It can save hair during chemo, but many patients don’t know it exists

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Six years ago, Ottawa’s Diane Hogan underwent chemotherapy after being diagnosed with ovarian cancer. After two rounds of the treatment, her thick hair was gone.

She wore a wig when she was in public to cover her bald head, but it was “the first thing I took off when I walked in the door”. It was itchy and hot, and made her feel less like herself during what was already a difficult period in her life.

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Earlier this year, Hogan had to begin another round of chemotherapy after her cancer returned. She worried that if she lost her hair again, it might be permanent. But this time she knew there was an option that might help her reduce hair loss during chemo. She jumped at the chance.

Hogan is one of a small number of cancer patients in Ottawa who have used scalp cooling technology designed to help protect hair follicles from the effects of chemotherapy by chilling the scalp. It doesn’t completely prevent hair loss, but can reduce it and promote quicker regrowth.

Scalp cooling involves wearing a cap that cools the scalp before, during and after chemotherapy. The temperature narrows the blood vessels in the scalp and decreases blood flow, which means less of the chemotherapy drug reaches the hair follicles and they are less likely to be damaged.

There are two types of scalp cooling systems. One uses several cold caps that are kept frozen in a portable freezer or cooler with dry ice, according to the Canadian Cancer Society. About every 20 minutes, the cap must be replaced.

The newer system, which Paxman Scalp Cooling Systems uses, has just one cap into which cold fluid is continuously circulated. The cap lowers the temperature of the scalp to about 3 degrees C. It is approved by Health Canada as a medical device.

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The private treatment, which has long been used at cancer centres in Toronto and around the world, is not inexpensive. It costs upwards of $400 per session (the price goes down after six treatments). Still, some patients from Ottawa have opted to undergo chemotherapy in Toronto in order to use the equipment, according to Paxman representatives.

The machines that deliver the technology have been available at The Ottawa Hospital since this spring. But the company that owns and operates them says the future of the technology in Ottawa is precarious.

Paxman says it might have to pull the machines out because they are not getting enough use. A key problem is that many patients don’t know anything about it until it is too late to save their hair.

It is a tricky situation, admits one cancer patient who used the scalp cooling therapy earlier this year. The patient, who is also a medical professional, asked to remain anonymous to protect her identity. She said cancer doctors are extremely busy and focused on saving lives. They might also be uncomfortable promoting an individual private business.

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“I think there is a reluctance to talk about things that are not (publicly) funded,” she said.

Still, she said the treatment made a huge difference in how she felt during cancer treatment.

“Because you don’t have a lot of control over so many things, it is something you can have some control over.”

It also gives patients some sense of privacy about their diagnosis, patients say.

“It is nice to know when I go somewhere I am not screaming ‘Cancer patient, cancer patient!’ ” said Hogan.

Rebecca Abelson, a spokesperson for The Ottawa Hospital, confirmed that Paxman scalp cooling systems are available at the hospital’s cancer centres at the General campus and Irving Greenberg Family Cancer Centre, located at Queensway Carleton Hospital.

“Physicians are aware of this service and care teams are working to ensure patients have all the information they need,” she said.

Patients have to connect with the company directly to access the service. Scalp cooling treatments are not covered by OHIP but may be covered by private insurance. The hospital is “exploring ways to make these treatments more accessible,” said Abelson.

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Harry Goodman, the general manager in Canada of the U.K.-based company, said he came out of retirement to bring the technology to Canada after seeing how hair loss affected his wife while she was being treated for cancer.

“She lost her hair and it did not grow back. I saw what it did to her. The worst part was my grandchildren did not recognize her and were afraid to go to her.”

Deborah Penuik, Paxman’s business development manager, also lost her hair during chemotherapy.

“I didn’t have this opportunity when I was going through chemo 10 years ago,” she said. “I made peace with losing my hair, but not everybody can do that. They should be allowed to have the choice.”

Some funding is available in Ottawa to help more people use the service, said Peniuk. In Windsor, the cancer centre foundation provides funding for the service for patients with financial needs. The company has heard from patients saying they wish they had known it was available before their first chemo treatment, she said.

Ottawa’s Diane Hogan said she is hoping to live a long life after chemotherapy and sees the cold cap treatment as a “reassurance” for the future.

“If I live to be 100, I don’t want to go through the next 30 years with no hair.”

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