'Cooling Cap’ Helps Save Mom’s Hair during Breast Cancer Treatment

Podcast Transcript

Kyle: Hey everybody welcome to The Comeback I'm your host Kyle Michael Miller. During this episode we're talking with Jennifer Buckland, a mother of two who battled breast cancer and kept her hair during chemotherapy thanks to a cooling cap. We're also joined by her doctor, Director of Breast Oncology at Cleveland Clinic, Dr. Jame Abraham. But first, here's Jennifer in her own words.

Jennifer: Hi, my name is Jennifer Buckland. I'm 43 years old. I have two children, Ava age 10 and Zach age 7. In May of 2015 I was diagnosed with breast cancer and immediately underwent surgery, mastectomy with reconstructive surgery and 12 weeks of chemotherapy with one year of Herceptin infusions. I was fortunate enough during chemotherapy treatment to participate in a cooling cap study here at the Cleveland Clinic. Now I can say I'm cancer free three years later and still have my hair.

Kyle: Jennifer, Dr. Abraham, it's so great to see you guys.

Jennifer: Thanks! Thanks for having me.

Dr. Abraham: Thank you, Kyle.

Kyle: So Jennifer it's been three years since you beat breast cancer. You look terrific. How are you feeling?

Jennifer: Thanks, I'm feeling great. Definitely went through some ups and downs and have been focused on healing both physically and mentally and feeling stronger. I'm in a much different place even a year ago to today. And so I’m feeling good, feeling great actually.

Kyle: Do you feel you are back to your normal self now?

Jennifer: It's a new normal. It's not the normal I once knew but that's okay, I'm ok with that. I ran a half marathon for the Cleveland half marathon in May.

Dr. Abraham: Oh really?

Jennifer: I still owe you a photo. (Laughter) And I was starting to train for a full marathon but got injured. So now I'm the patient but I see that still on the horizon.

Kyle: Everyone who's diagnosed with cancer remembers the call, the call that they get. You were completely blindsided by that call. What do you remember about that day?

Jennifer: It was the end of May. There was a lot going on in the month of May. My grandmother passed away and in the midst of that I got a biopsy. I wasn't really giving it much thought. I came back from a trip to Boston with my family and I got a call from the pathologist saying we need to talk, and that's never a good call when somebody wants to talk to you directly. I got back to work the next day, still couldn't get a hold of pathologist. At my lunch break I ran into an office.

I think I told you this Kyle, I had this teeny tiny little sticky note that was smaller than the regular size sticky notes to jot down notes from this pathologist that was trying to tell me that they had found cancer cells. The language was foreign to me talking about DCIS and ductal carcinoma. Just foreign language to me. And I'm just trying to write on this little piece of paper and she just said ‘You know what, call the office. Let's get you in and we'll talk further.’ So yeah, it took me a while to kind of sink in what was going on.

I sat down with Dr. Fanning who discussed different options for me. I decided to opt for a mastectomy based on the characteristics of the cancer. From that mastectomy I got news that it was actually stage 1 invasive ductal carcinoma, so that prompted chemotherapy. One thing led to another. As far as the mammogram was, at age 40 you're just told by your primary doctor to go on in and get it checked out. Then you get another mammogram to repeat the first one because you have nothing to compare to. Then you go to the biopsy and it was just a very quickly moving kind of a falling out of the diagnosis. I didn't have much time to really process what was going on. I think when you're first diagnosed it takes a lot to wrap your head around what's going on and also to learn the language. I didn’t know, even though I work in the medical community, I don't know anything about anything for breast cancer.

Kyle: It's almost like a whole new world you were thrown into.

Jennifer: Right. So that one little sticky note isn't going to fill all the words that I need to explain what's going on. It's so complex.

Kyle: Dr. Abraham, Jennifer, like she just said, went through a mastectomy, chemotherapy, infusion treatments, reconstructive surgeries but she also had a new device called the cooling cap. What is the cooling cap and how does it work?

Dr. Abraham: We use chemotherapy especially when it is high risk and we're trying to prevent a recurrence of cancer anywhere in the body. As you heard from Jennifer, the diagnosis of cancer, the treatment really changes that person's life.

Jennifer: It comes to a complete halt.

Dr. Abraham:  Complete halt and it's…

Jennifer: A pause.

Dr. Abraham:  A pause and physical and emotional change. When we talk about chemo almost the number one concern from women is losing hair and changing their identity. You're losing hair, you heard about mastectomy, so these are all things which define that person. So, the cooling cap is a device which can potentially prevent chemotherapy induced hair loss. We did the original study which led to the FDA approval of this particular cooling device which Jennifer used. It’s almost like a helmet-like device. Patients put that on their head 30 minutes before starting the chemotherapy, then during chemo and they keep it on after the chemotherapy. It’s connected to a machine, Jennifer can probably explain this better, and a cooling fluid is circulating through this helmet-like device so it's keeping the scalp cold.

Kyle: And how cold does it get Jennifer?

Jennifer: I want to say it's below 32.

Kyle: So it's cold. (Laughter) Is it uncomfortable at first?

Jennifer: It is. It's kind of that mind numbing cold. That raw deep cold and then you get used to it. You forget about it.

Kyle: What are some of the other effects of the cooling cap? I know there are certain routines that you weren't able to do with your hair.

Jennifer: Right. So this is a whole ritual of preparing for it. I had chemotherapy each week once a week. The research team was pretty regimented in how they approached it as well. I couldn't use any hair products as far as hair dryer or flat iron. I had to brush gently and only wash every two, three times a week, very gently. You want to preserve whatever hair you had so they had a lotion that they put on the hair first and then they cover the rim of your scalp so that you don't have any kind of freezer burns. It’s a preparation for the cap and it worked.

Kyle: That’s great.  And it probably also made your morning routine a lot quicker. You couldn’t use a flat iron, you couldn’t use hair products… (Laughter)

Jennifer: Right and I’m addicted to flat irons so that was a hard one. (Laughs) But yeah, even tying your hair up in a ponytail holder things like that you couldn't do. You just had to be very gentle with your hair.

Kyle: And how long did that last?

Jennifer: The whole treatment?

Kyle: Yeah, for the cooling cap?

Jennifer: It was through chemotherapy treatment for 12 weeks.

Kyle: Dr. Abraham, is the cooling cap available for all cancer patients?

Dr. Abraham: The original FDA approval is for breast cancer and mainly early breast cancer. Our study was stage 1 to 2 breast cancer patients. We have that available in Cleveland Clinic now for breast cancer patients. The FDA is expanding its indication for tumors but predominantly focusing on breast cancer.

Kyle: Got it. Jennifer, obviously your main goal was to beat cancer but why was it so important for you to preserve your hair too?

Jennifer: Well I think it just keeps some sense of normal in your life. Losing your hair is a very visible sign that something is not right with a vibrant, healthy 40-year-old. My kids, my family, we could continue life as is and I think just plugging away at the day-to-day was important to me. And ‘oh by the way, I’m getting this treatment too’ it’s kind of a side note.

Kyle: Do you think that being able to keep your hair helped shield your kids from feeling the effects of their mom going through cancer?

Jennifer: Definitely. They really didn't miss a beat. They were young at the time. My son was two going on three, my daughter was six going on seven, so really little.

Kyle: Dr. Abraham, how does hair loss impact women emotionally who are going through breast cancer?

Dr. Abraham: As Jennifer said, the diagnosis of cancer really changes their life. Let's just say somebody is having surgery, of course that changes their appearance. Then as Jennifer is saying, the real feeling of sickness or being a so-called cancer patient comes when they get chemotherapy. Then as Jennifer is saying when they lose hair and appear in front of the rest of the world as someone who is sick.  So if we can at least help with one element of it, which is hair loss, there are multiple other things happening. There’s, vomiting, fatigue, neuropathy, all of those things. If we can help at least one key element of appearance I think it's really important. When we talk to the patients that's actually one of the things we talk constantly, hair loss and people ask ‘Am I going to lose my hair?’

Jennifer: I remember, Nancy, your nurse, she was telling me ‘Oh and by the way, you're going to lose your hair.’ I thought just real defiant, ‘I am not going to lose my hair, not going to happen.’

Kyle: And it didn’t!

Jennifer: It didn’t! But it just was like oh you're going to feel this, this, this and oh by the way this is going to happen. Get your wig, get your scarves and get prepared. Which I did, but I didn’t need it. I had to prove her wrong. (Laughter)

Kyle: So Jennifer, we're going to play a little game called Go Fish. I'm sure you've probably played it with your kids before. We have a fishbowl here in studio. Why don't you take the lid off of it and you're going to go fishing. There are three questions in there for you. Pull one out, read it and then give us your answer.

Jennifer: What's one thing you cherish now? My health for sure, health and vitality. The fact that I can get out and run, I did up to 15 miles. I've never done that in my life…so health. Dr. Abraham give me back my life. I have a dream team though, it’s Dr. Abraham, Dr. Fanning and Dr. Moreira. The breast surgeon, plastic surgeon and oncologist, that's my dream team.

Kyle: They took care of you.

Jennifer: Yes.

Dr. Abraham:  Thank you.

Kyle: And it probably also helps you, just normal things in your everyday life that you took for granted. People just waking up in the morning and having breakfast. You said you had two cups of coffee this morning. Like those little things, do they mean so much more?

Jennifer: Yeah, you miss those things when you're sick, ill and tired you just want to get up and do. You want to provide for your family. You want to work. I have a hard time sitting back and just letting life go by. I want to participate in it.

Kyle: Question two. Go fishing again Jennifer. (Laughter)

Jennifer: How has beating cancer changed your perspective at work? Oh that's a good one. I'm a physical therapist at Euclid Hospital outpatient rehab, shout out to my team there. I always would like to think that I had a lot of empathy on the job but once you have gone through something as big as what I went through you have a better, richer understanding of what the healing process is, what it takes to overcome. I feel like I can approach patient care with a much deeper, richer approach than I used to. I just have a different perspective and it gives you a little bit of street cred to say ‘I've been through this too. I know what you're going through because I've been through it.’

Kyle: And I’m sure your patients that you see appreciate that too.

Jennifer: Yes. So we see a lot of stroke-based neurological conditions and they’re, although it is not cancer per se, it is life-altering, life-changing and I get it.

Kyle: One more question in that fishbowl.

Jennifer: Where’s everybody else’s questions? (Laughter)

Kyle: It’s about you!

Jennifer: What would you like to say to encourage women diagnosed with breast cancer? I would like to say, and I think I've said this to you before, that you need to have faith in the medical community and stay true to your path. Just block out the noise that’s around you because there is a lot of noise. There are a lot of suggestions, ‘my aunt did this, my grandma did this’. I think you just have to be at peace with the path that you choose and that the doctors are going to lead you there.

Kyle: Dr. Abraham, what's your piece of advice for women battling breast cancer? Or even also talking just more broadly about why women should get screened.

Dr. Abraham: Now I can say that if you look at all the patients that come to my clinic, 80 percent of them will be cured or they'll have a long-term survival. My word is that breast cancer is a curable disease especially if it's diagnosed early. Fortunately in the U.S. about 80 percent of the breast cancers are diagnosed in stage 1 or stage 2 as Jennifer was saying. That’s mainly because of screening. It’s extremely important for women to have breast awareness and knowing how their breast is and second, do screening based upon their risk. They should be talking to their primary care doctors or family doctors about screening starting from the age of 40.

Kyle: What would you say to somebody who is diagnosed? Let's say they were getting diagnosed today, what would be your one piece of advice for them before they start on this whole new journey?

Dr. Abraham: I’ll echo what Jennifer said, it's really important to have a team whom you trust. It's really important to have a team. Breast cancer treatment is done by a team that includes a pathologist, a radiologist, a surgeon, medical oncology, radiation, plastic surgeon, nurses, and a genetic counselor. It's really, really important to have a team whom you can trust your life with.

Jennifer: Yes. I needed second opinions along the way. It seemed like every decision I made, it was shades of grey. I came to Dr. Abraham based on a second opinion and by the time I heard the information the second time around, he had a way of laying it out that just made sense to me. I think sometimes you have to hear it more than once and from a different perspective before you're at peace with it, at least for me it was. The same thing with radiation, I needed a second consult, they weren't sure if I needed it or not. In the end I did not need radiation but I have an alternative dream team member if I need him. He’s in the wings, if I ever need radiation. (Laughter)

Kyle: Well, we are so thrilled that you're doing so well right now.

Jennifer: Thanks!

Kyle: You look great, you feel good.

Jennifer: Yes!

Kyle: You're rebounding and the best is yet to come.

Jennifer: Yeah, thanks.

Kyle: Thank you guys so much for joining us today, and thank you everybody for listening. You can find additional podcast episodes on our website http://my.clevelandclinic.org/podcasts, iTunes, SoundCloud, Stitcher and Google Play. We’ll see you next time.