I was terribly traumatized when my doctors said I needed chemotherapy to treat really aggressive breast cancer thanks to the BRCA gene mutation that I never knew I carried. I didn't want drugs that are poisons in my body and I didn't want to lose my hair. There were, of course, other anxieties swirling in my head, but I had to quickly decide whether I would use cold caps in an attempt to mitigate chemo hair loss. Both my husband and I loved my hair. I had years invested in my pretty and long blonde hair. I identified with it. When I was younger, I wore it down to my waist. As I've aged, I've cut it shorter, but it's never been shorter than my shoulders. I did not want to lose it, especially to something as horrible as cancer. So, I decided to give the cold caps a try. Because I was in shock from the breast cancer diagnosis, my husband handled the logistical issues of finding the cold caps, renting them, and coordinating with my chemotherapy treatment center.
How Do You Use Cold Caps During Chemotherapy?Understand that using cold caps adds a significant layer of complication to chemotherapy. I used the cold caps from my very first chemo infusion. My infusions were every two weeks and would have normally lasted four hours before I could be sent home. Cold caps, however, needed to be worn much longer. They had to be worn before my infusion started, so my scalp would be cool when the medicine first hit my body. I also had to wear them for four hours after an infusion while high doses of medicine were still coursing in my system, potentially shutting down hair growth. In addition, during an infusion, we had to change the caps every 30 minutes, as the one I was wearing would heat up. It meant a new painful cap was placed on my head by my loving husband while nurses gave me infusions. I was pretty out of it with all the drugs they gave me to prevent nausea, but it made for a long and painful day. When I had my chemotherapy in the fall of 2013, cold caps were very new to my cancer treatment center. The infusion center had purchased the proper ultra-cold freezer, which is very different than home freezers, that was needed for cold caps. But, that was all the help they gave us. They knew very little about using cold caps and would not take any responsibility for assisting us. Also, they could only fit one person’s caps in the freezer at a time, which became a problem because each cold cap patient needed to pre-chill their caps in the "bio-freezer" for two days before an infusion. Unfortunately for me, the nurse scheduled myself and another patient using cold caps too close together, meaning my caps got bumped from the bio-freezer. I was not willing to delay my infusion because the type of aggressive cancer I had could only be cured by really aggressive chemo. I had my infusion with caps that were pre-chilled only one day prior and, as a result, I lost a lot of hair. Still, the good news is that the chemo nailed my cancer in the end, so the story has a happy ending, even if I lost chunks of hair at the time.
What is the Impact of Chemo on Hair?My hair did thin a lot during chemo, not just from this one scheduling snafu. The cold caps helped, but they did not prevent loss. They did save enough hair for me to wear what I called my “bun comb over” for three of the four months of chemo. For me, the biggest hair loss occurred in the mid-portion of my scalp because the caps were just too rigid to mold tightly to that area. I still get the chills when I think of the sound they made as my husband tried to bend and shape them to my head!
My scalp after 3.5 months of AC/T chemotherapy using cold capsThe scheduling snafu happened toward the end of the third month of my four-month chemo course. By that point, I felt too bald for the "bun comb over," so I started wearing a wig. Still, for me the caps were worth it because I could not face the double shock and loss of my lifelong hair identity at the same time I was reeling from the trauma of a breast cancer diagnosis. I was able to gradually acquiesce to the hair loss after I had the chance to cope with the cancer part.