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Episode 384: Learn About Scalp Cooling for Chemotherapy-Induced Alopecia

Release Date: 10/10/2025

Episode 414: Radiation Site-Specific Side Effects: Lung Cancer

The ONS Podcast

“Skin reactions, such as redness, dryness, and just irritation of the skin, can occur. Since we’re irradiating the lung, we can also cause a cough, and that’s due to the inflammation from the radiation. Patients can also get esophagitis if the tumor that we’re treating is close to the midline of the chest near the esophagus. And probably the most common side effect that we see is fatigue,” ONS member Amy MacRostie, RN, OCN®, radiation oncology nurse at St. Charles Cancer Center in Bend, OR, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS,...

Episode 413: Intrarenal Administration for Upper Urothelial Tract Disease: The Oncology Nurse’s Role

The ONS Podcast

“We thought, from a nursing standpoint, ‘What is our goal for doing this?’ What we wanted was first, education of the patient. Can we successfully educate the patient to prepare them? Can we alleviate as much anxiety as possible so that they feel comfortable coming in and having this done? The second goal is to preserve kidney function throughout the treatment. To date, we’ve been successful with that. And the third goal is to complete treatment without infection,” ONS member Chris Amoroso, BSN, RN, OCN®, registered nurse at Fox Chase Cancer Center in Philadelphia, PA, told Jaime...

Episode 412: Pharmacology 101: Cytokines

The ONS Podcast

“They are small, powerful little nuggets. They are actually small signaling proteins that our immune cells use to communicate. They really help regulate immune activation or inflammation and even the growth and survival of immune cells. When cytokines are used therapeutically in oncology, they help to stimulate immune cells such as T cells or natural killer cells to better recognize and attack cancer cells,” Maribel Pereiras, PharmD, BCPS, BCOP, clinical pharmacy specialist at the John Theurer Cancer Center of Hackensack University Medical Center in New Jersey, told Jaime Weimer, MSN,...

Episode 411: An Overview of Myelodysplastic Syndrome for Oncology Nurses

The ONS Podcast

“Not every patient with myelodysplastic syndrome (MDS) is going to progress and die. Only 10%–20% of them will evolve into acute myeloid leukemia. And not all of them need blood transfusions. Some present with low platelet count. It’s not just people who are anemic that have MDS—it’s different depending on what type of MDS they have. These are averages. We’re giving you statistics based on averages, and you’re an individual, so we want to treat you as an individual,” ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt...

Episode 410: The Evidence for the Environment’s Impact on Cancer Outcomes

The ONS Podcast

“Cancer and environmental disasters in particular, but the worsening of our environment, are really things that are great equalizers. And we recognize that we’re all kind of in this world together. We can really face these issues on a more human level. I think always recognizing that if we look at something, we think, ‘Well, that doesn’t relate to me or that problem is it really isn’t my problem’—it sure is,” ONS member Margaret “Peggy” Rosenzweig, PhD, CRNP-C, AOCNP®, FAAN, ONS scholar-in-residence and distinguished service professor of nursing and Nancy Glunt Hoffman...

Episode 409: An Overview of Interventional Oncology for Nurses

The ONS Podcast

“Interventional oncology has really evolved into an important component of modern cancer care and is often described now as the fourth pillar alongside medical, surgical, and radiation oncology. The specialty now encompasses a broad spectrum of image-guided procedures that support from cancer diagnosis, treatment, to effectively managing symptoms that are caused by the disease. In other words, what we’re seeing is that across the continuum of care, IO is playing a vital role,” ONS member Evelyn P. Wempe, DNP, MBA, APRN, ACNP-BC, AOCNP®, CRN, NEA-BC, executive director for advanced...

Episode 408: Radiation Site-Specific Side Effects: Breast Cancer

The ONS Podcast

“A side effect patients might experience is lymphedema. This is an increased buildup of lymphatic fluid in the tissues, either in the breast or in the arm and hand of the affected side. It’s quite problematic for women. They might feel self-conscious. It might feel uncomfortable that the arm feels like it’s throbbing or heavy. Clothing may not fit quite right. So we’re always on the lookout for lymphedema,” Maria Fenton-Kerimian, APRN, AOCNP®, nurse practitioner at Weill Cornell Medicine in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice...

Episode 407: Pharmacology 101: CAR T-Cell Immunotherapy

The ONS Podcast

“You want to try to act quickly and be able to know what the pathways are for appropriate escalating when a patient is having symptoms that are reflective of cytokine release syndrome (CRS) or neurotoxicity. These toxicities are very manageable and treatable when recognized early. To summarize, choosing the right patient, knowing the toxicity profile for each product, and acting early is really what helps to prevent severe outcomes with chimeric antigen receptor (CAR) T-cell therapy,” Maribel Pereiras, PharmD, BCPS, BCOP, clinical pharmacy specialist at the John Theurer Cancer Center at...

Episode 406: Drug Resistance Biomarkers and Their Impact on Cancer Treatment Choices

The ONS Podcast

“Our goal of precision oncology has been to shift to tailored therapies that can help to improve treatment efficacy and ultimately improve patient outcomes. Resistance biomarker testing can help the care team to detect these genomic changes that the tumor may have acquired during therapy that makes the cells resistant to therapy. This information can be extremely helpful when we’re talking about making choices about second-line or subsequent-line therapy,” ONS member Danielle Fournier, DNP, APRN, AGPCNP-BC, AOCNP®, advanced practice RN at the University of Texas MD Anderson Cancer...

Episode 405: Long-Term Multiple Myeloma Considerations for Oncology Nurses

The ONS Podcast

“The disease is increasingly managed as a chronic condition rather than a diagnosis with an immediate terminal outcome. Particularly, with earlier and more effective and sustained treatment options, we can make this disease a very chronic, long-term, livable condition. I want to make sure that patients are aware that this is not a death sentence. This is something that patients can live with for the long term,” Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer Center at Jersey Shore University Medical Center in Neptune, NJ, told Lenise Taylor, MN, RN, AOCNS®,...

More Episodes

“Chemotherapy-induced alopecia does cause a lot of stress. It’s associated with lower quality of life. Scalp cooling may really help improve quality of life. Some studies have shown that women in the scalp cooling group felt less upset about losing their hair and less dissatisfied with their appearance compared to the women in the control group that didn’t receive any scalp cooling. So a lot of these studies are showing it does have a very positive impact on psychosocial feelings and side effects in relation to overall cancer treatment,” ONS member Jaclyn Andronico, MSN, CNS, OCN^®, AOCNS^®, clinical nurse specialist at Memorial Sloan Kettering Cancer Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS^®, manager of oncology nursing practice at ONS, during a conversation about chemotherapy-induced alopecia and scalp cooling.

The advertising messages in this episode are paid for by Paxman. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Episode Notes

This episode is not eligible for NCPD.
ONS Podcast™ Episode 250: Cancer Symptom Management Basics: Dermatologic Complications
ONS Voice articles:

ONS Voice oncology drug reference sheets:

ONS Guidelines™ for Cancer Treatment-Related Skin Toxicity
Clinical Journal of Oncology Nursing articles:

Oncology Nursing Forum articles:

ONS Altered Body Image Huddle Card
Journal of Market Access and Health Policy article: Expanding the Availability of Scalp Cooling to All Patients at Risk of Chemotherapy-Induced Alopecia
HairToStay
Paxman patient assistance program
Rapunzel Project

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.

Highlights From This Episode

“Some of the classes that are high risk for chemotherapy-induced alopecia can include antitumor antibiotics, such as doxorubicin, epirubicin; antimicrotubule drugs, such as taxanes like docetaxel, paclitaxel; alkylating agents such as cyclophosphamide. The lower risk alopecia-causing chemo agents are the antimetabolite classes, which a lot of people know as gemcitabine or fluorouracil. We also are seeing patients experience some degree of alopecia with a drug called sacituzumab govitecan, which is an actual antibody–drug conjugate.” TS 2:09

“Scalp cooling is approved for solid tumor patients. Patients receiving chemotherapy agents, as we discussed before, with that high incidence of chemotherapy-induced alopecia really should be considered for scalp cooling as long as they don’t have certain contraindications. Some contraindications do exist for these populations. Those are patients that have cold agglutinin diseases, cryoglobulinemia, cryofibrinogenemia, and any cold sensitivity issues. Patients also with abnormal liver functions are not suggested to receive scalp cooling because their liver function is associated with the metabolism of the drug agent. It’s also not recommended for patients with hematologic malignancies who are higher risk for cutaneous metastatic disease or failed chemotherapy and even reduced survival rates.” TS 9:23

“Overall, scalp cooling has a good tolerance, but it’s important to be aware that scalp cooling can be uncomfortable for some, and it isn’t always tolerated by some patients. Patients have reported side effects such as headaches, dizziness, chills, cold sensations, scalp pain, head discomfort, and even claustrophobia. Among these, the most common is the cold feeling and headaches. So when caring for patients that undergo scalp cooling, the nurses really should recognize the patient’s feelings and help relieve that discomfort with position changes, prophylactic painkillers such as [acetaminophen] or [ibuprofen] if they’re allowed to take that, additional warm blankets. Even antianxiety medications can really help, especially if that claustrophobia feeling is there. So collaborating with that team, the doctors, the nurse practitioners, just to be aware that if the patient’s not comfortable during this treatment of scalp cooling, they should have those things on board prior to starting.” TS 12:23

“A lot of primary education points for nurses to review with patients is explaining the financial reimbursement process and assistance options—collaborating with that financial department within your institution. Also discussing the efficacy of the scalp cooling and the tolerability of it as well. I don’t know if patients are always aware of the feeling of the cold—really warning them, letting them know what they’re going to experience while in the chair attached to that cooling machine.” TS 18:55

“Nurses, we’re at the forefront of scalp cooling, and we manage a lot of this area that comes with the service. They are managing, the coordination of the care, the education. They’re assisting with that financial discussion and collaborating with the financial department. The symptom management—they’re helping make the patients feel more comfortable with the symptoms of scalp cooling. They are the real deal here, so they are the best in helping with the situation. Nurses should be really familiar with the efficacy, again, and the tolerability, the contraindications, the side effects, and the costs and even the access for scalp cooling.” TS 20:57

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