Sandton Oncology
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Frequently Asked Questions (Faqs)

Who is eligible?

The first 20 eligible patients, starting on 17 November 2014 will undergo the scalp cooling procedure at no cost, after reading the patient's information leaflet and signing the consent form provided by your treating Doctor.

You are eligible if you are receiving treatment with drugs with a high propensity to cause hair loss. These include, but are not limited to:

Anthracycline(Adriamycin, Epirubicin)
Taxane(Paclitaxel, or Docetaxel)
Your treating Dr will discuss the eligibility with you.

What are the exclusions criteria?

Patients receiving chemotherapy that is unlikely to result in total alopecia : eg Xeloda, Oxaliplatin, Cisplatin, dacarbazine, etc.
Your treating oncologist will explain this further should you have any questions.
Patients with cryoglobulinemia (a medical condition in which blood contains large amounts of proteins that become insoluble at cold temperatures)
Patients unable to sit for prolonged periods of time: you will be required to sit for a further 90 minutes after your chemotherapy is completed.
How often should I undergo this procedure?

Everytime you undergo your planned chemotherapy.

How do I prepare my hair for scalp cooling?

We recommend that the hair underneath the scalp cooling cap is lightly dampened prior to the fitting of the cap using lukewarm water - a water spray bottle is ideal for this. This is to ensure the best overall cooling conductivity between the cap and the scalp as the hair has insulating properties. The hair does not need to be very wet and any lengths of hair below the cap line do not need to be dampened.

A small amount of mild, perfume free conditioner (an amount no larger than a coin) should then be applied to the dampened hair. This helps with the removal of the cap on completion of treatment. The hair should then be combed back using a wide tooth comb or fingers so that the front hair line is visible. This is especially important if you have a fringe.

As the hair will still be damp on completion of treatment you may find it more comfortable to take a hat or head covering with you to wear on the way home.

Will scalp cooling work for me?

Successful scalp cooling depends on many factors such as type and stage of cancer, age, hair type, hair condition, general health. It is important to understand that hair loss does vary from one person to the next and retention of all hair cannot be guaranteed. Research has shown that scalp cooling is very effective across a wide range of chemotherapy drugs such as: Epirubicin, Doxorubicin, Taxol and Taxotere.

It is important to understand that you may experience some hair loss and overall thinning of the hair whilst using scalp cooling, and that the normal shedding cycle of the hair will continue. If some hair loss is experienced we would encourage you to persevere with scalp cooling - many patients report hair growth during their chemotherapy treatment whilst using scalp cooling as new hair growth is also protected from the chemotherapy.

Recent research has stated that patients should be advised not to buy a wig as a precaution, but wait until it becomes necessary*.

One of the most crucial factors for successful hair retention is to ensure that the correct size of silicone cooling cap is initially selected - good contact between the scalp and cap is essential to ensure that bald spots and patchy areas of hair loss are avoided. There are 5 different cap sizes available and your nurse will do their best to ensure you get the best possible fitting scalp cooling cap however you can also help to achieve this.

Can I wash my hair during chemotherapy?

If you are feeling up to it you can wash your hair immediately after your chemotherapy treatment. This may help you feel more comfortable especially if your hair has been dampened and conditioned prior to commencement of scalp cooling treatment. There is no need to leave the conditioner in your hair unless you feel unable to wash it out.

Remember to use a gentle shampoo that is not perfumed eg baby shampoo.

If you are on the scalp cooling system, you should preferably wash your hair 24 hours before every procedure treatment

How long does it take?

This will depend on the type of chemotherapy you are receiving, but on average it will be 2.5 hours in total.

For more information:

Breast cancer is the commonest cancer among South African women, followed by cervical cancer. The commonest cancer among South African men is Lung cancer. Radiation therapy involves killing cancer cells by using 'x-rays' therapy. Radiotherapy is of the modes of treatment cases involving the bladder, cervix, the skin or some parts of the head and neck, alone or in combination with chemotherapy.

Chemotherapy is effective in the treatment of a wide range of solid and haematological (blood) cancers, including breast, colon, lung cancers and lymphoma to name a few. Chemotherapy works by "killing" cancer cells at different phases of the cell cycle, which is the cycle that governs replication of cells. Biological response modifiers are substances that stimulate the body's immune system to attack cancer cells. They are produced naturally by the immune system where the cancer first develops and by the type of body tissue in which the cancer originates.

The symptoms of cancer depend on the site of the disease, but a lump, bleeding, a persistent cough and weight loss are some of the symptoms that one needs to look out for.

Oncologists are specialists who assess and treat cancer patients with chemotherapy or radiation therapy. We are a team of medical and radiation oncologists .i.e we use chemotherapy, radiotherapy and medical therapies (e.g. hormonal manipulation etc.) to treat different cancers.

 Radiation oncology is the science of treating diseases, mainly cancers, with radiation. Radiation also can be used less often to treat benign disease such as keloids.

Radiation oncology makes use of high energy x-rays, which deposit energy into cancer cells causing them to die and thereby preventing further growth and spread of the disease. The delivered radiation cannot be felt or seen and treatment sessions are therefore completely painless. Each treatment session takes about 15 to 20 minutes.

Modern radiation techniques are designed to spare normal tissue wherever possible, while delivering a high dose to the tumour (cancer) area. However, some irradiation of normal cells is unavoidable and this may produce side effects that are limited to the treatment site. Radiation-sensitive cancer cells are preferentially killed while normal cells are able to repair the damage caused, thereby producing a therapeutic benefit.

The goals of treatment with radiotherapy can be either curative or palliative. Palliative treatment is designed to improve symptoms such as pain, bleeding or obstruction of vital organs. Because of its good side-effect profile and high efficacy, radiotherapy is an excellent treatment modality to palliate the distressing symptoms that can be caused by cancers.  

Radiation oncology is sometimes delivered in combination with chemotherapy that acts as a radiation sensitiser, thereby improving the cell-kill of the radiation.

The DMO team comprises specialist radiation oncologists and radiotherapists who have had extensive experience and are respected nationally and internationally.

Brachytherapy is a form of internal beam radiotherapy Brachytherapy means treatment from a short distance. Using this technique, the radiation beam is delivered directly to the tumour, thereby reducing the amount of radiation delivered to healthy tissues to a minimum.  This treatment is typically given over one to five sessions that can take one to two hours to complete. It can also be delivered by inserting small radioactive “beads” at the tumour site, which remain there either until the cancer cells have been destroyed, or permanently.

External radiation therapy is the most commonly used treatment modality, and refers to radiation delivered from a distant source, from outside the body and focused at the patient’s cancer site. Typically the patient lies on a treatment bed and the radiation is delivered from a machine that moves around the patient, thereby targeting the cancer cells. The treatment is usually delivered over multiple sessions daily sometimes lasting up to six to seven weeks

Stereotactic radiosurgery involves sophisticated technology that delivers an extremely high dose to a small area with a minimal dose being delivered to surrounding normal tissues. At present, this technology is only available to treat cancers in the head region at our centres, but will become available for the treatment of tumours anywhere in the body in the near future. Treatment can often be delivered in a single session – in contrast to external beam radiation

Radiotherapy at DMO is administered on an out-patient basis – you do not need an overnight stay at our centres. Typically, we will prescribe a single treatment each day, which lasts for about 10 to 20 minutes.

Yes – External radiation beam therapy is the most commonly used, and refers to radiation delivered from a distant source, from outside the body and directed at the patient’s cancer site. Brachytherapy involves the insertion of small radioactive “beads” at the tumour site, which remain there either until the cancer cells have been destroyed, or permanently. This technique is increasingly being used to treat cancers of the cervix, uterus, vagina, rectum, prostate and eyes.

Stereotactic radiosurgery involves sophisticated technology that delivers an extremely high dose to a small area. At present, this technology is only used to treat cancers in the head and neck area.

Intensity-modulated radiation therapy (IMRT) is an advanced mode of high-precision radiotherapy that uses computer-controlled linear accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor.

There are three main treatments for cancer: surgery, chemotherapy and radiotherapy. Radiation oncology is used in three contexts: as the primary treatment (stand-alone), in addition to surgery or chemotherapy, or as a palliative modality to relieve cancer symptoms. However, the selection of treatment is generally site-dependent. For example, cervical tumour sites are normally treated with radiation therapy, while ovarian cancers generally respond better to chemotherapy. Your specialists will make this decision based on your test results, and will consult with you before proceeding. And if radiotherapy is not the best treatment option for you, we will refer you to the correct specialist

Side effects happen when healthy cells are lightly irradiated – a process that is, unfortunately, unavoidable. These can include fatigue, and skin reactions, but are site-dependent and are generally reasonably well tolerated. Most radiation oncology patients can continue to function normally during and after their treatment.

In most cases, DMO will follow a post-treatment programme. Your radiation oncologist usually likes to see you two weeks after completion of treatment and, from there; your follow-up care plan is tailored to your needs. We will continue to monitor your recovery at regular intervals. Your radiation oncologist will clearly explain to you how often you will need to come for follow ups and which investigations will be required to monitor your progress.

The effects of radiotherapy are often delayed for up to three months after completing the treatment. The prescribed treatment needs to be completed and, a few months later, x-rays or scans will be recommended to monitor the effects of the treatment. Symptoms such as pain or bleeding often improve while on treatment but you will still need to wait four to six weeks to assess the full effect.

Radiation deposits energy into cancer cells causing them to die thereby preventing further growth and spread of the disease. Cancer growths often shrink or disappear completely following treatment. Thereby, cancers can be cured using radiation therapy

A healthy balanced diet is recommended whilst on radiation treatment. Mild exercise can be beneficial in combating the fatigue experience due to radiation therapy. Make sure you attend treatment sessions on a regular basis and do not miss any treatments without consulting with your radiation oncologist. A positive mental attitude is essential.

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