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

Release Date: 10/10/2025

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®,...

Episode 404: Tailor Patient Treatment Education for Non-Oncology Indications

The ONS Podcast

“We print education sheets that we have, and we say, ‘Just ignore this part that says cancer. You’re getting this med but for a different indication.’ And then you have to really point out what our goals of care are. You’re using the information that, as oncology nurses, we like and love, but we’re having to cross it out and say, ‘Just read this portion and just do this here.’ And that can be challenging for the nurse and probably confusing for the patient,” ONS member Brandy Thornberry, RN, OCN®, outpatient infusion and VAD supervisor at Logan Health in Kalispell, MT,...

Episode 403: Pharmacology 101: Checkpoint Inhibitors

The ONS Podcast

“Because the premise of immune checkpoint blockade centers around elevating the immune function, we should always take a great deal of caution around those patients who have high immune risks. Those include patients with autoimmune disorders. That’s one of our biggest questions that we ask, usually every consult that we’re seeing with solid tumor. ‘Do you have any history of autoimmune disorders? Tell me a little bit more about it. Is it being treated? What are your symptoms like?’ And then also patients who have undergone organ transplants. Now, interestingly, this does include stem...

Episode 402: Radiation Site-Specific Side Effects: Head and Neck Cancer

The ONS Podcast

“It’s important to clarify that most patients will experience and at least some side effects—and often several. So prevention really means reducing severity, complications, and long-term impact rather than avoiding side effects altogether. This process starts before radiation begins and continues throughout the treatment and includes dental evaluation, baseline swallowing assessments, and thorough patient education,” ONS member Astrid Amoresano, RN, OCN®, lead oncology nurse specialist at New York Proton Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager...

Episode 401: Multiple Myeloma Treatment Considerations for Oncology Nurses

The ONS Podcast

“You also want to deal with patient preferences. We do want to get their disease under control. We want to make them live a long, good quality of life. But do they want to come to the clinic once a week? Is it a far distance? Is geography a problem? Do they prefer not taking oral chemotherapies at home? We have to think about what the patient’s preferences are to some degree and kind of incorporate that in our decision-making plan for treatments for relapsed and refractory myeloma,” Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer Center at Jersey Shore University...

Episode 400: Pharmacology 101: Radioimmunoconjugates

The ONS Podcast

“Radioimmunoconjugates work through a dual mechanism that combines immunologic targeting with localized radiation delivery. The monoclonal antibody components bind to specific tumor-associated antigens such as CD20, expressed on malignant B cells. Once found, the attached radioisotope delivers beta radiation directly to the tumor, causing DNA damage and cell death,” Sabrina Enoch, MSN, RN, OCN®, CNMT, NMTCB (CT), theranostics clinical specialist at Highlands Oncology in Rogers, AR, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a...

Episode 399: National Hazardous Drug Exposure Registry

The ONS Podcast

“The United States does not have a national cancer registry. We have a bunch of state registries. Some of those registries do collaborate and share information, but the issue is the registries that do exist typically do not report cancer by occupation. So, we cannot get our arms around the potential work-relatedness of the health outcome given the current way the state registries collect information. What we’re trying to set up, is a way to make what is currently an invisible risk, visible,” ONS member Melissa McDiarmid, MD, MPH, DABT, professor of medicine and epidemiology and public...

Episode 398: An Overview of Multiple Myeloma for Oncology Nurses

The ONS Podcast

“[Multiple myeloma] is very treatable, very manageable, but right now it is still considered an incurable disease. So, patients are on this journey with myeloma for the long term. It’s very important for us to realize that during their journey, we will see them repeatedly. They are going to be part of our work family. They will be with us for a while. I think it’s our job to be their advocate. To be really focused on not just the disease, but periodically assessing that financial burden and psychosocial aspect,” Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer...

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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