This article originally appeared in the Waterloo Region Record by Bill Doucet on January 10, 2025. Photo taken by Matthew McCarthy.
Phuong-Anh Belore, left, and Ashley Joyes with a Cold Crown, Wednesday.
Mathew McCarthy Waterloo Region Record
Ashley Joyes and Phuong-Anh Belore wear several hats.
Joyes is a mother of two boys, a Toronto fashion school alum and a fundraiser for her charity, The Scrunchie Fund. Belore has been registered nurse in the oncology department at Grand River Hospital for more than a decade and a clinical tutor at McMaster University where she earned her bachelor of science.
But the friends and business partners have a common passion as co-founders of Cold Crowns, which offers rental cold caps to help women keep their hair when going through chemotherapy treatment.
The pair started the Kitchener-based company in October 2023 after Belore went on a fact-finding mission to help a patient traumatized over losing her hair through cancer treatment.
The woman, she said, came in for her second treatment, but that morning, chunks of her hair started falling out. She told doctors she was going to quit treatment for her curable cancer, unable to deal with the hair loss.
After nurses convinced her to continue treatment, Belore felt she could help by looking for wigs for the women from places that specialize in oncology patients. She found nothing. But she “stumbled” on information about cold capping. She did her research and it kick-started Cold Crowns.
Cold capping, Belore said, is the process of wearing a cap, kept between -32 C to -35 C with dry ice, one hour before chemotherapy treatments, during, and anywhere from two to five hours after. Caps have to be switched out every 25 minutes.
The cap constricts the blood vessels in the scalp so not much of the chemotherapy reaches the area, as well as putting the hair follicles in a dormant state so it’s not absorbing a large amount of the chemotherapy.
“Less absorption of chemotherapy and less chemotherapy reaching those areas decreases the amount of damage to the hair follicles, which increases your hair retention rate,” she said.
Belore contacted Joyes, and with her fashion background, the pair developed the company’s black caps.
Cold capping has been used for cancer patients in the U.K. for 30 years, Belore said, and since about 2017 in the U.S., but is relatively obscure in Canada.
The pair have found only one other company in the country involved in cold capping, noting the company mails out the cold cap after an order is placed, along with a video on how to use it.
Belore said Cold Crowns offers a more hands-on approach, working with clients through the process and after when regaining hair.
“A lot of people have really appreciated having a service like this,” Belore said.
“The other thing is, because of my oncology background, we are very well informed with pre-medications, so we know exactly when they need to start cold capping and how long they need a cold cap for afterwards. They appreciate the support that we offer to get the services as well.”
She noted the reason most people don’t know about cold capping — she hadn’t heard about it until she researched wigs — was because most oncologists believe they are “homeopathic wish-wash.”
“I think a lot of oncologists are mainly focused on treating the disease and the side effects like nausea, neuropathy, that kind of stuff. They’re focused on treating the cancer, making sure that that person survives. There’s a little less focus on the mental health aspect, unfortunately,” she said.
Another reason she believes oncologists don’t mention the service is because it is not covered by insurance and has to be paid for out of pocket.
“I think that’s extremely frustrating to hear as a patient because there is an option out there, but they’re just not being told about it because it’s not covered by insurance. Some of these patients can pay out of pocket to help retain their hair and it really helps with their mental health,” Belore said.
The price ranges based on the chemotherapy treatment plan, as some are conducted every three weeks for six cycles, while others are once a week for 12 cycles. The average cost is $500 to $600 a month.
A misconception, Belore said, is people using the cold cap will keep all their hair, which isn’t possible — but she said clients retain enough hair to feel comfortable in their own skin and not wear a wig. Another misconception is woman who lose their hair in treatment will just grow it back. That’s not a certainty either, she said.
“We are very transparent with our clients about the amount of hair retention that they will have because it does vary depending on treatment,” Belore said.
Joyes noted she put a lot of work into perfecting the caps to make sure they are effective.
“So far it’s been quite successful,” Joyes said. “Our goal is just spreading enough awareness so that the hospitals start to realize that this is a great practice, and it is successful. That’s the stage that we’re in, but we have had many clients and they’ve all been successful with retaining the majority of their hair. It’s been quite amazing.”
Cold Crowns can be contacted via their website at www.coldcapcrowns.com.
Bill Doucet is an award-winning reporter/photographer with the Waterloo Region Record. Reach him at bdoucet@therecord.com
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