Working at the Port of Oakland, Eve Grossman-Bukowski is used to feeling the bay breezes blowing through her thick, wavy hair. Even after a diagnosis of cancer and the resulting chemotherapy, keeping her hair has been a priority.
"I have 7-year-old twins and they know that I have cancer and for me, looking normal for them, it's very important for them to see a mother that looks normal and has energy," Grossman-Bukowski said.
To keep the chemotherapy drugs from causing her hair to fall out, Grossman-Bukowski freezes her scalp. First her husband Patrick unpacks a device known at the penguin cold cap from a cooler of dry ice and then begins wrapping her hair. The cap contains a lightweight gel, that stays soft even a very cold temperatures. In a little over half an hour her scalp will cool to about 31 degrees.
Doctors say the effect has been known for many years.
"The idea behind scalp cooling is that by cooling down the scalp, it constricts blood vessels and decreases the delivery of the chemotherapy drugs to hair follicles," Dr. Michelle Melisko of the UCSF Cancer Center said.
Grossman-Bukowski was already able to keep her hair through a previous round of chemo.
Although widely used in Europe, the freezing technique is not more widely used because the FDA and some doctors in the U.S. have concerns about the potential safety of cold caps.
"The concern that the cancer cells would hang out in the scalp and that chemo wouldn't get to the scalp," UCSF oncologist Dr. Hope Rugo said.
Rugo says whiles there is little evidence to support those concerns, the caps have not been rigorously tested in the U.S. Her team at UCSF has just launched a pilot study of a competing technology called the DigniCap. Manufactured by the Swedish company Dignitana, it employs a machine to cool the cap while it is worn, rather than relying on a freezer.
Cancer patient Heather Millar says the freezing process can cause pain as the temperature is lowered.
"It's like sticking your head in Lake Tahoe for six hours," she said.
But like Grossman-Bukowski, Millar says it is worth the sacrifice to keep her hair.
"I'm a very open person, I've been writing a blog about this experience, it's not that I'm so private, I just don't want to explain that I have cancer to the postal man," Millar said.
UCSF is recruiting early stage breast cancer patients for its DigniCap study. Patients who do not meet the criteria can invest in the penguin cold caps if they choose. Doctors will track the outcomes of both groups.
If the caps are proven to reduce hair loss, doctors believe that could lessen the concerns many women have about chemotherapy.
"Almost universally for women, they find it's the single biggest hurdle to get over," Rugo said.
Researchers at UCSF are hoping to expand their trial as they go, eventually opening it to a broader range of cancer patients.