What changes, and why it matters
Most people carry a mental picture of how they look. They may not always like it, but they are used to it. The National Cancer Institute describes how cancer and its treatment can change that picture, and lists changes people often face:
- Hair loss, including eyebrows and eyelashes
- Skin and nail changes
- Scars or other changes from surgery
- Weight gain or loss, or swelling from certain medicines
- Loss of a limb
- An ostomy
- Loss of fertility
Some changes are short-term and some are lasting. The American Cancer Society notes that changes to skin, nails and hair are usually temporary but can still be stressful during treatment. Other changes are invisible to everyone but you. According to the National Cancer Institute, those losses are real, and it is okay to be upset about them.
The feelings that come with a changed body
Body image after cancer is rarely just about vanity. It touches identity, privacy, attractiveness, and the sense of being yourself. Common reactions include:
- Grief for the way you used to look, or the way your body used to work
- Not recognizing yourself in the mirror, or avoiding mirrors altogether
- Self-consciousness in public, such as worry that an ostomy will leak or that people will stare
- Anger at your body, at the illness, or at the treatment that saved your life but changed it
- Fear that a partner will be less attracted to you, or that a new partner would reject you
- Worry, for parents and grandparents, that a change in appearance might frighten a child
- Feeling you have no right to mind, because you are supposed to be grateful
The National Cancer Institute calls feelings of anger and grief about body changes natural. You can be thankful for treatment and still mourn what it cost.
Body image is about more than appearance
How you feel about your body also includes how much you trust it. After cancer, some people feel betrayed by a body that became ill, or uneasy in one that tires quickly or no longer works the way it did. Others feel a loss of privacy after months of being examined, scanned and touched by strangers.
These feelings can spill into closeness with a partner. The National Cancer Institute notes that feeling bad about your body can lower sex drive, which can make you feel even worse about yourself. That side of things is covered in Intimacy and Sexuality After Cancer: The Emotional Side.
Loss of fertility is one of the changes no one else can see, and for some people the grief arrives later, when plans for a family come back into view. The National Cancer Institute notes that, depending on age, the treatment received and the time since treatment, some people may still be able to have children, and that families come together in many ways, including adoption. Questions about your own fertility belong with your care team; the feelings about it are worth making room for too.
If you are single, body changes can shape how you feel about dating. The National Cancer Institute describes common worries: how a new person will react to hair loss, scars or an ostomy, how and when to bring up cancer, and a fear of rejection that keeps some survivors from the social life they want. One suggestion it offers is to wait until you feel a sense of trust and friendship before telling a new date about your cancer.
Ways people come to terms with body changes
Allow yourself to grieve
The National Cancer Institute encourages people to mourn their losses and to know that sadness, anger and frustration are allowed. Trying to talk yourself out of grief usually makes it last longer, not shorter.
Care for your body in ways that feel good to you
The American Cancer Society notes that some people care most about comfort rather than looks, and that this is okay; for others, small steps to care for their appearance help them feel more like themselves. A new haircut, a scarf, clothing that fits the body you have now, or makeup can give some people a lift. Check with your care team before using new products on skin that has been treated.
Move as you are able
Many people find that being active, even gently, helps their self-image and their sense of control over their body, according to the National Cancer Institute. Talk with your doctor about what is safe for you, and start slowly.
Talk with the people close to you
Loved ones can struggle with your changes too, and their worry or comments can add stress. Telling them what helps, such as not commenting on your weight or simply treating you as usual, can spare both sides a lot of guessing.
Find people who understand
Talking with others who have been through similar changes can make them feel less isolating. The National Cancer Institute suggests support groups and talking with other patients for advice. With time and help from others, it notes, many people adjust and move forward.
When it may help to talk with someone
It may be worth talking with a mental health professional if you are avoiding social events, mirrors or intimacy for months, if you feel ashamed of your body most of the time, or if the changes have opened up older struggles with appearance, weight or self-worth. The American Cancer Society suggests raising body image concerns with your cancer care team, who may recommend support services or specialists.
A psychologist can offer a private place to sort through what the changes mean to you. Dr. Lehmann's approach is insight-oriented and integrative, considering your history and relationships alongside practical coping skills. Learn more about cancer-related emotional support, and ask the practice whether she can help with your situation.