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Cleveland Clinic Innovations. (2017). #10, Scalp cooling for reducing chemotherapy induced hair loss. Retrieved from http://innovations.clevelandclinic.org?Summit?Top-10-Medical-Innovations/Top-10-for-2018/10-Scalp-Cooling-for-Reducing-Chemotherapy-Induce.aspx

Breast Cancer. (2018). Cold caps and scalp cooling system. Retrieved from https://www.breastcancer.org/tips/hair_skin_nails/cold-caps

National Cancer Institute [NCI]. (2017). FDA clears wider use of cooling cap to reduce hair loss during chemotherapy. Retrieved from https://www.cancer.gov/news-events/cancer-currents-blog/2017/fda-cooling-cap-chemotherapy

Rugo, H. S., Klein, p., Melin, S. A., Hurvitz, S. A., Melisko, M. E., Moore, A., … Cigler, T. (2017). Association between use of a scalp cooling device and alopecia after chemotherapy for breast cancer. The Journal of the American Medical Association, 317(6), 606-614. doi: 10.1001/jama.2016.21038

Schaffrin-Nabe, D., Schmitz, I., Josten-Nabe, A., von Hehn, U., & Voigtmann, R. (2015). The influence of various parameters on the success of sensor-controlled scalp cooling in preventing chemotherapy-induced alopecia. Oncology Research and Treatment, 38(10), 489-495. doi:10.1159/000440636

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Paxman Scalp Cooling. Rest of the world Overview.

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The system consists of a 'cold cap' made out of light weight silicone that connects to the refrigeration unit via the cooling line. The caps come in different sizes to accommodate most head shapes.
https://www.paxmanusa.com/

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The system consists of a tightly fitted silicone cap that connects to the cooling and control unit. The cap has sensors that monitor scalp temperature. The temperature is regulated by the cooling and control unit throughout the treatment allowing comfortable cooling therapy.
https://dignicap.com/

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FDA has evaluated several studied including studies by Rugo et al. (2017) and

Schaffrin-Nabe, Schmitz, Josten-Nabe, von Hehn, and Voigtmann (2015). Based on the studies, FDA approved two systems for scalp cooling therapy: The DigniCap system and the Paxman System (NCI, 2017).

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It is very distressing for the patients to receive news of their cancer diagnosis. For women especially, it is even more devastating to know that the hair loss is inevitable with chemotherapy treatment. Some patients do not complete chemotherapy cycle or avoid chemo treatment altogether due to the distressing side effect of hair loss. Scalp cooling technology allows to receive cooling therapy before, during, and after chemotherapy and help reduce the frequency and severity of hair loss (NCI, 2017).

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In order for my facility to adapt this technology, I need to choose the team to evaluate everything about it: effectiveness, cost, and other aspects. My strengths are: achiever, competition, activator, relator, and focus. I am going to be the leader of this group and I will need the team that will be able to follow my direction as well as to be productive with their assigned tasks. In addition, my team should be able communicate with each other and function independently as well as collaboratively. The team that have put together is the following:
- David - Deliberative. I choose David for his ability to seriously evaluate the technology. He will be able to ask the right questions about it and identify any risks related to it.
- Sheila - Strategic. I choose Sheila because of her ability to research and acquire different ways of getting the technology if faced with unexpected choices.
- Pablo – Positivity. I choose Pablo because he will be able to keep the team moving forward and keep them excited about the technology and its benefits for our facility and the patients.
- Fernando – Focus. I choose Fernando because he will be able to find ways of getting technology to the facility, its cost, set-up, and operation requirements.
- Carter – Communication. I choose Carter so he can keep the team communicating with each other and keep each member of the team with the assigned task. He will also be able to make necessary communication going with the vendors that provide the technology.

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Chemotherapy induced hair loss can be devastating. To help patient through the difficult time of chemotherapy sessions and subsequent hair loss, the scalp cooling technology offers a solution. Though not 100% effective,  the scalp cooling system is proved to be effective in reducing hair loss. The cost of the system is a concern though. Most insurance carriers do not cover this therapy, and patients are left to pay out of pocket. To its advantage, however, this technology lacks significant adverse effects. I believe that cancer centers throughout the US should offer this technology to their patients to help minimize devastating side effects of chemotherapy.

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- Not 100% effective.
- Expensive, average cost >1,000$ depending on the number of cycles of chemotherapy.
- Most of the time, it is not covered by insurance.
- There are concerns that scalp cooling system prevents chemotherapy from reaching cancer cells that might be in the skin of the scalp (Breast Cancer, 2018).
- Cannot be used on patients on indefinite chemotherapy.
- Headaches caused by cold, neck and shoulder discomfort, pain from wearing the caps for extending periods of time (NCI, 2017).

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-Two scalp cooling systems are FDA approved in the US (NCI, 2017).
- Noninvasive system.
- Many women agreed that the cost of the scalp cooling therapy is appropriate and comparable with the cost of the wig (Breast Cancer, 2018)
- Significant results in preventing hair loss due to chemotherapy supported by studies.
- Helps preserve dignity and compliance for chemo treatment.
- No significant adverse effects.
- Can be done conveniently in the cancer center during and around the chemotherapy treatment.

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Scalp cooling technology works by reducing the temperature of the scalp immediately before, during, and after chemotherapy treatment. Scalp cooling causes the blood vessels to constrict which reduces the amount of chemotherapy received by hair follicles. In addition, cold reduces the cell division of hair follicles, and since chemo attacks rapidly diving cells, inactive or less active follicles are less likely to be affected by chemo medicine.
Breast Cancer (2018).

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This technology has been presented as a #10 for top 10 innovations by Cleveland Clinic (2017).

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Scalp Cooling for Reducing Chemotherapy Hair Loss: Top 10 Medical Innovations 2018