my own home, I felt that the gathering dusk heightened the pensive mood that everyone in the room seemed to have. My entire family was there to provide support. It was like an event that one had to witness and I tried my best to embrace the moment as positively as I could.

Most cancer patients experience hair loss as a result of chemotherapy. While people who do not have cancer may have varying stages of alopecia at some point in their life, those undergoing treatment are most vulnerable to hair loss because the chemicals used to target cancer cells also destroys hair cells.

The cocktail, that combination of burning chemicals that was injected into my body, was like an M240 machine gun shooting both good and bad cells at the rate of 950 rounds per minute. My hair follicles, which were in charge of producing my hair by dividing every 23 to 72 hours, were no match for the assault weapon and were clearly collateral damage.

It was then that I realized that it was only a matter of time before it would attack not only the hair on my scalp but also my eyebrows, lashes, the hair on my arms, legs, armpits, and even those in the nether regions. Well, at least there is no need to be terrified of the infamous Brazilian wax!

Cancer and hair loss
Hair loss due to chemotherapy not only affects the hair on your head, but also lashes, eyebrows and all the hair on your body.

Someone once asked, “How can I control my life when I cannot control my hair?” It is a perfect metaphor for people who need some organization in their lives, but what happens if one does not have hair, or has lost it in the battlefield of chemotherapy? Does that mean that one has lost control over one’s life? For most patients, cancer and hair loss go hand in hand. It seemed very much so as I clutched clumps of falling hair in the shower during those days. There were days when my health, like my hair, was slipping through my fingers and waxing philosophical just became a hobby.

The barber took out his trusty electric razor and started parting what was left of my hair in sections. I heard the whirring of the razor before it landed on my head, much like a lawn mower does on a grassy lawn. My lawn was now in patches and desperately needed some serious makeover.

I tried to peep at my family through wisps of hair hanging on my forehead. My son, who was 12 at that time, was a mix of awe and good humor at seeing his mom turning into a skinhead. My dad, though, looked serious, and my mom had that look in her eyes that I knew was borne out of sadness and pity. It was then that I took in a deep breath and knew these were the people I wanted to have beside me at a time like that. As the remaining patches of hair fell gently on the floor, I could not help but shed a tear.

I had lost all my hair, but in the process of fighting against cancer and hair loss, I found myself and a lot of other little lessons along the way.


Text by Anne Sarte

This was the second part in a series of three. Part three will be published in two days.

Photo credits: Jose Martinez via Flickr

arianne leishman via Flickr

Dealing with Cancer and Hair Loss, Part 1

Cancer and hair loss

Cancer and Hair Loss Part 1

Several years ago, I was diagnosed with breast cancer. One of my elder sisters had died of it at the age of 39. Although the rest of us females in the family did not go through testing to see if we were genetically predisposed to it, it clearly made the case when I found out I had it – decades after she passed away. For most people, Cancer and Hair Loss will come together. This is the story of my journey.

Genetics, stress, diet, lack of exercise and pollution are all contributors to disease and we just have to deal with the bodies we are given. Since I have a small frame, the external effects of mastectomy did not sink in as much. I was not giving Kim Kardashian a run for her money by a mile before the surgery, so looking like Kate Moss afterwards was not such a bad prospect after all. It was useless taking before and after pictures because one would not notice the difference if someone was flat as a board from the start.

Then it dawned on me – it is easy to have an appendage such as a breast taken out because no one would notice it as much anyway unless you had triple D implants done before. What was difficult to accept, and adjust to, was the imminent hair fall as a result of chemotherapy. Hair, or the lack of it, is something that is more difficult to cover. And in most cases, cancer and hair loss are linked together. I have had all sorts of hairstyles in the past – from pixie to shaggy, from Goldie Hawn curls to Mulan straights – but I have never, ever been bald before. Not until my chemo.

Two weeks after my first treatment, my hair was still hanging onto my scalp for dear life. I was about to give myself a pat on the back for growing such strong hair but that moment did not last long. I was sitting in front of my work desk one morning and I noticed a few strands falling. It looked as if chemo, cancer and hair loss do coincide, even for people with a lot of hair. As I sat down to work each day, the strands seem to fall faster – first, they fell on my shoulders and I would grab a handful and put them in the nearby trash bin. Then they fell on my lap, and soon gathered in a pile on the floor beside me.

Cancer and hair loss
Cancer and hair loss are oftentimes coincidental and can be a traumatic experience.

I realized that I could just sit there and my hair would literally shed, just like leaves falling off a tree in autumn. The difference was that autumn leaves are always beautiful but my hair fall was not a pretty sight. Soon, I had filled up the trash bin and I had to empty it so I could repeat the same process. It was getting obvious that my hair was thinning out faster in some areas. When my scalp started to look like a map of islands, that was the time I decided to shave my head.

A lot of decisions during a cancer journey are made because one has to, not because one wants to. It feels better when one has a choice to make, or several choices to choose from, but disease has a way of pushing you against the wall, staring you in the eye, and sticking a gun against your chest.

You decide either to live or to die slowly. To resist or give in. To breathe or suffocate. To fight back or crumple on the ground.

When my doctor told me I had cancer, I knew I had to undergo surgery – as soon as possible. There was no other choice for me since I did not want to die just yet. In my mind, dying before one reaches 50 is not an option for someone who still has family to take care of, and a promising future ahead of her.

After surgery, I made the decision to go through chemotherapy. As much as I wanted to try alternative methods, I did not think time and genetics were on my side.

A month or so after my first chemo, when I was having seriously bad hair days on top of a compromised immune system, I had no other choice but to shave my head and go bald. I will never forget that day because that seemingly trivial event of having a haircut completely changed the way I viewed life.


Text by Anne Sarte

This is the first part in a series of three. Part two will be published in two days.

Photo credits: michellehurwitz via Flickr

Beth Punches via Flickr