Nurses Help Bridge Patients Undergoing Chemotherapy to Scalp Cooling Therapy


A nurse-led intervention demonstrated initial success in connecting patients to scalp cooling therapy and reducing the impact of alopecia.

A nurse-driven program successfully connected patients undergoing chemotherapy with scalp cooling treatment, according to results that were presented as a poster during the 47th Annual Oncology Nursing Society Congress. Furthermore, patients who completed the program expressed high satisfaction levels with scalp cooling and retained 50% more hair than anticipated with this type of treatment.

Overall, 15 patients elected to undergo scalp cooling therapy and more than 80 treatments were administered since June 2021. Although 2 patients stopped treatment because they felt overwhelmed, patients who completed all cycles expressed high levels of satisfaction, according to the study authors. In addition, the nursing staff reported satisfaction with the amount of training and resources provided during implementation and “are proud” that scalp cooling is offered at their institution.

Many patients expressed gratitude for being connected to the therapy through testimonials.

“It really sucks to go through cancer treatment, I am so glad I had scalp cooling… I am so appreciative I was given the chance to save my hair and keep a part of my identity,” 1 patient shared during a testimonial.

“Nurses are at the forefront of promoting and educating patients throughout the care continuum for supportive care interventions, such as scalp cooling,” Linda Amacher, BSN, RN, OCN, of Froedtert & the Medical College of Wisconsin, addedin a presentation of the findings. “[In this case,] there was quick adoption by nurses, and processes were integrated into clinic and infusion workflows without significant challenges.”

More than 75% of patients with cancer fear experiencing alopecia because of chemotherapy. Since scalp cooling was FDA approved in 2017, patients and oncology care teams have become interested in its ability to reduce the volume of hair loss induced by treatment.

Following favorable efficacy and safety data with scalp cooling, a team of oncology nurse decided to pilot a scalp cooling program at a community-based cancer center connected to the Froedtert Medical College of Wisconsin.

Investigators created an interprofessional team to oversee the program implementation. The team was led by an oncology clinical nurse specialist and included other nurses, providers, a scheduler, managers, and aesthetics wellness coordinators. The members were tasked with evaluating costs, machine support, space, scheduling, and staff workload. They also set to create roles, workflows, scheduling templates, nursing documentation texts, patient education, and evaluation tools.

Staff training included a demonstration of how scalp cooling works, the clinical data and efficacy behind it, and cooling machine system procedures, including patient introduction and education. Nurses and aesthetic coordinators specifically learned about patient enrollment, prescription, consent, cap fitting, system operation, and patient hair care and education materials.

Having an advanced practice nurse—driven program was a key to successful implementation, the authors concluded, noting that overall, the implementation was successful and well received.

“Patients that have completed all treatments have expressed high satisfaction on our evaluation forms and are happy to report retaining more than 50% of the hair expected,” concluded Amacher. “Staff have also expressed satisfaction in the amount of training received resources provided and are proud that we offer scalp cooling.”

Other cancer centers may wish to consider program development using a nurse-driven model, Amacher added.


Amacher L, Herriges D, Portz D, et al. Hairs the deal: implementing scalp cooling for chemotherapy-induced alopecia at a community-based cancer center. Presented at: 47th Annual Oncology Nursing Society Congress; April 27-May 1, 2022; Anaheim, CA. Abstract P44.

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