More chemotherapy patients to keep hair after cooling trial success

2019-06-11 03:13:19

A pilot in Nelson to prevent hair loss in chemotherapy patients has been so successful it will now be rolled out in hospitals around the country.

The six-month scalp cooling pilot began at Nelson Hospital in December 2017, the first time the treatment had been trialled in New Zealand.

It involves chemotherapy patients wearing a rubber cap with gel coolant circulating through it. The coldness narrows blood vessels beneath the skin of the scalp, reducing the amount of chemo reaching hair follicles.

Nelson Marlborough Health consultant oncologist Dr Kate Gregory said 10 women used the scalp cooling machine during the pilot.

Of those who persisted with treatment, none lost more than 50 per cent of their hair and some had as little as 10 per cent hair loss. All had enough hair after treatment that they were confident to go out without needing to wear wigs or hats.

"Some people find the first 10 minutes when their head is cooling down the most difficult, but once they have gone through that they have managed fine."

The cap needed to be applied before, during and after treatment so could extend the time spent at hospital by up to two hours. In Nelson, a volunteer was trained to fit the cap on patients which ensured the clinic could still run efficiently.

Following the pilot, the scalp cooling machine would remain at Nelson Hospital to be used by breast cancer patients.

Gregory trained in the UK as an oncologist where scalp cooling treatment was used routinely, which led her to approach the Breast Cancer Foundation New Zealand for funding to begin the trial. She said it was now becoming more common in the United States and Australia.

"It is a well established treatment, the trial was about how it impacted on the running of the clinic and how the patients tolerated it."

She said hair loss was "hugely distressing" for patients, with many describing it as the side effect they dreaded most.

"It's been really encouraging to see women at the end of their chemotherapy looking normal. Most people will lose a bit of hair, not that anybody looking at them would notice."

The Breast Cancer Foundation funded the pilot at a cost of $67,500, which covered the machine and a specialist nurse to prepare patients.

Now, the foundation has said it will fund up to 10 scalp cooling systems worth $500,000 in public hospitals around the country.

Foundation chief executive Evangelia Henderson said the Nelson Hospital trial achieved better results than previous clinical trials which gave confidence that the treatment would work in New Zealand.

"We know it's not the kind of essential service that the average DHB will ever be able to prioritise; there are just too many competing demands for funds. So we figured that if we want this technology to be available to Kiwis going through breast cancer, we have to step up."

DHBs could apply for a grant for a scalp cooling machine through the foundation website. Because the treatment required patients to spend additional time in the oncology clinic, Henderson said it was asking DHBs to demonstrate they had planned for that and could manage scalp cooling so it wouldn't delay or disrupt the delivery of chemotherapy.

Breast cancer was a "heartless disease" that affected more than 3300 people every year and Henderson said treatment could be "harrowing".

Donations from generous Kiwis had made the scalp cooling roll-out possible.

"These systems will reduce suffering by helping women keep most of their hair."

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