Why don’t all hospitals in Quebec offer the option to use cooling caps?
Some hospitals in Quebec provide cooling caps to patients free of charge, though in limited quantities. Some facilities use manual caps (such as Saint-Sacrement in Quebec City and Legardeur in Lanaudière), while others have fixed systems (such as in Gatineau). These hospitals handle the changing of caps and the installation for patients, offering a turnkey service that can simplify the treatment process. However, due to the overwhelming workload of healthcare staff, the protocol may not always be followed precisely, and essential information about hair care before, during, and after use may not be communicated correctly, potentially affecting results. The use of cooling caps for patient well-being is often seen as an additional burden on staff in an already strained healthcare system. The associated costs are also high. This is why some patients choose to rent manual caps in parallel to adhere to the manufacturer’s protocol and/or continue treatments at home to optimize their chances of success. Ideally, hospitals would implement autonomous systems or consider solutions such as biomedical freezers, dry ice supply, or self-service caps for patients. The Foundation is actively working to create support programs to make life easier for chemotherapy patients who wish to preserve their hair. Check the [https://gardetescheveux.org/en/obtenir-du-soutien/](Get support) section of our website to learn more about upcoming programs, which we hope will be supported by partners. At the same time, it is crucial to understand the key success factors that can influence the effectiveness of this method, and it is important to question your healthcare staff about this if the method is offered at your hospital:
- **Adhere to cooling time**: To effectively prepare the scalp before chemotherapy, it is recommended to wear the caps for 50 minutes before the infusion starts and throughout the infusion according to the manufacturer’s instructions. Chemotherapy agents typically remain very active in the body for at least 4 hours, according to the drug monograph (the drug’s half-life is a good reference point). Using fixed or manual cooling caps offered by the care environment often requires the patient to stop using the caps (often to free up their chair in the chemotherapy room) after only 1.5 hours post-infusion, which is a major issue. Wearing the cap for at least 3 to 5 hours after the infusion is essential, which is why manual cooling caps that can be continued at home after the infusion have proven effective. This significant difference in cooling duration undoubtedly explains the variation in the quality of results obtained.
- **Maintain cap temperature**: Keeping the caps at the correct temperature is crucial, which is why manual caps should be changed every 20 to 25 minutes. Some care centers that offer manual caps might choose to change them every 45 to 50 minutes, but this frequency does not maintain a sufficiently low temperature and reduces their effectiveness.
- **Follow hair care protocol**: The chemotherapy still weakens the hair follicles, so it is essential to follow a rigorous hair care protocol. For example, a patient who does not follow the recommended hair washing protocol, uses non-recommended hair products, or applies dye will see their results affected.
- **Respect cap lifespan**: Generally, crylon gel loses its effectiveness after about 1 year of use, or approximately 3 patients. Some care centers continue to use the same caps year after year, which diminishes their performance over time. It is important to inquire about this.
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