68 Gynecologic and breast cancer patient experiences with scalp cooling to reduce alopecia

Objectives: Chemotherapy-induced alopecia represents a significant patient concern. The DigniCapTM Scalp Cooling Device is not covered by health insurance and patients pay out of pocket for each chemotherapy infusion. Previous reports comprised of heterogeneous populations with mixed results have not focused on the patient experience. We sought to assess patient satisfaction and efficacy of scalp cooling to reduce alopecia. Methods: Patients with gynecologic and breast cancers in all disease/ treatment stages were invited to participate in an IRB-approved telephone survey at an academic affiliated community cancer center during the summer of 2021. The survey consisted of 10 questions using a 1–10 scale to assess symptom severity and satisfaction. Results: 35 patients were contacted and 28 completed the survey (80.0%). Mean age was 51.6 yrs and 78.5% identified as non-Hispanic white, 14% Hispanic, and 7% Asian/Pacific islander. Ovarian/ tubal cancer was most common (51.3%), followed by breast (35.7%), endometrial (7.1%), and cervical (3.5%). All patients received paclitaxel 175 mg/m2 BSA. The total number of chemotherapy cycles with scalp cooling ranged from 2–17. The majority of patients were very or somewhat satisfied (71.3%) with 57% of patients reporting greater than 50% hair preservation. The most common side effects were uncomfortable coldness and headache. Most side effects improved within 30–60 minutes (60.7%) while 39.2% reported symptoms persisted throughout. Finally, the majority of patients (57%) felt that the financial cost ($180/infusion) was worth it and would definitely recommend its use for others. Conclusions: Scalp cooling may allow for hair preservation in the majority of patients with gynecologic and breast cancers treated with paclitaxel. Most patients were satisfied with their experience. Additional research is needed to explore the financial implications and variation in experience among different racial/ethnic and socioeconomic groups.