The Facts

Cooling the scalp effectively reduces the delivery of chemotherapy to this part of the body and therefore, the issue of scalp metastases as a potential risk of scalp cooling merits further discussion.

The naturally occurring incidence of scalp metastases in patients with breast cancer is approximately 1 in 4,000.

Over the last 20 years many studies have been undertaken in which scalp cooling has been investigated and reported.

There is no clinical evidence that cooling the scalp during adjuvant and palliative chemotherapy regimes increases the risk of developing scalp metastases and the issue remains entirely theoretical.

Those few cases of scalp metastases which have been reported in connection with scalp cooling were in patients who were being treated for existing advanced metastatic disease.

Paxman Hair Loss Prevention Systems have been in use over the past 9 years and during this time have treated thousands of patients throughout the UK and Europe . We are not aware of any reported increase in the incidence of scalp metastases and endorsements have been received from medical professionals which support these claims.

Professional Opinion

"We have used scalp cooling extensively for a number of years at this hospital and I have used it increasingly since I was appointed here in 1996 as this was the existing practice.

As we discussed, I confirm that I am not aware of any randomised data showing an increased risk of developing scalp metastases in patients who have received scalp cooling with their chemotherapy, either in an adjuvant or palliative setting. Our own anecdotal experience is that I have seen 2 or 3 patients in the last 5 years with scalp metastases, none of whom had previously experienced chemotherapy with scalp cooling. In other words, through our experience, I have seen no patients in whom I have felt that this might, conceivably, be a contributing cause to the development of scalp metastases."

J Joffe, MacMillan Consultant in Medical Oncology, Huddersfield Royal Infirmary.

	Click here to view/print the paper titled "Efficacy and safety of cooling helmets for the prevention of chemotherapy-induced alopecia: a prospective study of 911 patients " Spaëth et al

	Click here to view/print the paper titled "Efficacy and tolerance of a scalp-cooling system for prevention of hair loss and the experience of breast cancer patients treated by adjuvant chemotherapy" Protière et al.

Click here to view/print the paper titled "Scalp metastases and scalp cooling for chemotherapy-induced alopecia prevention" C. Christodoulou et al, Medical Oncology Department, Henry Dunant Hospital, Athens. Annals of Oncology 15 September 2005.