Scalp cooling in breast cancer: What are women's experiences? A description and qualitative study

BackgroundChemotherapy and adjuvant chemotherapy are still the primary methods for the treatment of Breast Cancer. However, chemotherapy-induced alopecia (CIA) remains almost universal and is rated by patients with BC as one of the most distressing treatment-related adverse effects. Many studies in the literature highlight that the use of Scalp Cooling (SC) leads to excellent results in preventing hair loss but there are no studies that delve into the psychosocial sphere of women during SC treatment. This study aims to explore the experiences of patients undergoing SC, collect patients' reasons for accepting the treatment, and describe hair loss with the DEAN score.MethodsA description and qualitative study with convenience sampling; 30 patients treated with the SC of the Dept. of Oncology Senology of INT IRCCS G. Pascale were enrolled. The Instrument used is divided into three parts: (1) biographical information and chemotherapy treatment (T0); (2) assessment with the Score Dean for hair loss (T0, T1, T2) and patients' perceptions of treatment discomfort with a 4-point Likert scale; (3) open-ended questions to allow patients to report their experience and motivation concerning treatment.ResultsOnly two patients (6.7%) had a Dean score of 2 (range 25-50%); the most reported perceptions of discomfort were: heaviness in the head (40%), feeling cold, and dizziness (23%). Qualitative Responses: patient1 [I received the marriage proposal a month before I found out about my disease and I was not ready to give much explanation]; patient2 [Not losing my hair makes me feel less sick...]; patient3 [I am a hairdresser and I could not continue working without hair]; patient4 [I wanted to continue being a full-time grandmother without scaring my grandchildren]; patient5 [I did not want to be seen with different eyes...]; patient6 [To not feel sick, I am only 25 years old...].ConclusionsDespite various side effects and discomfort all women in the study recommended the treatment. The strategies recommended to reduce discomfort were: a blanket and towel on the shoulders and a hot water bag behind the neck, a woolen band to cover the forehead and ears, or a hat to wrap wet hair. Such strategies can direct nurses to provide effective interventions in patients undergoing SC.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.