1Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA.
2University of Michigan Medical School, Ann Arbor, MI, USA.
3Department of Ophthalmology, University of Michigan, Ann Arbor, MI, USA.
4Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
5Rogel Cancer Center, 1500 E Medical Center Dr SPC 5916, Ann Arbor, MI, 48109, USA.
6Departments of Surgery, Pathology, and Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
7Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. mburness@med.umich.edu.
8Rogel Cancer Center, 1500 E Medical Center Dr SPC 5916, Ann Arbor, MI, 48109, USA. mburness@med.umich.edu.
Chemotherapy-induced alopecia (CIA) is a stigmatizing and psychologically devasting side effect of cancer treatment. Scalp cooling therapy (SCT) is the most effective method to reduce CIA, yet it is underutilized. We investigated factors that may impact scalp cooling discussion and use.
We performed a retrospective review of cancer patients from 2000 to 2019 who had documentation of SCT discussion in the electronic medical record. The University of Michigan Rogel Cancer Center registry was used to identify the total number of cancer patients eligible for SCT during 2015-2019. Chi-square tests were used for outcome and patient characteristic comparisons (p < 0.05).
From 2000 to 2019, 194 patients had documentation of SCT discussion. Of those, 72 (43.6%) used SCT, 93 (47.9%) did not use SCT, and the remaining 29 (17.8%) had unknown SCT use. A total of 5615 cancer patients were eligible for SCT from 2015 to 2019. As compared to those who did not have documented SCT discussions, patients who had documentation of SCT discussions in that period (n = 161, 3.0%) were more likely to be female, have breast cancer, be less than 45 years old, and live in a zip code with average income > US $100,000 (all p < 0.0001). Between 2015 and 2019, 57 patients (1.02%) used SCT. On univariate analysis, patient-initiated conversation about SCT (p = 0.01) and age less than 65 (p = 0.03) were significantly associated with decision to use SCT.
There were distinctions in the types of patients who have documented discussions about SCT. Improving patient knowledge about the availability of SCT and increasing access to this technology for all eligible cancer patients may enable more patients to achieve improved quality of life by reducing or preventing CIA.
Chemotherapy-induced alopecia; Cold cap therapy; Hair loss prevention; Manual cold caps; Scalp cooling therapy.
