Scalp cooling therapy (SCT) is an approach used to reduce the risk of chemotherapy-induced alopecia, but this therapy has not been widely implemented in the United States. Researchers surveyed oncology providers to understand contributors and barriers to its usage and reported their findings in the journal JCO Oncology Practice.

For this study, the researchers distributed a 33-question survey through the American Society of Clinical Oncology (ASCO) Research Survey Pool. The survey questions aimed at assessing provider knowledge, barriers to use, degree of support, and the frequency with which providers initiated discussions with patients regarding SCT.

The researchers invited 600 oncologists to participate through the ASCO Research Survey Pool, of whom 25.8% responded to the survey. Among respondents, 62% reported favoring SCT always or most of the time, and 67.1% expressed a belief that SCT should be offered to all patients. This contrasted with the frequency with which they reported initiating discussions with patients about SCT, as only 26% expressed they did so always or most of the time.

Continue Reading

The likelihood of initiating conversations with patients regarding SCT was greatest among providers treating breast cancer, those who reported being very familiar with the technique, those working at a facility with machine SCT, and those who reported that they had read SCT literature during the prior 2 years (P ≤.0001 for each).

Reasons given to not initiate discussion of SCT with patients include financial concern for the patient (58.0%), which also was the most common reason why providers were not always in favor of SCT (67.9%). The second most common reason to not initiate conversations about SCT and not favor its use was a concern regarding efficacy (31.3% and 42.9%, respectively).

Reasons providers did not support use of SCT were financial concern for the hospital (51.3%) and staff constraints (50.0%).

The most common patient-related factors reported by providers were importance of hair preservation to the patient (73%) and patient sex (44.7%). Respondents also reported on reasons patients may decline SCT, such as financial concerns (69.7%), patient not greatly concerned about hair loss (44.1%), and safety concerns (13.8%).

“Our findings suggest the need for physician education and exposure to SCT, through either physician-directed learning or short training programs, and clear institutional guidelines for the use of SCT,” the study authors stated in their conclusions.

Disclosures: Some study authors have declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Novice M, Novice T, Henry NL, et al. Identifying barriers and facilitators to scalp cooling therapy through a national survey of the awareness, practice patterns, and attitudes of oncologists. JCO Oncol Pract. Published online September 16, 2021. doi:10.1200/OP.21.00273