Scalp Cooling and Hair Loss

iStock-537307838Great news for women who must have chemotherapy for breast cancer! The relatively simple measure of cooling the scalp before the administration of chemotherapy and then for a while afterward reduces hair loss quite a bit, Rick and I discuss on PodMed this week. That's as published in two studies in JAMA. And as Rick freely admits in the podcast, those of us who are fortunate enough not to have had treatment for cancer that includes prospective or actual hair loss may consider it a relatively minor inconvenience when compared with things like profound fatigue and vomiting, but a significant number of women cited in these studies identified hair loss as their reason for choosing not to undergo chemotherapy, potentially life-extending or not. So clearly developing ways to reduce or eliminate this side effect contributes substantially to quality of life.

The procedure to utilize the scalp cooling device was simple and in one study, involved cooling the scalp to 37 degrees F for 30 minutes prior to chemotherapy infusion, during the infusion itself and afterward for 90-120 minutes.  To me this sounds like extra time spent at the infusion center but more importantly if my head was chilled my body would follow! My hope is that heated blankets were provided to these women to avoid chills. Results for both studies indicated that hair loss was reduced by 50% or greater among those whose scalps were chilled compared to 0% reduction for those in the placebo arm.  Women who retained their hair also reported feeling more attractive than those who didn't. Rick cites a few thousand dollars added to the total cost of treatment by employing this strategy, and we both hope insurance will soon provide coverage for it.

Other topics this week include Associations of maternal BMI and insulin resistance with the maternal metabolome and newborn outcomes in Diabetologia, Opioid Prescribing and Risk of Long-Term Use in NEJM, and Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians, in Annals of Internal Medicine. Until next week, y'all live well.

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