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ONCOLOGY
Scalp cooling for cancer patients
Scalp cooling is changing the face of cancer, by helping thousands of people keep their hair while undergoing treatment for chemotherapy.
Cancer affects people in different ways, but one of the most traumatic side effects of chemotherapy is hair loss. The process can make a patient feel like they are losing control of their body and their appearance, at what is already an extremely difficult time in their life. Chemotherapy does not have to mean hair loss though, as many people across the UK and throughout the world are finding out after using a pioneering scalp cooling technology.
Developed in Huddersfield, the Paxman Scalp Cooling System is changing the face of cancer, by helping thousands of people keep their hair while undergoing treatment for chemo.1
Scalp cooling (the cold cap)
can be used with all solid tumour cancers that are treated with chemotherapy drugs such as taxanes (e.g. docetaxel), alkylating agents (e.g. cyclophosphamide) and anthracyclines/DNA intercalating agents (e.g. doxorubicin). These drugs target rapidly dividing cells and the matrix keratinocytes, which results in hair loss. Scalp cooling cannot be used with the following conditions: l Haematological malignancies (leukaemia, non Hodgkins and other generalised lymphomas).
l Cold allergy. l Cold agglutinins. l Manifest scalp metastases. l Imminent bone marrow ablation chemotherapy.
l Imminent skull irradiation.
The procedure For a successful treatment, the scalp needs to be maintained at a constant temperature. This is achieved by the correct fitting of the cap. Pre-cooling of the scalp takes 30 minutes prior to commencement of drug infusion. This ensures the scalp is at the required temperature before chemotherapy is administered. The cap should be worn throughout the administration of the chemotherapy drugs and for 90 minutes afterwards. The system requires minimal nursing supervision.
Cancer chemotherapy affects rapidly dividing cells and, at any given time, 90%
FEBRUARY 2017
Pam Fitzpatrick fitting a patient with a cooling cap.
of human hair follicles are in the actively dividing phase. Hair loss frequently occurs due to partial or total atrophy of the hair root bulb, causing constriction of the hair shaft, which then breaks off easily. Cell division is metabolism-driven – this process is decelerated by cooling. Also, a decrease in the metabolic activity of the cells in the hair follicle could cause a more general reduction in the cytotoxicity of chemotherapy drugs localised to the scalp.
Scalp cooling causes blood vessel vasoconstriction, which has been shown to reduce blood flow in the scalp to 20-40% of the normal rate, resulting in less chemotherapeutic drug being delivered to the hair follicles. The rate of drug diffusion across a plasma membrane is reduced – therefore lower effective drug doses may enter the cells. It is also suggested that reduced biochemical activity due to cooling makes hair follicles less vulnerable to the
damage of chemotherapy agents. Gregory et al²
found that alopecia
prevention occurred when scalp temperature was reduced below 22˚C and Bulow et al³ demonstrated that a subcutaneous temperature below 22˚C corresponds to an epicutaneous temperature of 19˚C. Results from these tests indicate that the equipment used in the study reduced scalp temperatures to an optimum constant level for alopecia prevention.
The level of success is determined by how well the scalp temperature is lowered and maintained throughout the treatment period. The Paxman cap has been specifically designed from lightweight silicone to help achieve this, and the equipment has been scientifically tested to prove its effectiveness. Independent observational studies have demonstrated the safety and effectiveness of the Paxman Scalp Cooling System in the prevention of chemotherapy induced hair loss
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