Save your hair on TCHP with cold capping

Published: March 22, 2024

TCHP chemotherapy, also known as docetaxel, carboplatin, trastuzumab, and pertuzumab regimen, is a standard treatment for breast cancer. This combination therapy is used for HER2-positive breast cancer.

The drugs in the TCHP regimen work together to target and destroy cancer cells. Docetaxel and carboplatin are types of chemotherapy drugs that interfere with the growth and spread of cancer cells. Trastuzumab (Herceptin) and pertuzumab (Perjeta) are targeted therapy drugs that specifically target HER2-positive breast cancers.

TCHP chemotherapy is effective in treating breast cancer, especially when combined with other treatments like surgery or radiation therapy. It has proven successful in improving outcomes for patients with HER2-positive breast cancer by reducing the risk of recurrence.

What is TCHP?

TCHP chemotherapy is a cancer treatment that combines traditional chemotherapy medications with targeted therapy drugs like pertuzumab and trastuzumab. This neoadjuvant therapy aims to shrink tumors before surgery and decrease the risk of cancer recurrence.

The main goal of TCHP treatment is to reduce the size of the tumor before surgery, although many people continue to receive TCHP after surgery to eliminate any remaining cells. By combining traditional chemotherapy with targeted therapy drugs, this treatment approach offers a comprehensive strategy for combating certain types of cancer.

This combination therapy involves using pertuzumab and trastuzumab alongside traditional chemotherapy medications. Pertuzumab and trastuzumab are part of a class known as targeted therapies, specifically targeting cancer cells while minimizing damage to healthy cells. TCHP drug combination consists of:

  • Taxortere (docetaxel)
  • Carboplatin (Paraplatin)
  • Herceptin (trastuzumab)
  • Perjeta (pertuzumab)


  • The use of neoadjuvant TCHP chemotherapy can help to reduce the size of the tumor before surgical removal.
  • Combining targeted therapies with traditional chemotherapy may improve the effectiveness of the overall treatment regimen.
  • Patients undergoing TCHP may have access to patient assistance programs that provide support for their prescription medications.


  • Like any form of chemotherapy, neoadjuvant TCHP can cause side effects such as nausea, fatigue, hair loss, and decreased blood cell counts.
  • The combination treatments may pose an increased risk for certain adverse reactions compared to standalone traditional or targeted therapies.

TCHP chemotherapy typically lasts for 18 weeks, involving six cycles of medication. Each cycle spans around three weeks. This duration is crucial in ensuring the effectiveness of the treatment and allowing the body to recover between cycles.

Common side effects of TCHP

Patients receiving this combined approach should be aware that they might experience more pronounced side effects due to the inclusion of both types of medication in their treatment plan. However, these symptoms can often be managed through proper medical support and care throughout the course of their treatment.

  • Hair loss
    54% of people will experience hair loss as a result of TCHP chemotherapy. Many people say it’s one of the most distressing side effects of chemo because it impacts their self-esteem and mental wellbeing.
  • Diarrhea
    One of the most common side effects of any type of chemo is diarrhea, impacting 72% of people undergoing treatment.
  • Low white blood cells
    Just under half of patients will experience low white blood cells. This means your immune systems isn’t working properly and you have a higher risk of getting an infection.
  • Mouth and throat sores
    As a result of low white blood count, you may find you develop inflamed and painful sores in the mouth and throat, making eating and swallowing difficult.
  • Nausea and vomiting
    45% of people undergoing TCHP will feel sick when undergoing treatment. Most people feel ill within 24 hours of chemo, although some people experience delayed symptoms up to seven days. Your medical team may give you anti-nausea meds to help relieve this symptom.
  • Fatigue
    Fatigue is a very common side effect of chemo (42%). It can range from mild fatigue, where you feel tired but are still able to do everyday tasks, to extreme fatigue, where you simply can’t get out of bed.
  • Anemia
    This is caused by a low red blood cell count and can be life-threatening if it drops too low. If you are anemic, you may feel dizzy and tired, find your short of breath and look pale. Your medical team will check your bloods regularly as 37% of people experience it, but if you’re feeling any of these symptoms you should let them know.
  • Constipation
    Constipation can be very uncomfortable, causing abdominal discomfort, bloating and nausea and even blood in your stools. 16% of TCHP patients will experience it – but you don’t need to suffer alone. Tell your medical team who will be able to advise on the best course of action.

What is the success rate of TCHP chemo?

The effectiveness of TCHP very much depends on the stage of cancer and the individual’s response to different drugs.

Although a large scale real-word study does not exist, a study of 447 breast cancer patients, treated between January 2016 and August 2020, had pathological complete response (pCR) of 64%, or in other words, a 64% rate of disappearance of all invasive cancer after treatment.

To read more, see:

For more evidence, see: The evidence that cold cap therapy works

Managing hair loss on TCHP

Hair loss is one of the most distressing side effects for many patients, but for many, cold capping provides a solution to this particular concern.

  • Why do people lose hair on chemo?
    Chemotherapy works by targeting rapidly dividing cells, a hallmark of cancer cells. Unfortunately, this action is not specific only to cancer cells; it also affects other rapidly dividing cells in the body, such as those in hair follicles. This can cause hair loss or thinning because the hair follicle is destroyed by the chemo.
  • Will I lose my hair on TCHP?
    Docetaxel, the “T” in TCHP, is known to cause hair loss in many patients. This drug interferes with cell division, which can halt the production of new hair cells and lead to hair loss. The severity of hair loss can vary from person to person and is influenced by the dosage and duration of the chemotherapy.

While some chemotherapy drugs may cause more hair loss than others, the combined effect of multiple drugs, like TCHP, can lead to a higher likelihood of experiencing this side effect.

How do Cold Caps stop hair loss on chemo?

Cold capping involves wearing a special cap filled with a gel coolant before, during, and after each chemotherapy session. This process works by constricting blood vessels in the scalp, reducing the amount of chemotherapy drugs that reach the hair follicles. As a result, some patients may experience minimal or no hair loss during their treatment.

What are the alternatives to coping with hair loss?

Losing hair can be emotionally challenging, but it’s important to remember that hair loss is a common side effect of TCHP chemotherapy. If cold capping is not for you, many people find comfort in wearing headscarves, hats, or wigs. Some even embrace their baldness as a symbol of strength and resilience.

JosieHow can Penguin Cold Caps help?

Penguin Cold Caps has been helping TCHP patients save their hair for over 20 years. Many patients undergoing TCHP chemotherapy have successfully retained their hair using these specially designed caps. Success rates vary among individuals due to factors such as age, type of cancer treatment received (chemotherapy drugs), and overall health status, but most patients on TCHP have had a high success rate.

To find out what to expect from cold capping wit Penguin, see: What to expect on the day.

Cold capping isn’t guaranteed to work for everyone or for all types of chemotherapy treatments; however, to find out whether it’s right for you, speak to your local Penguin Cold Cap representative will be able to advise.

Request a callback with your local rep

Bernice’s Story

Bernice was diagnosed with Triple Positive Breast Cancer and used Penguin Cold Caps to successfully saved over 60% of her hair on TCHP.

“I am happy with the results – any hair I did lose sprouted back very quickly afterward, and three months post chemo, no one could tell I’d lost any hair at all.”

Read Bernice’s, and many other patient success stories.

Finding a support network

Communicating openly with friends and family about your feelings regarding hair loss is crucial. Sharing your emotions can alleviate the burden you may feel and provide you with much-needed support during this difficult time.

Finding a support group for individuals undergoing similar experiences can be immensely beneficial. Connecting with others going through chemotherapy allows you to share stories, offer advice, and gain perspective on coping mechanisms that have helped them navigate the process.

Join the Chemotherapy Support Group on Facebook.

Get in touch

If you’re about to undergo TCHP chemotherapy treatment and are worried about losing your hair, request a call back to talk to your local Penguin Cold Cap rep. Fill out the form below and we will be in touch.

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