Keeping hair during chemotherapy

This story was originally published in October 2018.

No one would know Hillary Piniaz just finished six rounds of chemotherapy at Baptist MD Anderson Cancer Center.

The 31-year-old breast cancer survivor looks in the mirror these days, more than seven months after finding a lump on her breast, and feels exactly like her pre-cancer self.

Some days, it seems like her cancer never happened at all. This mental strength, Piniaz said, stems from one seemingly small thing: her hair looks just as full and healthy as the day she was diagnosed with breast cancer.

"Not that my hair is my identity, but I've always had really long hair," said Piniaz, a St. Augustine elementary school teacher. "Everyone I talked to about their cancer treatment told me losing their hair was the hardest part."

Her surgical oncologist didn't mince words either. "I've been doing this for 28 years, and I can count on one hand the number of patients I've seen who didn't lose their hair during chemotherapy for breast cancer," said Christopher Pezzi, MD, the chief surgical oncologist at Baptist MD Anderson. "I told Hillary she was going to lose her hair, but that it would grow back."

Cold cap saves hair follicles

Dayra Avila-Lima, MD, a breast medical oncologist at Baptist MD Anderson, said hair loss associated with chemotherapy treatment is quite distressing for many women, but the development of cool cap technologies to prevent hair loss has relieved some of the stress associated with a diagnosis of breast cancer.

"The cooling cap system allows patients such as Ms. Piniaz to maintain a sense of self during such a stressful time in their life," Dr. Avila-Limai said.

The motivation to keep her long tresses led Piniaz to research a relatively new option for female and male cancer patients: cold caps and scalp cooling systems that provide patients with options beyond hair loss and wigs.

The scalp-cooling system consists of tight-fitting chilled caps that reduce blood flow to the scalp, resulting in fewer chemotherapy drugs reaching the hair follicles. When follicles are not exposed to a full dose of chemotherapy, hair is more likely to survive treatment.

Covering the cost of a cold cap

Unlike wigs, cooling caps are not covered by most insurance companies. However, patients with a health savings account or a flexible spending account can use those funds to cover the cost. Piniaz paid for hers out of pocket. But, to her, the cost (about $300 per treatment) was worth it.

Even now, as she undergoes another year of targeted therapy, Piniaz exudes a positive outlook. She attributes some of her good vibes to lifestyle choices: organic food, regular exercise, complementary Eastern medicine (acupuncture) and, of course, toxin-free hair care products.

"My cancer is gone, and I still feel like myself," Piniaz said. "I look like myself. To me, if insurance covered cooling caps and more people knew about them, it would be the norm. I think this should be available to everyone. That's my new mission."