A Guide to Cryotherapy During Chemo

How to Stay Comfortable While You're on Ice

I spent four hours, every infusion, intentionally freezing my hands, feet, mouth, and scalp while poison dripped into my veins. If that sounds insane, I understand. It felt insane the first time I did it too. It's also, to this day, one of the best decisions I made during treatment, and I want to walk you through exactly how I did it, in case it helps you make the same decision for yourself.

What cryotherapy actually is, and why anyone would choose to be cold on purpose during chemo

Cryotherapy, in this context, just means using cold — ice packs, chilled gel devices, cooling caps — on specific parts of your body during chemo infusion. The logic behind it isn't mystical, it's mechanical. Cold causes vasoconstriction, meaning it narrows your blood vessels in the cooled area. Narrower blood vessels mean less blood flow reaches that tissue while the chemo drug is circulating, which means less of the drug actually reaches those specific cells while your veins are flooded with it. You're not blocking the treatment from working where it needs to work — the drug still goes everywhere it needs to go through your bloodstream to fight the cancer. You're just temporarily throttling how much of it lands in a few particular places that don't need to take the hit: your mouth, your hands, your feet, your scalp.

It's a genuinely well-studied idea, not just something patients invented out of desperation, though I understand why it might sound that way. Oral cryotherapy in particular has a solid body of clinical research behind it, with meta-analyses showing it meaningfully lowers the risk of developing mucositis in patients on certain chemo regimens. Frozen gloves and socks have their own growing body of research behind them for preventing nerve damage in the hands and feet, especially with taxane-based chemo drugs. I want to be upfront that the research is stronger for some of what I did than others — more on that as we go.

My regimen, and the nickname that should scare you a little

I was treated with Nivo AVD for Hodgkin lymphoma — nivolumab, an immunotherapy drug, combined with AVD, which stands for Adriamycin, Vinblastine, and Dacarbazine. The A is the one you need to know about. Adriamycin, also called doxorubicin, is a bright, almost startling red when it's administered, and it has earned itself a nickname among patients and nurses alike: the Red Devil. It's not called that for the color alone. It's called that because it's one of the harder chemo drugs to tolerate, and among its side effects are two of the ones I built my entire cryotherapy routine around: oral mucositis and peripheral neuropathy.

What oral mucositis actually is, explained simply

Here's the way I came to understand it. Your mouth is, by a wide margin, the fastest-healing tissue in your entire body. Bite your cheek and it's usually smoothed over within a day or two — nowhere else on you regenerates that quickly. That speed comes from cells in your mouth dividing and replacing themselves constantly, far faster than most other tissue.

Chemo doesn't know the difference between a cancer cell dividing rapidly and a healthy cell dividing rapidly. It just attacks rapidly dividing cells, indiscriminately, because that's the whole mechanism by which it fights the cancer in the first place. Your mouth, precisely because it's so good at healing itself, ends up looking like a prime target to a drug that's hunting for fast-dividing cells. The result is oral mucositis: inflammation, and often painful sores or ulcers, in the mucous membrane lining your mouth. It can make eating, drinking, and even talking miserable, and in more severe cases it can be serious enough to delay treatment entirely.

What peripheral neuropathy actually is, explained simply

Peripheral neuropathy is nerve damage, usually in the hands and feet, caused by certain chemo drugs traveling out to the extremities and injuring the nerve endings there. It can show up as tingling, numbness, burning, or a pins-and-needles sensation, and depending on severity, it can affect fine motor skills — buttoning a shirt, picking up a coin — or your ability to feel your feet properly while walking. Unlike a lot of chemo side effects that fade once treatment ends, neuropathy can be stubborn. For some people, it never fully goes away.

The gear I used

I want to be specific here because the specifics are what actually made this workable for me. I used SuziPad cooling mittens and booties, with extra ice pack refills so I could swap them out mid-infusion once they warmed up. I used the Chemo Mouthpiece for oral cryotherapy. And I used a cooling head cap, partly for the documented benefit of reducing hair loss, and partly on a personal theory of mine I want to be honest about: I suspect the cold cap may have also helped protect me from some of the chemo brain fog that hits so many patients, since it's using the same vasoconstriction principle on the scalp and, by extension, potentially reducing drug exposure to tissue close to the brain. I want to be clear that this is my own theory, not an established clinical claim — the research on cold capping is focused on hair preservation, not cognition, and I haven't seen it studied for brain fog specifically. I'm sharing it because it's a real possibility worth discussing with your doctor, not because I can prove it.

I froze everything at home in my regular freezer, then transferred it into a portable freezer the morning of infusion, which we hauled into the infusion center in a small wagon. My infusions ran about four hours, so keeping everything cold enough, long enough, took real logistics.

I also brought a heating pad and a blanket, which turned out to be just as essential as the ice itself. Being cold in four separate places for hours at a time is genuinely hard on your body, and keeping my core warm was what made the rest of it tolerable.

The step-by-step protocol I followed

Here's exactly how I ran it, infusion after infusion, once I'd gotten the system down.

We'd arrive, plug in the portable freezer, and get set up. I'd let the nurses access my port and give me my pre-meds first, before doing anything with the ice. As soon as pre-meds were done, I'd put on the SuziPad booties and mittens — and I'd always wear socks underneath the booties, which made a real difference for comfort and kept the cold from being unbearably direct against my skin.

Next came the nivolumab, the immunotherapy portion, which I didn't need to cold-protect against — cryotherapy was specifically for the Red Devil portion coming later.

About 15 minutes before the Adriamycin infusion started, I'd start using the cold cap and the chemo mouthpiece, and I'd switch out the ice packs in my mittens and booties for fresh ones, so everything was at maximum cold right as the harder drug began. I'd swap the mouthpiece for a fresh one again right as the Adriamycin infusion actually started, to make sure my mouth stayed as cold as possible through the highest-risk window. I only had the one head cooling piece, so unlike the mouthpiece, I wasn't able to swap it mid-use — something to consider if you're building your own kit and want continuous maximum cooling on your scalp throughout a longer infusion.

Once the Adriamycin infusion finished, I'd switch the mouthpiece one more time and keep using oral cryotherapy for another 15 to 20 minutes past the end of the infusion, since the drug is still circulating in your system even after the IV stops. I'd keep the head cap on until it was no longer cold to the touch, then remove it. And I'd wait a full 15 minutes after my very last infusion of the day ended before taking off the mittens and booties, giving the vasoconstriction time to keep doing its job even after the chemo itself was done running.

Through all of it — every single infusion — I had a heating pad on medium heat tucked between my back and the chair, and a blanket over the rest of me. It was cold. Genuinely, seriously cold, in a way that took real mental effort to sit through for hours at a time. The heating pad and blanket were what let me tolerate it.

What it got me

I did not develop a single mouth sore through my entire course of treatment. To this day, I have no symptoms of neuropathy in my hands or feet. I can't promise you the same outcome — bodies and regimens differ, and cryotherapy doesn't have a 100% success rate in the research, either. But for me, the hours of cold were a direct trade for after-effects I never had to live with, and I'd make that trade again without hesitation.

Before you try this yourself

Please talk to your oncology team before building a routine like this. Cryotherapy isn't the right fit for everyone — certain conditions, like cold agglutinin disease, cryoglobulinemia, or some circulatory issues, can make deliberate cold exposure genuinely risky rather than helpful, and some chemo regimens don't carry the same mucositis or neuropathy risk that would make this worth the effort in the first place. Your care team knows your specific drugs, your specific risks, and your specific health history in a way that no blog post, mine included, ever will. Ask them if you're a good candidate. Ask them what they've seen work for other patients on your exact regimen. Let them help you build a version of this that's actually right for you.

One last thing

This is not easy. I'm not going to pretend the hours of deliberate cold were pleasant, because they weren't. There were infusions where I questioned whether it was worth it, where my hands ached from the cold as much as anything else about that day. But every single time, I reminded myself what I was protecting, and I kept going. If you decide this is right for you, you will have days where it feels like too much. Push through anyway. It was worth it for me. I believe, given the chance, it can be worth it for you too.

💜 Kayla