An exciting update that could make treatment less stressful.
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Thanks to caps that keep a patient's scalp very, very cold (like close-to-freezing cold), cancer patients may be less likely to lose their hair.

So-called cold cap treatment isn’t new, but last week the New York Times reported a long-awaited update: one of the gadgets, the DigniCap, may soon become the first scalp-cooling device to be approved by the U.S. Food and Drug Administration thanks to the promising results of a recent clinical trial. This is big news because FDA approval could up the odds that insurance companies would pay for the treatment and make it more widely available.

DigniCap works by pumping a coolant through tightly fitted headgear that patients put on about 30 minutes before their chemotherapy treatment and wear until a few hours after it ends, depending on the type of drug and dose. It's thought to save the hair by reducing blood flow to the scalp, thereby limiting the amount of chemo drugs that reach hair follicles. Chilling the scalp also slows the metabolic rate of follicles so they’re not as sensitive to the toxic chemicals.

Not every patient is a candidate: success of the cold cap depends on both the type and duration of chemotherapy, and it is only an option for those with solid tumors (like breast cancer), not blood cancers. But lead researcher Hope Rugo, MD, the director of breast oncology at the University of California, San Francisco, told the Times that in the trial of 120 breast cancer patients, most women kept most of their hair.

Although DigniCap is already being used around the world, to date, it has only been available in the U.S. through clinical trials. Many women in the U.S. have been using Penguin Cold Caps instead, which can be rented for $580 a month. (The average total cost is estimated to be around $2,000, which some women have been reimbursed for in place of a wig.) The Penguin method is more labor-intensive: think gel-filled, helmet-shaped ice packs with Velcro fasteners. The caps must be changed every half hour, and kept frozen with dry ice or in a biomedical freezer. (The nonprofit Rapunzel Project offers a list of hospitals that have the freezer.) Researchers at the University of California, San Francisco, just completed a separate clinical trial on the Penguin caps, with about 100 participants, that led to similar results as the DigniCap study, according to the Times.

As for how it feels: “painful,” “pretty intense,” and “like a brain freeze” are how some patients have described the treatment. After a few minutes, the scalp becomes numb.

For high school teacher Darcy Romondo, it was worth the outcome: “It’s self-esteem, it’s feeling like yourself, it’s confidence,” she told her local news station KSHB Kansas City. Her students didn’t even know she was going through chemo until they asked where she went every three weeks: “To me, that’s the best part of this is to have people completely forget and treat me like a normal person.”