sub-zero therapy lets a chemo patient keep her hair

Breast cancer patient uses super-chilled headgear to try to retain her hair

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By Stefanie Weiss
Special to The Washington Post
Tuesday, January 11, 2011

It's going to be a cold day in hell, so my friend Katherine dresses for the weather.

Iwatch as she pulls on a second pair of pants, a third shirt, warm socks. To guard against frostbite, she covers her forehead with moleskin, a thick bandage typically used to prevent blisters. Then she cuts panty liners (Light Days brand works well) into rectangles she sticks over her ears and her temples. ¶ Two things happen next, both unpleasant. Katherine's husband and sister-in-law struggle to tightly strap a gel-filled helmet, frozen to a temperature of 30 degrees below zero, to her head. Then a nurse connects an IV drip full of toxins to a port in her chest. Katherine wraps an electric blanket around herself, sinks into a Barcalounger and closes her eyes. ¶ "Oh, that's cold, that's really cold," she says. ¶ "I love it when you say that," her husband replies. "Otherwise, what would be the point?" ¶ Welcome to chemotherapy on the rocks. Chill the scalp, the theory goes, save the hair.

It sounds crazy, and it looks even crazier. That's Katherine Klein, professor of management at the Wharton School at the University of Pennsylvania, taping Kotex to her face and sticking her head into a blue Smurf hat so cold it would give a polar bear brain freeze. And that's her husband, John Gomperts, the director of AmeriCorps, wielding an infrared thermometer and enough dry ice to manage special effects at a Kiss concert.

Crazy, sure. But effective. After six chemotherapy treatments, thousands of dollars and a tremendous team effort, Katherine has a good prognosis and a full head of thick, blondish hair. Hallelujah!

Now, how'd she do that? And, let's be honest: Would you, in the face of a cancer diagnosis, go to all that trouble for your hair?

I remember the e-mail that came in June announcing that Katherine, 54 - a ridiculously fit, high-achieving, married-to-her-high-school-sweetheart mother of two - had early-stage cancer in her left breast and significant risk of a similar diagnosis on the right. In July, Katherine, who lives in the District, had a double mastectomy at Sibley Memorial Hospital. Since a single lymph node tested positive, she was told she needed six rounds of chemotherapy over 15 weeks.

She chose the dapper (and bald) Frederick Smith as her oncologist. As Katherine tells it, she was complaining to Smith about the prospects - very likely - of going bald herself for eight or nine months. (A little science here: Chemotherapy drugs are powerful poisons. Most kill all fast-growing cells indiscriminately - cancer cells, hair follicle cells, whatever. As a result, hair loss happens - not always but often, and it takes time for hair to grow back.)

Smith, Katherine recalls, "said in passing, with a roll of the eyes, 'You can try cold caps,' " a topic he'd written an article about in the 1980s.

"We used to use ice caps quite a bit back then," says Smith, whose office is in Chevy Chase. "It was a foam material you put in the icebox that was then put on the scalp a few minutes before, during and a few minutes after chemotherapy."

The theory, Smith explains, is that cold prevents hair follicles from absorbing the chemotherapy drugs, either "by reducing blood flow to the hair follicles or by causing freezing of the cells, which makes them less permeable."


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