When my friend Sam was diagnosed with Stage III ovarian cancer, she knew she would have to undergo chemotherapy and radiation. Her first thought was about her hair, but wasn't a vanity thing. She hated the idea that by losing her hair during chemo, she would be advertising to the world that she was sick. Hats and wigs are fine as cover-ups, but nothing can replace the real thing. That's why many cancer patients are turning to a new treatment that aims to prevent the hair loss that so often occurs as a side-effect of chemotherapy treatment.

They're called cold caps, and they are used to cool and even freeze the scalp before, during, and for a few hours after chemo to prevent hair loss. The treatment, which has been widely used in Europe, is gaining popularity in the U.S. It's time-consuming, uncomfortable and expensive — but according to users, the results are worth it. 

Essentially, the cold caps work like a tight-fitting ice pack worn on the head like a swim cap. (Like I said, uncomfortable.) The caps must be changed every half-hour to ensure they stay cold. As a result, patients who use this treatment must have access to a freezer and a runner who can bring them back and forth every 30 minutes. That's the time-consuming part. As for the expense, one popular system called Penguin Cold Cap rents treatment caps for $600 per month for a set of caps. According to the New York Times, some users have had success in getting insurance to cover the cost of the caps in lieu of a wig.

Another method, Dignicap, is simpler in that it uses cooling tubes rather than continual refreezing to cool the scalp. It's currently awaiting FDA approval, which — if granted — would make insurance authorization a lot easier to obtain.

In a recent clinical trial, researchers from the University of California, San Francisco tested the Penguin Cold Caps on 100 women who were undergoing chemotherapy treatment. The results have not yet been published, but Dr. Hope Rugo, the study's lead author and the director of breast oncology at UCSF, told the Times that "most" of the women in the study who used the scalp-cooling caps kept "most" of their hair.

Patients who have used cold caps say one of the best benefits is the privacy it affords them while dealing with their disease. They don't have to walk around town wearing that "I've got cancer" banner in the form of a bald head. 

Cold caps work by reducing the temperature of the scalp and hair follicles. This has two benefits: First, it slows the metabolic activity of the hair follicles so they are less affected by the chemo. And second, it restricts blood flow to the follicles, limiting the amount of chemo chemicals that can cause damage. 

With all of the expense, discomfort, and extra effort involved in using scalp-cooling, it's certainly not for everyone. But for patients who are worried about losing their hair, their privacy, and their identity while dealing with cancer, it offers a viable alternative to hats and wigs.

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