Supporting the Whole Patient: The Psychological Value of Scalp Cooling in Breast Cancer Treatment

When I was diagnosed with breast cancer, my life fractured into a before and an after. I underwent five months of chemotherapy, a unilateral mastectomy, and proton radiation. I lost a breast. I lost the life I thought I was building. And I nearly lost my reflection. 

But I didn’t lose my hair. 

That single detail often dismissed as cosmetic carried immense psychological weight. Because for me, and for many others, hair wasn’t just hair. It was identity. It was agency. It was one of the last outward symbols that still felt like mine in a season where so much had been stripped away. 

Studies show that up to 14% of breast cancer patients consider delaying or avoiding chemotherapy altogether due to fear of hair loss. That statistic is both staggering and unsurprising. Hair loss is often the first visible signal to the world that you’re sick and it changes not just how others see you, but how you see yourself. 

In the text threads with other women in treatment – hair loss was a frequent topic. It came up early and often, usually with grief. Some women were devastated by how quickly it happened. Others shared that their kids reacted differently toward them once their hair was gone. A few said their partners struggled to adjust to the change. Many found wigs uncomfortable or unnatural and didn’t want to wear them, but also didn’t feel safe or seen without them. What struck me most was how many women said they hadn’t even known scalp cooling was an option. The choice had never been mentioned. Cost and access were major barriers too especially for women of color, women with limited financial means, and those navigating care alone. Again and again, I saw how something that could have supported their mental and emotional wellbeing simply wasn’t offered. 

That was what struck me most. 

Before starting chemotherapy, I researched every possible way to preserve both my health and sense of identity throughout treatment. I first came across scalp cooling through a friend’s suggestion and a Google search. When I met with my oncologist, I was relieved to learn it was included in the patient education session. I was lucky, not everyone is told it’s an option. 

During my rabbit hole search I found a lot of online chatter. The responses were heartbreaking; many women had never heard of it. Others said they were told it was too expensive. Some were told it wouldn’t work, or that it wasn’t worth it. 

The truth is, scalp cooling is a health equity issue. This FDA-cleared technology can reduce chemo-induced hair loss but with out-of-pocket costs of $2,000–$3,000 or more, it’s been treated like a luxury. And for women in marginalized communities, it’s often entirely out of reach.

Now, we stand at a pivotal moment. With new CPT codes recently approved by the AMA (set to go into effect in January 2026), scalp cooling has a chance to become standard (not supplemental) care. But implementation won’t happen on its own. Most hospitals aren’t yet equipped to bill for it. Insurance companies are slow to move. And patients still don’t know it exists. 

When I began using scalp cooling, I didn’t know if it would work. I just knew I needed to try. And every time I looked in the mirror and still saw me, it reminded me that I was more than what I was going through. That mattered. That anchored me. 

Scalp cooling doesn’t eliminate the trauma of cancer but it eases one piece of it. It gives patients a moment of grace in a world of clinical checkboxes. It allows a woman to show up at work, with her kids, or simply in her own skin, without an immediate explanation. 

If we truly believe in treating the whole patient, we must recognize that survival is not the only measure of success. Preserving a woman’s sense of self, her dignity, her identity, her autonomy is just as essential. This technology should never be a privilege. It should be a right. 

Because when you’re fighting for your life, you shouldn’t have to fight for your reflection too.

Photo: Natali_Mis, Getty Images

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