Keeping baldness at bay

COLD caps to prevent hair loss during chemotherapy may seem like a great idea to patients, but they have yet to catch on in Irish…

COLD caps to prevent hair loss during chemotherapy may seem like a great idea to patients, but they have yet to catch on in Irish hospitals. Olivia Newton John used a £20,000 cool cap to prevent hair loss when she was treated for breast cancer. At St Vincent's Private Hospital, Dublin, oncology nurses have recently acquired two cold caps for breast cancer patients undergoing chemotherapy who request them.

A new charity, the Caroline Woolfson Christie Appeal, was launched in the UK last week to encourage the use of cold caps in oncology units there. It was started by a woman who lost her hair during treatment for breast cancer, only to discover that the hospital had a cold cap but did not offer it to her.

Chemotherapy stops cells from dividing with a view to killing off the dividing cancer cells. Hair follicle cells divide most rapidly of all so that they are often the first to be affected when chemotherapy begins.

The cold cap stops hair loss by cooling the scalp to extremely low temperatures so that the blood vessels constrict, thus reducing the exposure of the hair root to the cancer drug and slowing the metabolic activity in the hair follicles so that they divide less rapidly and are less vulnerable.

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This information has been known for 20 years, although it has yet to be used on a wide scale, despite the fact that hair loss can be so psychologically painful that some patients choose to undergo less aggressive regimes rather than suffer alopecia. For others, getting the full dose of chemotherapy - even if it means losing all their hair - is a small price to pay in exchange for remission of a tumour.

Professor Jim Fennelly, retired oncologist with St Vincent's hospital and chairman of the Irish Cancer Society's medical board, says that sometimes doctors have to weigh the trauma of hair loss against the chances of a cure in treating patients when deciding how high a dose of a drug to give, although today fortunately not all chemotherapy drugs cause hair loss.

Jean Touhig, of the Irish breast prostheses manufacturer Tru Form, is developing an Irish model which would cost less than £1,000 and is filled with frozen gel.

Albert Switzer, director of General Medical, Dublin, is currently supplying cold caps to the Irish market. French research has shown that 85 per cent of patients treated with Taxotere keep their hair when they use the cold cap, while those who do not suffer alopecia in 80 per cent of cases.