Does Cold Cap Therapy work with 5-FU chemotherapy?

If you’re starting a chemotherapy treatment plan that includes 5-FU can may have some questions about side effects, including hair loss.

The good news is, 5-FU is not strongly associated with significant hair loss. Hair thinning, if it does occur, is usually mild. However, in many cancer treatment plans, 5-FU is combined with other chemotherapy drugs like irinotecan, docetaxel, or cisplatin.

These drugs are more likely to cause substantial hair loss. Cold capping is much more effective when used during the infusion of these specific drugs, rather than for 5-FU alone.

Here, we’ll explore what 5-FU is, its role in cancer treatment, common combinations with other drugs, and how cold capping can be used effectively in these cases.

What is 5-FU?

5-FU, or 5-fluorouracil, is a widely used chemotherapy drug for treating several cancers, including colorectal, breast, head and neck, and gastrointestinal cancers. It works by interfering with cancer cells’ ability to divide and grow, which helps stop the spread of the disease. Often, 5-FU is part of combination regimens that pair it with other drugs to boost its effectiveness.

Typical 5-FU treatment plan

For many cancers, 5-FU is delivered via a portable pump over 46 hours. This slow infusion allows the drug to target cancer cells while minimizing some side effects.

The pump provides a steady, low dose of 5-FU, which is different from shorter infusions typically given with other chemotherapy drugs. Because of this delivery method, cold capping during the entire infusion is generally impractical.

Effectiveness of 5-FU in cancer treatment

5-FU is a cornerstone of chemotherapy for many cancers, especially colorectal and gastrointestinal cancers. When combined with other drugs, it has been shown to improve survival rates and reduce the risk of recurrence. This versatility makes it a key part of regimens like:

• FOLFOX: Combines 5-FU with leucovorin and oxaliplatin.
• FOLFIRI: Pairs 5-FU with leucovorin and irinotecan.
• DCF: Includes 5-FU with docetaxel and cisplatin.

These combinations often make treatment more effective by attacking cancer cells in different ways.

Common side effects

Like most chemotherapy drugs, 5-FU can cause side effects, but its impact on hair is generally mild. Here are some common side effects of 5-FU:

• Digestive Issues: Nausea, diarrhea, or mouth sores may occur.
• Skin Sensitivity: Some patients experience dryness or sensitivity to sunlight.
• Fatigue: Feeling tired is common during treatment.
• Hand-Foot Syndrome: Redness, swelling, or peeling of the skin on the hands and feet.

Hair loss with 5-FU is usually limited to mild thinning, making it less likely to cause total hair loss compared to other drugs.

How does Cold Capping stop hair loss with 5-FU chemotherapy?

Cold cap therapy, or scalp cooling, is a technique that reduces blood flow to the scalp during chemotherapy. By cooling the scalp, less of the chemotherapy drug reaches the hair follicles, helping to preserve hair.

While 5-FU itself is mild in terms of hair loss, the way it’s delivered via a pump over 46 hours makes cold capping impractical for this part of the treatment.

However, if you are receiving additional drugs alongside 5-FU—such as docetaxel, irinotecan, or cisplatin, which have higher risks of hair loss—you may benefit from cold capping during the infusion of those drugs.

Drugs often combined with 5-FU and hair loss

Cold capping might still be a good option if your treatment includes one or more of the following drugs commonly paired with 5-FU:

• Leucovorin (Folinic Acid): Enhances the effects of 5-FU. Hair loss is generally rare.
• Oxaliplatin: Used in FOLFOX regimens. Hair loss is common but usually, mild to strong thinning may occur.
• Irinotecan: A part of FOLFIRI regimens. Hair loss is more likely, ranging from thinning to total loss.
• Docetaxel: Often combined with 5-FU in regimens like DCF. Hair loss is significant, affecting scalp hair, eyebrows, and lashes.
• Cisplatin: May be used with 5-FU for certain cancers. Hair loss can happen but is typically less severe.
• Capecitabine: An oral drug related to 5-FU. Hair loss is uncommon but mild thinning may occur.
• Mitomycin-C: Occasionally paired with 5-FU. Hair loss is mild.

For patients concerned about hair loss, cold capping during the infusion of these drugs (rather than 5-FU itself) can help reduce hair loss effectively.

Penguin success with chemotherapy treatment

Penguin Cold Caps has helped many people undergoing chemotherapy maintain their hair, providing both practical and emotional benefits.

While we do not recommend capping for the continuous pump delivery of 5-FU, many patients have found success using cold caps with drugs like docetaxel, irinotecan, and cisplatin, which are often given alongside 5-FU.

Penguin Cold Caps offers support and guidance throughout the process, helping you navigate treatment with confidence.

We have many patient stories, talking about what it’s like to use the Penguin Cold Caps and what saving their hair means to them.

The clinical evidence for cold capping

Clinical research supports the effectiveness of cold cap therapy in reducing hair loss for many chemotherapy regimens.

While 5-FU itself causes minimal hair loss, using cold caps for the drugs it’s often paired with—like docetaxel or irinotecan—can make a significant difference.

These studies confirm that scalp cooling is a safe and non-invasive way to manage one of the most emotionally challenging side effects of chemotherapy.

In summary

If your treatment plan includes 5-FU, you may not need to cold cap for the pump-based infusion, as 5-FU is unlikely to cause significant hair loss. However, if you are receiving other drugs in combination with 5-FU that are known to cause hair loss, cold capping during those infusions can help.

Request a call to talk to a Penguin representative in your area who will advise you whether cold capping is right for you. With the right approach, you can take steps to feel more in control and confident during your chemotherapy journey.

How easy is it to order from Penguin?

Ordering from Penguin is designed to be as straightforward as possible. We coordinate with you to ensure your caps arrive in time for your chemo treatment.

Plus, we connect you with a local rep to assist with everything from sourcing dry ice to providing training or arranging a professional capper if desired.

Here’s what to expect when you choose Penguin:

What to expect on cold capping day with Penguin

Wondering what your cold capping experience will look like on the day of your first chemo?

Penguin Cold Caps provides comprehensive support to ensure you feel prepared and confident. From receiving your cold caps in advance to the option of hiring a professional capper, Penguin Cold Caps makes it easy to be ready for your treatment day. Here’s a quick look:

Preparation

Your Penguin rep ensures you receive your cold cap kit ahead of time, so you can practice fitting it and understand the process.

During your chemo

Whether self-capping or using a professional, you’ll start capping about 50 minutes before infusion. Penguin reps offer detailed instructions on timing, cap changes, and maintaining the right temperature throughout your session.

After your chemo

Continuing to cap post-treatment is crucial for success, giving your body time to process chemo toxins and protecting hair follicles from damage.

For a complete guide, including tips on what to bring to stay comfortable, visit Cold Capping with Penguin: What to Expect on the Day.