Reducing alopecia in breast cancer patients undergoing chemotherapy with scalp cooling

Abstract

Introduction: Chemotherapy for breast cancer treatment may cause hair loss which leads to negative effects on the physical and mental status of the patients especially in their body image. Generally, the hair will regrow within 3 months after the completion of such agents. However, some regimens including docetaxel bring about long-term effects such as permanent hair loss (permanent alopecia) and this is one of the patient’s reasons for refusing chemotherapy. The Surgical Oncology Daycare Unit has provided scalp cooling cap to patients receiving chemotherapy which aim to reduce the degree of hair loss, increase the quality of life, enhance psychological support, and promote the image of patients.

Objective To reduce the level of hair loss (level 4-5) in breast cancer patients receiving chemotherapy to 50% within 12 months.

Methods 1) Educate the nursing team caring for breast cancer patients receiving chemotherapy with scalp cooling and improve work instruction. 2) Prepare a leaflet for patients undergoing scalp cooling. 3) Create gel support to decrease the gap between the mid part of the scalp and the cover cap. 4) Apply the facial strap to make the gel cap closer to the scalp. 5) Record the size of the gel cap and cover cap for each patient to identify individually.

Results: The hair loss in breast cancer patients receiving chemotherapy with scalp cooling decreased from 84.42% to 72.50%.

Conclusion The nursing guidelines for reduction of the hair loss in breast cancer patients receiving chemotherapy with scalp cooling have been developed. Work instruction was revised for assessing hair loss levels based on Sinclair's scale. The facial straps were applied to keep a cool gel cap attached to the scalp. Moreover, the self-care leaflet for patients and the guideline for assessing the level of hair loss have been conducted according to Sinclair's scale by demonstrating pictures of the hair grading system.