Vanderbilt-Ingram Cancer Center has started offering scalp cooling, which mitigates hair loss for patients receiving certain chemotherapy regimens.
The DigniCap Scalp Cooling System was launched this month at Vanderbilt-Ingram Cancer Center Belle Meade. It is available for patients with solid tumors from breast cancer, prostate cancer, ovarian cancer, uterine cancer and lung cancer. The system consists of a tightly fitting silicone cap connected to a cooling and control unit, as well as an insulating outer cap. The system is more efficient and comfortable than portable options for scalp cooling that patients can bring with them to infusion visits.
Karline Peal, MBA, RTT, associate operating officer of Vanderbilt-Ingram, has led the initiative to begin the service after being recruited in 2020 from Northwestern Medicine in Chicago, which offered scalp cooling at select locations.
In addition to serving Vanderbilt’s patient population, there is a personal connection to scalp cooling for Peal.
“When I was a child and my mom had cancer and lost her hair, it wasn’t only traumatic for her; it was traumatic for us kids to see her lose her hair. That’s part of the reason why I advocated for this contracting process here because although many women battling cancer may not care about their hair, there is a huge portion — especially younger women with children — who do care. They want to go to work with their own hair, go to school functions and maybe a child’s wedding. One of the women we treated at Northwestern was so grateful she could go to her son’s graduation with her hair.”
Bringing the cooling system to Vanderbilt-Ingram entailed contracting with a vendor, identifying a clinic to pilot the service, and training administrative staff how to inquire with insurance companies about coverage and then input the payment codes for reimbursement.
Minimizing hair loss can benefit patients emotionally, said Sonya Reid, MD, MPH, assistant professor of Medicine in the Division of Hematology and Oncology.
“Hair loss can be a very emotional experience to patients who are already dealing with a new cancer diagnosis,” Reid said. “I discuss scalp cooling as an option to reduce hair loss for patients receiving certain types of chemotherapy for breast cancer.”
The Belle Meade clinic was chosen as the pilot site for the service because it sits in a convenient location, and it typically has longer infusion hours than other Vanderbilt-Ingram clinics and can accommodate the extra time patients need for the cooling system to be administered, Peal said.
The Food and Drug Administration first granted marketing approval for the DigniCap system for patients with breast cancer in 2015, then in 2017 the FDA expanded the authorization, making it the first cooling cap cleared for use in cancer patients with solid tumors receiving chemotherapy.
The FDA granted the initial authorization after a medical study demonstrated that more than 66% of patients treated with the DigniCap system reported losing less than half their hair.
The cooling system constricts blood vessels in the scalp, which reduces the amount of chemotherapy that reaches cells in the hair follicles. The cold temperature also decreases the activity of the hair follicles and slows down cell division, making them less affected by chemotherapy, the FDA said in a release. The agency noted, however, that scalp cooling may not work with some chemotherapy regimens.
The system is not approved for pediatric patients, patients with certain cancers and patients undergoing specific chemotherapy treatments. The FDA noted that it may not be appropriate for patients with cold sensitivity or susceptibility to cold-related injuries.
