Jessica H Avoiding Hair Loss During Chemotherapy: Jessica's Story

"Everyone is very surprised at how quickly, how thick, how fast, my hair is growing back."

Like many cancer patients facing chemotherapy, Jessica Heline of Tinton Falls was concerned about side effects, including a telltale one: hair loss. So, when an oncology nurse at Monmouth Medical Center (MMC) mentioned that a scalp cooling system could help counteract that problem, Jessica figured it was worth a try.

“It appealed to me because I learned I might keep my hair—and if I did lose it, it would likely grow back faster afterward,” says Jessica, 31, an engineer and mother of a 3-year-old boy.

Jessica was diagnosed with stage 2B invasive ductal carcinoma in her left breast in April 2019. Since cancer had spread to a few of her lymph nodes, her doctors recommended chemotherapy before surgery. While Jessica was primarily concerned with surviving the disease, she wanted to look as normal as possible.

Reducing Hair Loss

With scalp cooling, a patient wears a special cap during chemotherapy sessions to help prevent damage to hair follicles, explains Manpreet Kohli, MD, Director of Breast Surgery at MMC, where the Paxman scalp cooling system—one of two on the market—has been used since 2019.

Cooling the scalp, also known as scalp hypothermia, causes blood vessels to constrict, limiting the number of chemotherapy drugs that can destroy hair follicles. Chemotherapeutic drugs target rapidly dividing cells— both cancer cells and normal cells, such as hair follicles. Limiting blood flow to normal hair follicles can help preserve them while allowing chemotherapy to treat a malignancy thoroughly.

The system delivers coolant to reduce scalp temperature by a few degrees.

Research has shown that scalp cooling therapies are effective in 50 to 80 percent of patients, reducing hair loss to less than 50 percent, according to the American Society of Clinical Oncology. Success depends on the type and dosage of chemotherapy drugs.

“We’ve had some really good results,” says Dr. Kohli. “Some patients have had almost no hair loss at all, while others have lost a significant amount and stopped using the cap. Some have lost around 30 percent of their hair and continued using the cap. Once they stopped, their hair grew back almost instantaneously.”

Scalp cooling also helps to preserve a patient’s natural look, notes Dr. Kohli. “When someone loses their hair entirely, it can take years to grow back to the original length,” she says. “Also, hair can grow back differently—curly or gray, for instance.”

Jessica with her doctor
Manpreet Kohli, MD, Director of Breast Surgery at Monmouth Medical Center, recommended that Jessica Heline use a scalp cooling system to help prevent hair loss during chemotherapy. NOTE: This photo was taken before mask and social distancing recommendations were in place.

A Full, New Layer of Hair

Jessica started using the scalp cooling system in May 2019, when she had the first of eight chemotherapy sessions. About an hour before each session, she applied a conditioning treatment to her hair, then donned a cap connected to a refrigeration machine.

The treatment ended about an hour after each chemotherapy session. Overall, the cooling treatment lengthened each session by about two hours.

Jessica tolerated the treatments well.

“It’s cold when you first put on the cap, but you get used to it,” she says. “The more annoying part was wearing a tight cap for a long period of time.”

While some patients experience a headache, most report minimal if any discomfort, says Dr. Kohli. The most common complaint is feeling cold, which can be managed by simply bundling up with blankets and a warm drink.

“It’s low-risk and very safe,” she says.

Insurance coverage for scalp cooling is spotty, and out-of-pocket costs can run as high as $2,200, regardless of how many treatments a patient undergoes. Jessica says the money she paid was well spent.

“I kept my hair almost until the end of my treatments when it became thin and I started wearing hats,” says Jessica, who completed chemotherapy late last summer. “Then, about three weeks after my last chemo session, I had a full, new layer of hair on my head. It was about a quarter-of-an-inch to half-an-inch thick. Now it seems to be growing nearly twice as fast as normal.”

In September 2019, Jessica had a double mastectomy with reconstruction. Although the cancer was only in the left breast, Jessica opted to have both breasts removed. “I wanted to eliminate as much risk as I could,” she says.

Surgery was followed by six weeks of radiation. Now cancer-free, Jessica is planning to have a second-stage breast reconstruction this fall.

For the estimated one in 12 cancer patients who refuse to undergo chemotherapy because they’re terrified of losing their hair, scalp cooling can offer hope, says Dr. Kohli.

“It’s very satisfying to be able to ease people’s fears,” she adds.

The Best Candidates for Scalp Cooling

Men and women undergoing chemotherapy for solid tumors may be candidates for scalp cooling—as long as they can tolerate the cold, says Manpreet Kohli, MD, Director of Breast Surgery at Monmouth Medical Center.

The technique may not work as well with certain chemotherapy regimens, though. For instance, it doesn’t appear to be as effective for patients receiving drug anthracycline.

Talk to your medical oncologist to find out if you might benefit from scalp cooling.

For more information about cancer treatment at Monmouth Medical Center visit The Leon Hess Cancer Center.

To schedule an appointment with one of our cancer specialists, click here or call (844)-CANCERNJ or (844) 226-2376.