Body Image Issues? You're Not Alone

A breast cancer diagnosis affects virtually every aspect of a woman’s life and psyche. First, there is shock and concern: “Will I lose my life?” Then comes a second wave of worries: “Will I lose a breast? Will I lose my hair? Will treatment make me lose or gain weight? How will I look?”

“So much of a woman’s identity is tied to how she looks,” says Kim Lynch, R.N., breast health care coordinator at Mid Coast Hospital in Brunswick, Maine, and coordinator of the hospital’s Breast and Surgical Oncology Clinic. “The loss of one or both breasts is huge, and hair loss can be even more traumatic. Most people can’t tell right away if a woman has cancer, but with hair loss, it’s out there.”

Coping with the physical changes wrought by breast cancer and its treatment can be a struggle. There are resources, however, to help women look and feel better.

For women facing mastectomy, the choices include reconstruction at the time of mastectomy or much later. “More women today are opting for implants versus flap surgery, avoiding muscle involvement,” says Lynch. “And they have new nipples tattooed on. One patient I know goes to a nude beach regularly,” she adds. “She did it before her diagnosis and surgery, and she does it now.”

For women who prefer to be a bit more covered up at the beach and need a bathing suit that can hold a prosthesis, many bathing suit brands have styles designed specifically for this purpose. Regular one-piece and tankini styles can be altered to include an added pocket.

The same goes for lingerie. Lisa Cole, author of Lingerie: The Foundation of a Woman’s Life, urges women not to limit themselves to mastectomy bras with sewn-in pockets, noting that a seamstress can sew a pocket into any bra, broadening a woman’s options considerably. Get properly fitted, Cole advises, noting that if a woman wears the right style and fit of bra, no one will know she’s had a mastectomy or lumpectomy, and her clothing choices expand.

Hair loss—a frequent side effect of chemotherapy—can affect the head as well as the face, arms and legs, underarms and pubic area, Lynch points out. “A lot of women aren’t prepared for that,” she adds. The hair usually grows back after treatment ends, although some women report that it grows back in a different color or texture.

To camouflage hair loss on the head, a wig can enhance the appearance and boost spirits. If a woman wants to closely match her own hair color and texture, experts advise shopping for a wig while she still has her hair. “Or you can pick an entirely new hair color,” says Lynch.

She acknowledges that wigs can get uncomfortable. Occasionally, give the head a rest by wearing scarves, turbans or other attractive and easy-to-wear head wraps. Some hairpieces attach to hats and wraps with Velcro, giving the impression of a full head of hair. “Or you can be bold and go bald,” she says, recalling a patient in her 60s who staged a “coming out party” with her family.

Breast cancer treatment can also cause women to gain or lose weight. “Most women undergoing hormone therapy typically gain 10 to 15 pounds,” says Lynch. “And the steroids prescribed to prevent nausea from chemotherapy also cause weight gain.”

Choose clothing that you can wear whether you gain or lose a few pounds, such as pants with elastic or drawstring waistbands, wrap-around skirts and items made of fabric with some stretch.

“Many of these physical changes, like hair loss and weight gain, are temporary,” Lynch notes. “Most partners are very understanding about the loss of a breast; they’d much rather have you—alive—than your breasts.

“It’s important to acknowledge your hurt and pain [about the changes in your appearance],” she adds. “It’s real. But once you’ve accepted it, you can move on. Through this process, many women and their partners realize what’s really important and reorder their priorities. Women discover their beauty from the inside out.”

This article was first printed in Lifeline.

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