A Baclesse nursing team is to launch the world's first study comparing two techniques for preventing hair loss by cooling the scalp to determine which is more effective.
Hair loss: Why?
Breast cancer affects more than 2 million patients worldwide, and is the most common cancer in women, including in France (nearly 60,000 new cases diagnosed/year).
Chemotherapy treatments for breast cancer can cause certain side effects. Chemotherapy-induced alopecia (CIA), or hair loss, is one of these side effects, which is almost systematic without hair loss prevention devices. In most cases, it is temporary, but may persist in 10 to 20% of cases.
For patients and those around them, hair loss is considered a symbol of cancer, and sometimes the only outward sign of the disease. As a result, hair loss is one of the least tolerated side effects of chemotherapy. Some patients refuse chemotherapy to avoid hair loss. Hair loss can have significant psychosocial consequences, with a negative impact on self-image and psychosocial well-being. Hair regrowth usually starts 4 to 6 weeks after the last course of chemotherapy, but may be slower if certain molecules are used, including those used in breast cancer chemotherapy.
What can be done about it? By cooling the scalp
At present, only scalp cooling with cooling helmets during chemotherapy sessions has been shown to be effective in reducing hair loss.
Indeed, cold has the effect of constricting the blood vessels of the scalp and reducing blood flow near the hair bulbs during and after treatment. The medication will circulate less around the hair roots, protecting them from the treatment. The use of these cooling devices is harmless. There may, however, be unpleasant effects, such as a headache from the cold. Patients are advised to bring warm clothing with them, as the cold on the scalp is better tolerated when the body is warm.
Scalp cooling not only reduces the risk of hair loss, but also promotes earlier, better-quality regrowth. The compressive application of these helmets optimizes the vasoconstrictive effect of cooling and reduces blood flow to the scalp.
Baclesse launches ICELAND, care research on 2 cooling helmets
From early 2023, the Centre Baclesse, funded as part of a hospital nursing and paramedical research program, will be setting up a new care research study to compare two scalp cooling devices used in the prevention of chemo-induced alopecia (CIA) or hair loss that occurs during chemotherapy treatments in breast cancer.
Currently, two scalp cooling techniques are used:
"Classic cooling helmet versus electric cooling helmet
Firstly, the classic cooling helmet is a gel-filled device that is kept cold in a freezer (-25°C) before being fitted to the patient's head. This technique requires several helmet changes during a single chemotherapy session (as the helmets heat up on contact with the scalp).
Secondly, the "scalp cooling" technique, or electric cooling helmet, takes the form of a helmet with automated circulation of a cooling liquid always at the same temperature (around 0°C). Most French centers, including the Centre François Baclesse, limit themselves to the use of conventional cooling helmets. In international trials, these two devices have proven their effectiveness compared with no prevention (helmets versus no helmets).
The ICELAND study will compare these two techniques to determine which is more effective in managing this side effect. It will involve a group of 206 patients over a total period of 36 months.
It will also look at other issues such as patient and caregiver comfort levels, body image, quality of life, return to work and/or daily activities, caregiver time and the cost of each device.
The aim is to offer patients the most effective technique, while respecting the financial constraints of a healthcare establishment. The Paxman® electric cooling helmet to be used in the study has been in development for over 20 years, and more than 100,000 patients worldwide have benefited from this device. Paxman® is a British family business. It was born out of the chemotherapy-treated breast cancer of the founder's wife, who, despite prevention with a conventional cooling helmet, had lost her hair and was traumatized by it. Her husband, an expert in refrigeration devices (cooling for draught beer), was determined to develop a new device.
This study should provide results that will lead to best practice recommendations on hair loss prevention for patients treated for breast cancer, and determine which of the 2 techniques is the most effective. It will provide an answer to a question that has so far received little attention, but is nonetheless essential for patients.
At the Centre François Baclesse, the ICELAND study is being set up by theParcours de soins Sein team, represented from left to right in the photo by : Tiphaine LEROUX, Rose-Marie CHARLES and Charlotte DUPONT (nurses), François GERNIER (care research coordinator) and Dr Adeline MOREL (medical oncologist).
