How cryotherapy prevents hair loss from chemo

For women getting chemotherapy to treat breast cancer, there’s a new device that could help them keep their hair.

Hair loss with chemotherapy is a hallmark side effect of the treatment. And until now, most women undergoing chemo had to accept it as part of the unavoidable price to pay for the potentially life-saving therapy.

But the Food and Drug Administration (FDA) just approved a new cooling cap that some women have already been using to prevent hair loss when being treated. The device, made by Swedish company Dignitana, has been available in Europe but is now approved for marketing in the U.S.

“Hair loss from chemo is probably ranked among the most dreaded side effects of chemotherapy,” says Dr. Tessa Cigler, assistant professor of medicine at the Weill Cornell Breast Center, which tested the cap on some of its patients. “I think this will make such a difference in so many women’s lives.”

The device, called DigniCap, has an inner layer that circulates very cooled liquid at 37 degrees F around the scalp; another layer essentially holds that cap in place and insulates the cold. The cold temperature chills the hair follicles, making the cells divide less frequently, and therefore making them less attractive as a target for the chemotherapy agent, which homes in on rapidly dividing cells like those in tumors. The cold also constricts blood vessels in the scalp, making it harder for the chemo drug to reach the hair follicles.

In a study that the FDA considered in its review, of 101 breast cancer patients at five centers in the U.S. who used the cold cap, the device prevented hair loss in 70% of the women. Without the cap, say doctors, the chemotherapy regimens the women received lead to hair loss in nearly 100% of cases.

Women don DigniCap about 30 minutes before starting their chemotherapy, wear it throughout the treatment and for another 30 to 60 minutes afterward.

The Weill Cornell Breast Center study involved women with early-stage breast cancer receiving the most common chemo regimens, so Cigler says that more studies are needed to see if it will work for other chemo combinations for other types of cancer and for later stage patients. Certain chemo regimens may simply be too harsh for the cryotherpy to work, for example.

Some doctors also raised the concern that for cancers that might spread to the brain, the chilling effect of the cap might prevent chemotherapy from working on stray cancer cells there. More studies will also reveal more about this potential danger as well.

In the meantime, the cap represents a huge improvement over the current cold cap technology, which involves rotating ice packs that have been frozen in dry ice, on the head every 30 minutes. Dignicap automates the cooling process and makes it less cumbersome for patients.

This article first appeared in TIME. Read the full story here.

Additional coverage on ABC News.

Weill Cornell Breast Center Conducting Free Genetic Testing for BRCA1 & BRCA2

The Weill Cornell Breast Center would like to invite all patients who meet the following criteria to contact us about free genetic testing for the BRCA1 and BRCA2 mutations:

  • Metastatic breast cancer
  • Her2neu negative breast cancer
  • No more than two prior regimens of chemotherapy in the metastatic setting

If you meet the criteria above, you may be eligible for free genetic testing. If you test positive for the gene mutation, you may be eligible to participate in one of our treatment trials.

Please contact Marta Cobham, RN at 212.821.0780 or mac2034@med.cornell.edu or Naomi Kornhauser, MPH at naw2007@med.cornell.edu for more information.

Keeping Your Hair During Chemo

Dr. Tessa Cigler, a Weill Cornell oncologist involved in the cold-cap studies, said she first learned about cold caps from a patient who had researched the treatment and learned about their use in Europe. After studying the European data on cold-cap treatment, she allowed her patient to use them and became interested in conducting her own research.

The success of a cold cap treatment often depends on the duration and type of chemotherapy regimen, so not every woman is a candidate, Dr. Cigler says. In addition, cold caps are typically used only on patients with solid tumors, like breast cancer, and are not suitable for patients with blood cancers.

“Cold cap therapy is really empowering to many patients,” Dr. Cigler said. “It has allowed many patients to protect their privacy, and allows women to maintain their self-esteem and their sense of well-being during a really difficult time.”

http://nyti.ms/1Abgsgn

Results: Phase I/II Study of the Antibody-Drug Conjugate Glembatumumab Vedotin in Patients With Locally Advanced or Metastatic Breast Cancer

Dr. Linda Vahdat and her colleagues are very excited to be involved in the development of glembatumuma vedotin as it has the potential to be among the very first drugs for triple negative breast cancer.

http://jco.ascopubs.org/content/early/2014/09/29/JCO.2013.52.5683.full.pdf+html