Hair can be saved during chemotherapy, but many patients don't know it

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Six years ago, Ottawa resident Diane Hogan was diagnosed with ovarian cancer and underwent chemotherapy. After two rounds of treatment, her lush hair was gone.

She wore a wig in public to hide her baldness, but “it was the first thing I took off when I walked in the door.” The wig was itchy, hot, and made her feel even less like herself during an already difficult time in her life.

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Earlier this year, Hogan's cancer returned and she had to undergo chemotherapy again. She feared that if she lost her hair again, it would be permanent. But this time, when she learned there was an option that might help her reduce hair loss during chemotherapy, 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 protect hair follicles from the effects of chemotherapy by cooling the scalp. While the technology doesn't completely prevent hair loss, it can reduce it and encourage faster regrowth.

Scalp cooling involves wearing a cooling cap on the scalp before, during, and after chemotherapy. When the scalp's temperature increases, blood vessels in the scalp narrow, reducing blood flow, so less chemotherapy drugs reach and are less likely to damage hair follicles.

There are two types of scalp-cooling systems. According to the Canadian Cancer Society, one uses multiple cooling caps that are frozen in a portable freezer or cooler with dry ice. The caps should be changed about every 20 minutes.

The new system used by Paxman Scalp Cooling Systems has just one cap through which cold liquid is continuously circulated. This cap reduces the temperature of the scalp by approximately 3 degrees C. The system has been approved as a medical device by Health Canada.

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The private treatment, which has been available for years at cancer centers in Toronto and around the world, isn't cheap — costing more than $400 per session (with rates dropping after six treatments). Still, Paxman representatives say some Ottawa patients have chosen to get their chemotherapy in Toronto so they can use the device.

The machine that provides the technology has been available at The Ottawa Hospital since the spring, but the company that owns and operates it says the technology's future in Ottawa is unclear.

Paxman says he may have to remove the device because it is used so infrequently. A big problem is that many patients don't know anything about it until it's too late to save their hair.

It's a tricky situation, acknowledged one cancer patient who underwent scalp-cooling therapy earlier this year. The patient, who is also a medical professional, asked not to be named to protect her identity. Cancer doctors are extremely busy and focused on saving lives, she said, and may be reluctant to advertise their own businesses, she said.

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“I think there's a reluctance to talk about something that's not (publicly) funded,” she said.

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

“You have some control over it because you have no control over a lot of things.”

Patients also said they felt they had some privacy regarding their diagnosis.

“It's nice to go out somewhere and not have to yell, 'Cancer patients, cancer patients!'” Hogan said.

Ottawa Hospital spokesperson Rebecca Abelson confirmed that the Paxman scalp-cooling system is available at the hospital's cancer centre on its comprehensive campus and at the Irving Greenberg Family Cancer Centre at the Queensway Carleton Hospital.

“Doctors are aware of the service and care teams work hard to ensure patients have all the information they need,” she said.

Patients must contact the company directly to receive the service. Scalp-cooling treatments are not covered by OHIP but may be covered by private insurance. The hospital is “looking at ways to make these treatments more accessible,” Abelson said.

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Harry Goodman, the UK-based company's Canadian president, said he came out of retirement to bring the technology to Canada after seeing his wife suffer hair loss while undergoing cancer treatment.

“Her hair fell out and never grew back. I saw what happened to her. The worst part was that my grandchildren didn't recognise her and were too scared to go and see her.”

Deborah Penuik, a business development manager at Paxman, also lost her hair during chemotherapy.

“I didn't have this opportunity 10 years ago when I was undergoing chemotherapy,” she says. “I accepted that I would lose my hair, but not everyone can. Everyone should have the choice.”

In Ottawa, Peniuk said there is some funding available to make the service available to more people. In Windsor, the Cancer Centre Foundation is funding the service for financially disadvantaged patients. The company is hearing from patients that they wish they'd known about the service before their first chemotherapy treatment, he said.

Diane Hogan of Ottawa said she hopes to live a long life after chemotherapy and thinks the cold cap treatment will give her “peace of mind” for the future.

“If I live to be 100, I don't want to spend the next 30 years without hair.”

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