How a cooling cap could change breast cancer treatment

When Donna Tookes learned she had breast cancer last winter, the 59-year-old thought she had no choice but to accept one of the most dreaded side-effects of chemotherapy: losing her mane of silver hair, a feature that strangers young and old frequently stopped to admire.

"I had resigned myself," Tookes told CBS News. "I had purchased an array of scarves, about 10. And I actually practiced tying them."

Tookes was diagnosed with breast cancer in January after her annual mammogram, when her doctors detected some mild calcifications in her right breast. These clusters of white flecks visible on her scan indicated there might be something seriously wrong. After a few subsequent tests, Tookes learned she had HER2 breast cancer, an especially aggressive form that can be difficult to treat. Though her doctors caught the cancer early, they wanted to be certain it would never return, which meant a unilateral mastectomy followed by 12 rounds of punishing chemotherapy.

"You have a consultation before you start chemotherapy," said Tookes, who lives with her husband and children in Stamford, Connecticut, and has worked for more than three decades as a flight attendant. "I was told I would lose my hair. And then the nurse assured me, she told me 'you're beautiful,' and that I was one of the only ones who could carry the bald look because I have that bone structure."

But her family could see that losing her hair would take a serious toll on her psyche. Tookes had heard about some treatment in Europe that helps prevent chemo-related hair loss, though she didn't know many details. Secretly, her husband began to conduct research. He wrote to friends in Sweden, who were able to obtain information about a new and innovative therapy called a scalp cooling cap. He soon found out that Mount Sinai Beth Israel in New York City was involved in a clinical trial on the device, known as the DigniCap System, which is worn by a patient during chemotherapy transfusions.

The snug cap is secured onto a patient's head each time she undergoes chemotherapy. It chills the scalp down to 5 degrees Celsius so that the blood vessels surrounding the hair roots contract, meaning that less of the toxins from chemo enter the hair follicle. This minimizes -- and in some cases completely stops -- a patient's hair from falling out.

At first, Tookes was slightly skeptical, but her family finally convinced her to move her cancer treatment from her hospital in Connecticut to Mount Sinai Beth Israel in New York City.

Dr. Paula Klein, assistant professor of medicine, hematology and medical oncology at the Icahn School of Medicine at Mount Sinai and principal investigator for the clinical trial, told CBS News the device has been effective at limiting hair loss in nearly all of her patients enrolled.

"Unfortunately, in breast cancer the two most active agents are associated with significant hair loss," said Klein. "For many women with early stage breast cancer, they are getting chemotherapy for prevention of recurrence."

Klein said overall, women who use the cap lose just 25 percent of their hair. There are some patients who lose more and a lucky handful who lost no hair at all.

The clinical trial is now in its final phase. The company behind the cap, Dignitana, will be submitting results to the U.S. Food and Drug Administration by the end of November, and hope to win FDA approval for the cap in 2015.

For women struggling through a difficult medical ordeal, the benefit is significant. Research published in 2008 in the journal Psycho-Oncology looked at 38 existing studies on breast cancer treatment and quality of life issues, and found hair loss consistently ranked the most troubling side effect of treatment for women. "Significant alopecia [hair loss] is problematic," said Klein. "Every time you look in the mirror, you remember you're getting cancer treatment."

Many breast cancer survivors report that even when their hair finally grows back after chemotherapy it is often different in color or texture than the hair they had before, due to the period of time it takes the hair follicles to recover from the damage caused by the drugs.

Moreover, the feelings associated with hair loss impact nearly every aspect of a breast cancer patient's life -- from her self-image and sexuality to whether or not she is comfortable at work or even walking into the supermarket to buy a quart of milk.

When she first prepared for treatment, Tookes worried how people would react to her appearance if she lost all of her hair. But it didn't happen. Seven weeks into chemo, she finally felt confident enough to return the unused wardrobe of scarves. She still had a full head of hair. Because the cooling therapy was used only on her scalp, Tookes did still lose her eyebrows and "everything south of there."

Tookes is now cancer-free and says the therapy helped her stay optimistic about her prognosis. "My mother used to say, you just comb your hair and get yourself together and you'll get through hard times," she said.