Cold caps approved by FDA

Breast cancer patients have the option of keeping their hair during chemotherapy, or at least some of it. The Food and Drug Administration (FDA) announced in a press release on Dec. 8, 2015 that they have approved the first “cold cap” for marketing in the United States.

Kelly Ralston, of Encampment, used these cold caps before FDA approval for chemotherapy in 2014. While she still lost some hair, Ralston was able to keep half of her hair by using the cooling cap. The FDA mentions the Dignitana DigniCap Cooling system, which is a machine that one wears during chemotherapy treatments in order to freeze the hair follicles, restricting blood flow and preventing the drugs from reaching them.

Ralston used the Penguin Cold Caps, which were stored in a medical grade freezer and changed every 30 minutes during treatments. The caps were approximately minus 36 degrees Celsius, but Ralston said that it was not so cold that one would not want to use them.

Ralston’s journey began after asking oncologists about possibilities for not losing her hair, eventually hearing about cold caps from a doctor that specialized in breast cancer for younger women. She said learning about the cold caps was, for her, the moment when she realized she could make it through chemo. As a breast cancer survivor, Ralston thinks that more people would be open to or find peace with cancer treatments if they could just control something.

In Ralston’s experience, the hardest part of cancer was the thought of going bald because then everyone would know she was a cancer patient. The refrain she often heard was “It’s just hair. It will grow back,” but while Ralston felt that she would rather live than have hair, of course, it wasn’t simply hair. “It’s an identity and part of how you identify yourself,” Ralston said. With keeping at least some of her hair, she was able to control how she identified herself, which she did not want to be as a cancer patient all the time. “Saving your hair is not saving your life,” Ralston said, but the details about her improved quality of life leads to a glowing recommendation of cold caps, even if she does not love her hair post-treatment.

Ralston still experienced hair loss by the handfuls, which made her believe day after day that she would go bald during treatment. She didn’t, though. Her hair got thinner, but she did not go bald, which made the difference to her during treatment because despite the differences she saw, she did not have to be a cancer patient everywhere she went.

Before FDA approval, the caps were still available but could not be covered by insurance. Now, patients at a hospital or cancer center that have the DigniCap machine will be able to use it, hopefully covered by insurance. Not all cancer patients may benefit from the cold cap, but the FDA said that the possibility of missed cancer cells from restricted blow flow in the scalp for breast cancer patients is extremely low.

Ralston was able to afford the cold caps, which were rented, and the necessary freezer through the Rapunzel Project, a non-profit dedicated to helping chemotherapy patients keep their hair, and generous donations from the community. The Rapunzel Project donated the medical grade freezer in which the cold caps must be kept, which Ralston then donated to the Meredith and Jeannie Ray Cancer Center in Laramie. The overall cost of the caps was about $4,500.

About a-year-and-a-half after the start of her chemotherapy, Ralston said she has needed several haircuts to bring her hair all to one length, but she is nearly there. Ralston had very thick, straight hair before treatments and now has thinner hair that is half-curly, half-straight, since some was lost and grew back differently. Although she misses the hair she had before chemo, Ralston said she would do it again if she had to. “I didn’t look sick,” Ralston said, which made it “totally worth it.”