Comparable Effectiveness of 45- and 20-Minute Post-Infusion Scalp Cooling Time in Preventing Paclitaxel-Induced Alopecia
Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
"Despite the progress made in delivering scalp cooling effectively, it remains underutilized. One reason for lack of use is the perceived burden on infusion center resources based on the need to perform prolonged scalp cooling both before and especially after the initation and completion of each chemotherapy session. This multi-center clinical trial, just published in Supportive Care and Cancer, studied reducing post-infusion cooling time after weekly paclitaxel to 20 minutes and demonstrated similar success rate of 75% compared to the usual 90-minute post infusion cooling. Adapting this reduced time is more convenient for patients and impacts minimally on infusion centers. More centers should adopt this effective intervention, so a broader group of patients have access to scalp cooling and its beneficial effects."
I don't know how new this technique is. I've yet to have chemotherapy so have no experience with it, but it has been discussed a number of times on this site.
If you follow the link given above, it mentions that the Dutch hospitals used "Paxman cooling machines for one person", and, "Scalp cooling was applied 30 min prior to the chemotherapy administration until 20 or 45 min after the end of infusion. Paclitaxel was infused over 1 h in all patients. Scalp cooling was applied during all planned cycles of chemotherapy, unless the patient decided to stop the cooling procedure based on intolerance, hair loss, or for other reasons."
Cancer.org has a section titled, "Cooling Caps (Scalp Hypothermia) to Reduce Hair Loss".
It's a cap with water in it, attached to a machine which brings it down/ keeps it at a very cold temperature (7C if memory serves). When it's cooling down (which takes about 15 mins) it's really painful, well it was for me, but then your scalp goes numb and you're fine.
I had it when I first had chemo and saved about 70% of my hair, I'd estimate. When i was diagnosed with MBC I definitely wanted it again and indeed had it for the first cycle, but after that I couldn't because they found mets on my skull and neck, and the cap is a very tight fit. So instead I lost my hair.
(It was just growing back nicely when I had to have radiotherapy to my brain... and kaboom! Hair fell out far more comprehensively than with the Docetaxel. Shiny and smooth as a billiard ball!!!)
It was weird to me that more women weren't doing the cold cap tbh, as it is so effective! The timing issue might be a factor, and/or the temporary pain (only bad for about five mins, though!)
I had my first chemo in 2005 and it wasn't around then, maybe it wasn't around in 2009 either but pretty much since then yes. So it is far from new at this point and yet it does seem that not so many places offer it. I'm sure it is a combo of hospital being tight with their $ and possibly insurance too. I mean if you are a smaller hospital with less competition you can easily get away with offering less. It sucks that more don't care about quality of care! The cold cap has not personally appealed to me because I hate the cold! BUT I was also younger when I lost my hair and chose to go bald and not wear a wig either. I'm not sure I feel as bold if I have to face that again in the future so it would be very nice to have that option to keep my hair! All women should have that option!
I know here in the US the responsibility falls to the patient who has to buy or rent the equipment. It is quite expensive and cumbersome as the cap has to be changed every 20". At least this was true 4 yrs ago during my first chemo. Insurance did not pay at the time.
when the initial dx was identified in Oct 2011, i was reading about the 'cold cap;' it was being offered by the breast onc. i did not need one. however, a woman i met, did, and she said it saved much of her hair.
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75 mg Ibrance & 10 mg inhibitor 
Hair loss or thining and hair color 
No benefit of chemo for ER+HER2- invasive lobular beyond estrogen therapy
Scan results after 11 months of Fulvestrant and Ibrance-75
