Chemotherapy-induced alopecia (CIA) is a common and distressing side effect of chemotherapy treatment. Significant progress has been made during the past 2 decades in treating many of the side effects associated with cancer chemotherapy including emesis, hematopoietic cytopenias, xerostomia, infection, pain, and thrombosis. Similar progress has not been made in the prevention of CIA, apart from scalp cooling. We set out to examine the uptake, patient satisfaction and efficacy (as perceived by medical staff and patients) of scalp cooling treatment among patients receiving chemotherapy.
We reviewed a prospectively maintained database of patients who were offered scalp cooling treatment in our oncology dayward between 01/10/2014 and 22/06/2018. We analysed patient uptake and efficacy as perceived and recorded by medical staff (“medical efficacy”). A questionnaire was sent to patients who had accepted scalp cooling treatment and were alive at follow-up, to assess patient perceived efficacy and patient satisfaction. Patient perceived efficacy was compared to medical efficacy using the Fisher’s exact test.
The mean age was 60.1 (SD 10.9) and 91.4% of the patients were female. Uptake for scalp cooling was 49% (120/245). 75% (90/120) of patients were alive at follow up and 51% (46/90) responded to the questionnaire. Scalp cooling was considered efficacious in 63% (29/46) of patients, versus 43.3% (52/120) as assessed by the medical team, Fishers test p = 0.0253. 86.9% of patients who accepted scalp cooling and responded to the questionnaire (40/46) agreed or strongly agreed that they were satisfied with their choice to try scalp cooling, and 67.4% (31/46) agreed or strongly agreed that their experience of scalp cooling was a positive one. There was a strong association between patient perceived efficacy and satisfaction (p < 0.001).
The use of scalp cooling to prevent chemotherapy induced alopecia is an effective treatment in our real-world population. Patients were more likely than the medical team to consider scalp cooling treatment effective. We found high levels of patient satisfaction with the decision to try scalp cooling, even among patients whose treatment was ineffective.
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