Decision-making guide

Keeping your hair despite chemotherapy has several advantages, such as:

• Preserve your attachment to your hair by protecting it;
• Maintain your usual appearance;
• Not being “labeled” as a “cancer patient” at first glance by everyone and being able to decide to whom we choose to reveal our health condition;
• Avoid, for yourselves and for your loved ones, the constant reminder of the illness with the slightest glance in the mirror, the slightest gust of wind on your bald head or the slightest movement of your wig or bonnet;
• Increase your comfort at the level of the head: the bald head can be sensitive, itchy, many have a cold head, wearing a wig can be impractical or uncomfortable especially when exercising or when puffing heat often induced by treatments, etc.
• Continue your life with more “normality”, which leads to more active behaviors, helping to make yourself less affected by treatments and increase your vitality;
• Contribute concretely to loved ones who want to help us so much and often feel helpless;
• Having a feeling of control over part of the protocol, while the care team's support can be confusing for those who feel this need for control;
• Experience the satisfaction of a first “victory”, very early and repetitively in your treatment protocol, by managing to Garde tes cheveux;
• Have the feeling of being taken seriously and of being well informed by your healthcare team, and engaging in chemotherapy treatment in a more voluntary, less “backwards” way;
• And so many others...

Cooling the scalp can help preserve your hair, but does not guarantee its complete preservation. Even with an effective protocol, mild to significant hair loss can occur. Although it may go unnoticed by others, you may notice a change in the appearance of your hair. However, many users of scalp cooling caps have been able to continue their daily lives without those around them really noticing any difference. Potential hair loss can be felt in a concealed manner (general loss of volume) and/or localized (around the ears, at the bottom of the neck for example). It varies from person to person and from medication to medication, but some hair loss is to be expected at some point during your treatment. No one can predict the results. Positivity is your best ally throughout the duration of treatments. It can be a challenge, but focusing on the positive aspects can really impact your treatment experience. Try to focus on the hair you still have on your head rather than the hair that has fallen out. Remember that without caps you would be 100% bald typically 17-21 days after receiving your first chemotherapy treatment. If you consider every preserved hair a victory, then the method will definitely be satisfactory for you. To find out more, see the [https://gardetescheveux.org/blogue/](Hair Tips) section of our [https://gardetescheveux.org/blogue/](Blog) section.

Authentic testimonials from people who have gone through the same process can greatly inform your understanding of what using scalp cooling caps really means. These stories are available in our [https://gardetescheveux.org/blogue/](Blog) section as well as in our Facebook group: [https://www.facebook.com/groups/199883352355289](the Garde tes cheveux Community). By reading the experiences of people who have followed treatment protocols similar to yours, you will gain a realistic perspective of the results others have achieved. However, it is essential to keep in mind that every story is unique.

It is essential to remember that the use of scalp cooling caps also promotes stronger, healthier and faster hair regrowth, our follicles being preserved. Even in the event of substantial hair loss, the use of caps can make the difference when it comes to regrowth. This gives you options, faster. You will also probably never look bald during treatment. Additionally, some chemotherapy drugs, such as Taxotere (docetaxel), can cause permanent (in about 5% of cases) or partially permanent alopecia. The use of scalp cooling caps also aims to protect your hair follicles against the possibility of such alopecia, ensuring healthy and sufficient regrowth.

Using this method requires additional time and energy. We must mobilize and take action. It's also a great way to mobilize those around you who are wondering how to help you and be useful. Making the scalp cooling cap experience a collective project with your family and friends can bring joy and optimal results.

If your healthcare center does not offer the use of scalp cooling caps, or if the rental of these caps is necessary to continue your treatment at home, have you assessed the total costs? This should include cap rental, security deposit (refundable upon return of caps), cost of dry ice, and cooler rental or purchase. We recommend that you contact your private insurer to check whether the use of scalp cooling caps is covered by your contract. Consulting your accountant to have the use of caps recognized as a tax-deductible medical expense is also a good idea.

Rest assured that we are here for you and to answer your healthcare staff's questions. If in doubt, or if your medical team does not recommend it, contact us. We will even be happy to put them in touch with oncologists at the University of Montreal Hospital Center (CHUM) who can reassure them. If possible, we can also help you put you in contact with a patient in your hospital who has used the method so that he or she can support you in your efforts by sharing their experience. . Remember that the use of caps is your choice. Your hair, your choice. There are three arguments to put forward if there is resistance to allowing the presence of a companion with you:

• The scalp cooling cap is a medical device recognized by Health Canada which requires an attendant to comply with the protocol. Consequently, the hospital must allow an attendant for the purpose of medical assistance. This is not a simple visitor.
• “Above all, a phrase that summarizes the fundamental principle of medical ethics, often attributed to Hippocrates, the ancient Greek physician considered the father of modern medicine. This maxim is often formulated in Latin as “Primum non nocere,” which literally means “First, do no harm.” This ethical principle reminds health professionals that their first duty is not to cause harm to their patients. Refusing a companion who jeopardizes the effectiveness and respect of the protocol and consequently the well-being of the patient is an action which directly harms him, in contravention of this oath."
• The Minister of Health Christian Dubé issued, in February 2023, a Directive asking hospitals to collaborate in order to facilitate access to the use of scalp cooling caps for those who wish to use them.

In the event of refusal, contacting the head of the department, the hospital patient committee, the complaints office or the hospital Ombudsman is one avenue.