Factors influencing patients’ decision to undergo scalp cooling in breast and gynecological cancer.

Abstract

e24175 Background: Chemotherapy-induced alopecia is a common and distressing side effect associated with the treatment of breast cancer (BC) and gynecological cancer (GC). Scalp cooling (SC) during chemotherapy decreases hair loss; why patients opt in or out of SC is unknown. A pilot study was conducted to determine reasons for opting in or out of SC. Methods: Patients at Loyola University's Cardinal Bernardin Cancer Center with BC and GC who were offered SC from 4/11/18 to 6/26/19 were asked to complete a survey ranking the importance of pre-specified factors behind their decision to (or not) pursue SC. The study was approved by the IRB. Chi-squared and Fisher’s exact tests were used on categorical variables; Wilcoxon rank sum test was used on continuous variables to determine any difference between those who opted in or out of SC. Results: 23/31 patients who were offered SC completed the survey (n = 12 [52.2%] opted to pursue SC, n = 11 [47.8%] opted out of SC). The average patient age was 51. Among patients who opted to pursue SC, maintenance of a sense of “normalcy” ranked as the most important factor behind their decision, followed by the impact of hair loss on children and family. Among the patients who opted not to pursue SC, patients ranked the cost of SC as the most important factor behind their decision. There were no statistically significant differences between patients who opted to pursue SC and those who did not in age, cancer type, relationship status, income, ethnicity, employment status away from the home, or presence of children or partners living in the home. Conclusions: Maintenance of a sense of “normalcy” and cost of treatment were the most important reasons behind patients’ decision to undergo or not undergo SC. Data from this pilot study will be used in a larger prospective study to inform how reasons for and expectations of SC impact distress and QOL.