After being told she had breast cancer in 2006, Ella, a 42-year-old mother of two went into survival mode. Once the initial shock of her cancer diagnosis wore off, Ella knew surviving her cancer was everything, no matter what it took.
One week later, she was in the hospital being prepped for a double mastectomy.
In the weeks following her surgery, Ella, who also went through a round of chemotherapy, began to suffer depression and body image issues. Outwardly, the loss of her breasts and hair, along with changes to her skin and fingernails and “grotesque” physical scars left Ella feeling “like a mess.”
“My reaction was less than stellar,” Ella said, “but I’d reached my low. My chest was lopsided, I had fake boobs with expanders and purple looking scars and no nipples—lovely! My weight gain was out of control and my clothes no longer fit. My body was puffy and bloated, my face looked like a balloon, my cheeks are nearly always red, my skin hurt, I felt horrible and couldn’t sleep; I felt like crying all the time. Having cancer sucks!”
There’s no denying it, cancer and its treatment take their toll on a person’s body. While some physical changes may be short-term, others can be permanent and can affect how a woman feels about herself.
A diminished self-image, as well as other emotional, social and sexual issues are side effects of cancer treatment that, until relatively recently, weren’t talked about.
For many women, losing their breasts signify the loss of their femininity. For others, therapy-induced hair loss is devastating. For some women, it’s both. Coping with the grief of loss can be difficult to overcome, but there are things you can do to help ease the transition.
Social values and femininity
In the book, "New Frontiers in Ethnography" (Emerald Group Publishing, 2010) editor Sam Hillyard noted how historical and cultural emphasis on breasts is not only the “defining feature of femaleness and womanliness” with nurturing and erotic qualities, but female breasts, particularly in western societies, have also become ‘objectified and fetishized’ to have ‘emotional and symbolic significance “which gives the women value as women and gives them their self value.”
“Consequently with such a perceived values and worth placed on the breasts, it is unsurprising that society sees ‘the surgical alteration or removal of the breast as part of the treatment of breast cancer ... as significantly decreasing a woman’s femininity and overall self-esteem,’” the book says.
Surgeon Susan M. Cash, attending physician in the division of surgical oncology of breast surgical services at Baystate Medical Center in Springfield, Mass., said that breast surgery is unique because it deals with more than physical scars.
“Self image, cultural norms, and religious beliefs all affect how women view surgery for breast cancer. Women worry about starting new relationships and maintaining old ones. They worry about how they will look unclothed, not only to their significant others, but to themselves. Some women feel guilty about wanting to maintain physical appearance in the face of a cancer diagnosis,” Cash told The Republican newspaper.
Telling the ‘Negative Committee’ that meets in your head to sit down and shut up
Michelle Cororve Fingeret, Ph.D., an assistant professor in the Department of Behavioral Science at the University of Texas, MD Anderson Cancer Center created Body Image Therapy Service, one of the first programs in the nation to help breast cancer patients manage and cope with body image concerns, increase their self-confidence in social situations, and discuss treatment decisions that will affect their outward appearance.
Fingeret said that most of her patients struggle with isolation because they become unhappy with their bodies. Through counseling, she helps them regain social confidence.
“Every cancer patient experiences body image concerns,” she said. “It’s relevant and applicable to all.”
A negative body image and low self-esteem can affect a survivor's ability to be intimate with a partner, which has a major impact on quality of life. Good communication is essential to retaining or regaining intimacy after cancer. Fingeret advised women to get medical help if problems continue.
“I strongly encourage cancer patients to talk with their doctors about body image issues. This is extremely important before treatment so they’ll be better prepared for what to expect in terms of disfigurement or functional loss. Patients with unrealistic body image expectations end up having a much more difficult time adjusting.”
To help you cope with emotional issues such as body image and low self esteem, depression, personal relationships and communication skills or sexual issues related to your cancer, consider joining a support group or enrolling in counseling.
Face-to-face groups are available in many local communities through hospitals or medical centers, or you can find local groups online through Breastcancer.org or the American Cancer Society.
Experts say you can also strengthen your self-image by exercising regularly to reduce depression and improve overall self-esteem, practicing positive thinking and mental imagery, finding solace through spirituality, or treating yourself to a manicure or a new bra.
In the end, it’s about not being so hard on yourself, realizing that you’re beautiful inside and out, and every stage of life — cancer or not — requires each of us to change and adapt.
Lynette Summerill is an award-winning writer and Scuba enthusiast living in San Diego, CA with her husband and two beach loving dogs. In addition to writing about cancer-related issues for EmpowHER, her work has been seen in newspapers and magazines around the world.
Sources and patient information:
New Frontiers in Ethnography. “Breasts, Beauty and Body Image”. Sam Hillyard. Emerald Group Publishing, 2010, p. 131.
Breast Cancer Surgeon Susan Cash: ‘More than physical scars.’ The Republican. Anne-Gerard Flynn. 3 Oct. 2011. Access online at: http://www.masslive.com/breast-cancer/index.ssf/2011/10/breast_cancer_surgeon_susan_ca.html
Body Image Issues for Cancer Patients. MD Anderson Cancer Center. Network, Winter 2011. Lena Maciel. Access online at: http://www.mdanderson.org/publications/network/issues/2011-winter/body-image-issues-cancer-patients.html
“Social and Emotional Impacts of Cancer.” Online at: http://www.mdanderson.org/patient-and-cancer-information/cancer-information/cancer-topics/survivorship/health-and-well-being-after-cancer/index.html
Reviewed April 3, 2012
by Michele Blacksberg RN
Edited by Jody Smith