Today we live in a self-conscious world where most of us attach at least some of our identity and personal worth to our appearance. With social media at our finger tips 24/7 it can be almost impossible to escape the traps of physical, emotional, material and achievement comparisonitis. A quick scroll through your favourite social media channels will show you your besties, colleagues and public figures as the best ‘filtered’ versions of themselves. And of course I am no exception, no judgement here.
So what happens when your physical appearance rapidly changes as a side-effect of life saving treatment? For many patients there is little time to prepare mentally for the physical changes that occur as a result of cancer treatment. Sometimes a patient’s physical changes that occur because of treatment cannot entirely be predicted. A good example of this is hair loss in chemotherapy. Despite what you see in the movies, not everyone will loose their hair as result of chemotherapy.
Most cancer treatment is time critical and scheduled as a matter of urgency. Before you know it you are being wheeled into the operating theatre, being connected up to your first bag of chemotherapy or laying down for your first dose of radiation. Health professionals do their best to emotionally prepare patients for the physical changes ahead, however everyone’s body will respond a little differently. Equally, everyone has their individual perception of their physical appearance, value on their appearance, emotional capacity, resilience and pre-existing body image. Age is also an important factor, although anyone at any age can place significant personal importance on their physical appearance. Never assume!
Before I became a cancer patient, as a nurse I didn’t understand the impact and longevity of cancer side effects. When we think about cancer and treatment side effects we usually think about the physical changes caused by surgery, hair loss, weight loss, weight gain, nausea, fatigue and frailty. These are the side-effects that are easy to see and perhaps easy to understand. They are visible to us as patients and to those who know us.
However there are other cancer side effects that can be harder to detect. Some side-effects are more discreet or even invisible. For some patients the side-effects that others can’t see are the most debilitating and long lasting.
Our self esteem describes the way that we feel, value and think about ourselves as a person. Body image on the other hand, refers to the perception that we have of our body. A person’s body image is a reflection of how a person sees, thinks and feels about their body. Reduced self-esteem and body image during and after cancer treatment is common.
Some people feel extreme guilt about disliking the changes that have occurred to their body. Overwhelming feelings of “I should just be grateful that I am alive”, can be debilitating. The reality is that for some people, looking in the mirror is a daily reminder of trauma, a reminder of the impermanence of life, the ‘what if’s’ and the ‘what could have been’.
If this is occurring for you or someone that you know it is really important to seek professional help. Remember you are human, have undergone major life changes and you have been unwell. Please don’t place any added pressure on yourself by expecting that you should feel and respond in a particular way to your illness or the effects of your treatment.
Because I didn’t need chemotherapy to treat my early bowel cancer, I managed to escape a number of the ‘typical cancer’ physical side effects. Relatively speaking, my physical appearance changes were pretty mild. Seriously (crocodile-like) dry skin and a general feeling of ‘looking aged’ are my top appearance changes. Some days I look in the mirror and think WTAF happened, how have I aged so much in the last two years?
Perhaps it was the physical illness, the surgery, or the stress- in reality it is probably a combination of factors. But the new lines, the bags under the eyes, and loss of skin elasticity (I’ll spare you the list) all tell a tale of grit, an emergence from the depths of despair and… determination. I know that compared to so many other women in my cancer communities, I have escaped relatively unscathed for which I am extremely grateful.
It’s not all about the physical
Some patients also experience a loss of self-esteem when their physical abilities and capabilities have been impacted as a result of illness and treatment. Cancer patients may experience vulnerability and sometimes even a change in their professional, family and social status. All of these changes combined will impact on a person’s self-esteem, quality of life and relationships.
Reductions in self-esteem can have a significant impact on a person’s mood and lead to the person opting out of their usual activities including socialising, participating in hobbies, and working. This is really important. It is essential that patients, family and health professionals alike are aware of these potential side effects. The more aware that we are, the more likely we are to recognise and act early on these side effects to improve a person’s recovery and overall quality of life.
Not everyone feels that same
Not all cancer patients experience reduced self esteem. Some people find that they love their body even more after cancer. The inner strength and determination that these patients have found through illness and treatment provides them with a new strength and appreciation for what their body has achieved. Remember there is no wrong or right. Your experience is your own unique experience. Please do not add harsh self judgement to your ‘issues list’.
What women say – beautiful and raw quotes from my cancer community
” I think cancer is very much affecting us by taking away our beauty… you lose your hair, your nails, your skin changes, your eyebrows and eyelashes fall out… after the surgery our bodies are left mutilated and we sometimes have to see that change every day we take a shower… (one of my breast was removed and I could not look at myself in the mirror for months and still avoid it) the lesson that I have learnt through this process and the one I will share with my children is that true beauty lies within, in the spirit, in strength and determination to kick cancers butt by all means necessary!”
“I had a mastectomy right side. I get bad anxiety when just looking at it or touching it to put cream/moisturizer for the after care of radiation burn. Not mention I am losing more control over my bladder and bowel because of hormonal treatment, that’s embarrassing in public”.
“Losing hair etc didn’t bother me. Losing my organs and constantly pooing myself did”.
“I think losing my hair, eyebrows, eyelashes affected me more than my mastectomy. At least you can cover up surgery sure but if you have no hair etc then its harder to “hide” that”.
“I totally feel like I lost my dignity, sexuality and intimacy after being diagnosed with bladder cancer. I do unfortunately have an extensive history of sexual abuse as a child and young adult, so it really amplified and brought back memories which makes bladder cancer procedures really challenging to face. I can’t even think about wanting to to be intimate with my partner as the cancer procedures and my history have ruined that part of me. I definitely feel less of a woman with no intimacy desires which is sad”.
“I still remember the first day I saw my body after all my surgeries. I cried, I’d lost so much weight my skin was sagging everywhere, my abdomen was covered in stitches and I had a illeostomy bag hanging off body. I barely recognised the person in the mirror. My appearance continued to change with chemo, losing more weight, hair thinning and falling out. What makes it worse is my partner struggles with my appearance and is grossed out by my scars and bag. I’ve noticed that I’ve started to wear more makeup and do my hair, I can’t leave the house without trying to look normal..but I still look sick. I would love to feel beautiful and even get a compliment for once from my partner…but I don’t .. I long to be touched, just a simple hug or a kiss would mean the world to me…”.
“I think I’ve dissociated from my body a bit. It mostly does it’s job (gets my brain from one point to another so I can care for my son) and that has to be good enough for now. When I think about myself in my head I look like I did before it all happened. I don’t really ‘see’ myself as I am currently”.
“My self image has actually improved body wise. I have NO idea why. I absolutely despised my hair until a few days ago when I decided to colour it and it reached the length that it looked good in a headband. Tomorrow I’m having my brows and lashes done and getting a new pair of glasses to improve it even more”.
“I’ve lost my hair through chemo and had a fail reconstruction leaving my chest looking rather deformed. It doesn’t bother me anywhere near as much as it bothers others. I still feel like the same person before cancer but sooo much happier now. Our “image” doesn’t always reflect or define the way we feel and we are certainly NOT our bodies either. Image in my opinion really is, just an illusion”.
All feedback shared as always with permission. Mummas, I am forever grateful to you.
Strategies to improve body image and self-esteem
So, what steps can we take to improve the way that we feel and value ourselves? While there is no magic pill or silver bullet, there certainly are incremental steps that you take to improve how you feel about your body and self-image.
- Give yourself time to adapt to changes.
- Focus on the positives that you have in your life – external to your physical appearance.
- Be kind to yourself – pay attention to and avoid negative self talk.
- Improve your mindset through daily meditation and yoga.
- Daily affirmations (I like the work of Louise Hay)
- Write out a top 10 list of things that you do like about yourself. Appreciate what your body can do and what is unique about you. Put the list somewhere that you can see it regularly.
- Surround yourself with uplifting people.
- No comparitonitis. Avoid comparing yourself with friends, colleagues, acquaintances, celebrity and social media images.
- Have a break from social media.
- Get physical daily – exercise, walking, dancing, sport.
- Get creative (drawing, painting, craft).
- Get support – talk to a cancer counsellor or psychologist.
- Know that you are not alone. It is easy to feel like you are the only person in the world who is feeling the way that you are (I assure you, you are not).
- Wear comfortable clothes in colours that make you feel good.
Whatever strategies you choose to implement remember consistency is key. In the same way that one gym work out wont make you an award-winning body builder, an adhoc approach to improving your mental health or mindset wont work either. Commit to a month of implementing changes before you decide if they are working .
Organisations supporting women to find confidence after treatment
The Beautiful You Program located in Queensland on the Sunshine Coast, was founded 12 years ago by Debbie Clayton. Debbie established the community funded organisation after her mum passed away from cancer. The organisation offers a number of services including the ‘Look Beautiful Feel Beautiful’ mornings where guests can try on wigs, learn about skin care and how to apply make-up. The mornings are a great way to connect with other women going through a similar journey. In Debbie’s experience, cancer impacts a women’s self esteem immensely because of “loss of hair, libido, muscle pain, neurological issues and so much more”. Debbie encourages people with cancer to “look after number one, and take the time to recover”. Referrals are accepted directly from health professionals and patients. To find out more head to https://beautifulyouprogram.org.au.
Look Good Feel Better is a free national community service program, dedicated to teaching cancer patients how to manage the appearance-related side-effects caused by treatment for any cancer type. Services include face-to-face workshops, home delivered confidence kits, virtual workshops and confidence consults. To find out more information head to https://lgfb.org.au/who-we-are/.
Thank-you for reading,