Barrie Cassileth of Memorial Sloan-Kettering Cancer Center in New York said there are two reasons she doesn't recommend the use of cold caps.
"They rarely work, if ever, for the intended purpose, and they may prevent chemo from reaching cancer cells in the head area," she said.
And Dr. Stefan Gluck, professor of medicine at the University of Miami School of Medicine, said that "[a]lthough there is a meta-analysis showing that it may be [marginally] beneficial we do not recommend it."
But despite the concerns of the medical community, cold cap therapy has generated a tremendous amount of interest among many women. The discussion boards on BreastCancer.org, a non-profit organization dedicated to giving women the latest information about breast cancer, has more than 1,500 posts related to cold cap therapy. There are dozens of pages of comments from women who are in favor of using the caps.
"[My sister's] oncologist said they don't work," wrote one woman. "[W]hat a difference a year makes because I've met with 2 oncologists at two different places and both sort of [gave] in that they do work."
"It is very promising and I hope more women would find out about this. It makes chemo not as bad if you can look yourself and feel good while you go [through] it," wrote another woman.
Dr. Anne Moore, director of the Weill Cornell Breast Center in New York, said some of her patients have made a major push for the treatment.
"So when our patients came to us -- it's certainly patient-initiated -- we perked up our ears and listened to them and see no reason not to support it," said Moore.
Moore plans to undertake a study using Penguin Cool Caps.
Once skeptical, Zander now embraces the caps for some patients even though he acknowledges the need for more research.
"I think that's well balanced by the people who preserve their hair and get therapy they needed rather than decline therapy and have a clear increased risk," Zander said.
New studies are planned at the University of California, San Francisco and New York-Presbyterian Weill Cornell Medical Center.
In the meantime, now cancer-free, Billigmeier has started a non-profit organization called The Rapunzel Project to raise awareness about scalp cooling and encourage additional research.
The following medical centers have special freezers to accommodate the caps:
Beaumont Hospital, Royal Oak, Mich.
Minnesota Oncology, Minneapolis office
Minnesota Oncology, St. Paul office
University of California, San Francisco Medical Center, San Francisco
New York-Presbyterian Hospital/Weill Cornell Medical College, New York
Fairview Southdale Oncology Center, Edina, Minn. (coming soon)
Washington Oncology Hematology Center, Washington (coming soon)