Body image
Topics covered on this page:
How does this affect me?
Cancer can affect the way you look and how you feel about yourself (known as self-esteem). Physical changes such as losing your hair may surprise you when it happens and make you feel self-conscious or less confident. Common unwanted side effects of cancer treatment like radiation therapy, chemotherapy, and certain medications may affect your appearance. These side-effects can include hair loss, weight gain or loss, skin changes, and scars if you have surgery. These changes, while unpleasant, are not always permanent. For example, hair loss (called alopecia) may not always occur and for most treatments, hair loss is temporary. The amount of hair loss varies according to treatment type and the area being treated.
However, you may be one of the many people who undergo surgery and are faced with major changes in appearance. Common surgeries that remove cancer are a mastectomy (removal of the breast) for breast cancer or an ostomy (an opening for stool or urine to pass and collect into a pouch) for bowel or bladder cancer. The effects of these lifesaving surgical procedures may be difficult to process at first and may impact your self-esteem. It is important to remember that over time, you can find ways to connect with your body and build a positive self-image despite physical changes.
What can I do to feel better about the way I look?
Regardless of how your appearance is affected, it can be helpful to plan what you can do to increase your confidence during this difficult time and feel more like yourself.
How much hair you lose and when it will grow back depends on your treatment. You may notice hair loss from your head and other parts of your body after approximately two weeks of chemotherapy. This change may be sudden or gradual. If you are treated with radiotherapy, you will notice hair loss only in the spot that is being treated. Speak with your oncologist for more information about what changes to expect. It is ok to feel sad and mourn the loss of your hair, but there are several things you can do to cope:
- Get a short haircut before you start losing your hair – this will make your hair seem thicker and lessen the drastic change.
- Use a colourful headscarf or a hat to cover your head – you can mix and match colours with your clothes.
- Use mild shampoo and conditioner, gently pat your head dry, and brush carefully.
- Use a satin pillowcase to prevent friction against your hair while you sleep.
- Avoid perming, straightening, or curling your hair as this can damage it and make it more brittle.
- Do not shave your head as it can cause skin irritation. If you prefer very short hair, go to a hair salon where they will use an electric razor and guard.
- If you decide to cover your hair loss, consider purchasing a wig early on. You can match your wig with your natural hair colour and choose a style that suits you. Synthetic wigs are generally more affordable than natural wigs and easier to maintain, though they come already styled. Natural wigs look nice and can be restyled but need more maintenance. You can check out wig stores to learn about your options and get the information you need to make a decision.
A loss or gain in weight can also affect your self-esteem and impact how you relate to others. A common worry is whether or not you will be able to carry out your usual activities, especially if you were very active before treatment. It will take some time to adjust to these changes so be gentle with yourself and remember that your body needs time to heal and not all changes are permanent. Here are some things you can do to deal with weight fluctuations:
- Eat a balanced diet and talk to a dietitian for help in managing your appetite. They can also help you learn about a healthy diet and give you meal plan options.
- Exercise. You can try gentle exercises and stretching to boost your mood, improve your health, and give you strength. Consult your doctor before starting a new exercise routine.
- For more information see Looking After Yourself.
- Wear clothes that help you feel good. Choose an outfit that makes you feel confident to boost your mood.
- Spend time with people who accept you and appreciate you. This can help remind you that you are still you, despite some physical changes.
- Do not compare yourself to others. Everyone is different and people’s bodies are different, focus on caring for your body and on positive self-talk.
Surgery is a common treatment for breast and bowel cancer. Your oncologist may recommend this option depending on the size and location of your tumor. Depending on your individual case, surgery may involve removing a smaller or larger section of body tissue.
Breast cancer surgery
- A lumpectomy may be done to remove the lump and part of the breast tissue but not the whole breast. A mastectomy involves removing the whole breast. A few lymph nodes are often also removed to test for cancer spread. Ask your doctor to explain what the surgery involves and how much tissue will be removed so that you know what to expect.
- You may want to ask your healthcare team about a breast prosthesis (this would fit inside your bra and resemble the look of your other breast). You can ask your healthcare professional about options for a temporary, partial or a permanent prosthesis.
- You can also consider reconstructive surgery which can help rebuild your breast. Ask your doctor for a referral to a counselor and a specialist such as a reconstructive or plastic surgeon to talk about what options are right for you.
- Talk to a trusted friend or loved one about your insecurities; they may help you by listening to your feelings regarding surgery and remind you of your beautiful and positive qualities.
- Remember that it is OK if you choose not to have reconstructive breast surgery or a prosthesis. Every person is different and you may decide this is not the best option for you. For more information on your options see healthexperiences.ca.
- Be gentle with yourself and remember that it takes time to process change. If you are concerned about expressing your sexuality, talk to your partner and consider hugging, holding, and cuddling as ways to feel close.
- Pay attention to other parts of your body, treat yourself to a massage, get a manicure, or wear your favourite outfit and makeup. This can help remind you that you are attractive despite the changes from surgery.
Bowel and bladder cancer
Depending on the type and staging of your cancer, your surgical team may opt for creating a stoma which is a small opening on your abdomen that allows for the draining of stool (poo) or urine (pee). It collects into a pouch that can be emptied. These types of surgeries are more common than you may think and the result can be quite discreet and odour-less. However, it does take time to adjust to this surgical change.
- Keep in mind that people with ostomies can still go on to have full, active, and meaningful lives.
- It is important to express and share your feelings with your healthcare team, they can support you and help you manage your ostomy.
- It takes time to adjust to surgical changes, especially one such as an ostomy. Take the time to psychologically adapt; you may experience feelings of denial, shock, reservation, and sadness, but eventually you will adapt and find a way to cope. Talk to a counselor about this.
- You may want to join a support group for people with stomas and seek out community resources (see Where can I find help?).
- Communicate openly and honestly with your parner, it is normal to take time to adjust to your ostomy. Find ways to be intimate and feel close to one another such as hugging, holding, and talking about what qualities you admire and like best about each other.
You may notice your skin is more sensitive, itchy, red, or dry since starting treatment. You may also have scars from surgery that removed your cancer. Changes to your skin are common both during and after cancer treatment. Here are some tips you can follow to reduce skin damage:
- Wear a wide-brimmed hat and protective clothing to protect your skin from drying out or sun damage.
- Wear sunscreen when you go outdoors. Ask your healthcare team if sunblock is ok for your skin, if you are receiving cancer treatment.
- Use hypoallergenic products for sensitive skin.
- Moisturize frequently but talk to your healthcare team before applying products to an area that is being treated.
- Look at your scar but do not fixate on it. Instead focus on the parts of your body that you like and feel comfortable with.
- Remind yourself that your scar will look better over time, especially after sutures or staples are removed and it has had time to heal.
What help do I need?
- It can be helpful to keep track of your symptoms and concerns in a journal. For more information see Symptom Diary.
- You can also write down questions for your healthcare team and bring this list to your next appointment. Questions may include things about exercise routines, dietary plans, or what physical changes you can expect after or during treatment.
- Write down the physical changes you have noticed and what you will do to feel better.
- Think about asking your family or friends for help in carrying out your plan. For example, ask someone you trust to go wig shopping with you or plan a time to go through your closet’s contents to sort out the clothes that make you feel good versus the ones that no longer fit well.
- For more information see Problem solving.
Where can I find help?
You are not alone in your journey with cancer. Ask for support when you need it.
Talk to your doctor and nurses about the physical changes you are experiencing. They can guide you and give you information on what to expect with hair loss, weight and skin changes, and surgery scars based on your treatment.
- Ask your doctor for a “prescription for a wig” to help cover the cost through your private health insurance or so you get reimbursed when you file taxes.
- If you are undergoing major surgery to remove your cancer, your doctor may also refer you to another specialist who can talk to you about reconstructive surgery after the cancer has been treated.
- Your doctor can also refer you to a dietitian or counsellor for added support.
Ask about resources in your hospital and community such as the Look Good Feel Better (LGFB) program. This is a free program for women with cancer that focuses on improving body image and self-esteem. It provides tools and guidance on how to cope with changes in physical appearance and offers a one-time free workshop. They can also connect you with a hair stylist and make a wig consultation to address hair loss. Visit Look Good Feel Better or call 1-800-914-5665 for more information. There is a LGFB website specifically for men, where there is information on managing skin, hair, and body issues. Visit Look Good Feel Better For Men for more info.
Your hospital may also have information on where to find used wigs for free or at a very reduced price. This may be a helpful resource if you do not have private insurance and cannot cover the cost of a wig. Use the resources locator to search for wig stores and other resources in your area.
- Visit the Community Services Locator to find resources in your area such as support groups, wig stores, hair stylists, and many more.
- Quebec Cancer Foundation: The Foundation provides a resource directory where you can search for the organizations near you offering a variety of services including home help, lodging, transportation, and other supportive resources.
- Visit your hospital’s cancer library or ask your healthcare team for recommended books on physical appearance and body image. Self-help books may provide you with tips on how to improve your self-esteem related to your physical appearance.
- You can also join a discussion group online where you can ask questions and share experiences with other cancer patients and survivors who have gone through something similar. Check out healthtalk.org or Macmillan Cancer Support for more information or ask your hospital about local support groups.
Lean on your loved ones for support and spend time with those who value you. They can remind you that you are still you despite changes to your physical appearance and they can help you regain some confidence. Let your family know about what changes to expect such as hair loss so that they can support you when/if it happens.
What can I do to look after myself?
Looking after yourself can help your confidence. Along with eating well and exercise, try your best to sleep well and explore these relaxation strategies to decrease your level of stress.
Good sleep can be difficult if you are worrying about something in particular, like your appearance. Sleep is important as it can affect your ability to heal. The following strategies may help your sleep:
- When you feel ‘sleepy’ it is time to go to bed – trust your body to let you know when it’s time for bed.
- If you can’t fall asleep after 20 to 30 minutes, get up and do a relaxing activity before you try again.
- Take time to relax before bed by doing an activity you enjoy like reading, listening to music, or taking a warm bath. It is best to turn off the tv or computer 60 minutes before you go to bed.
- Get up at more or less the same time every morning and let natural light into your space.
- Avoid long daytime naps. If you nap for less than an hour in the afternoon, you may find you have more energy during the day. It is best to nap in a room other than your bedroom if you can.
- Avoid caffeine after lunch and alcohol after supper.
- Go to bed neither too hungry nor too full.
Relaxation strategies are a useful way to help relax your mind and body. The good thing about these techniques is that they can be done almost anywhere. For more information see Relaxation Strategies.
- Breathing exercises. This focuses on slow, deep breathing. Even a few minutes of deep breathing can help you relax.
- Progressive muscle relaxation. This involves tensing and relaxing a muscle, or group of muscles, one at a time.
- Guided imagery or visualization. Some people find that this technique relaxes them by helping them imagine being in a place that makes them feel calm in real life. Guided means someone talks you through the process in person or using a recording.
- Meditation. Meditation is a practice of quieting the mind, usually by focusing attention on the breath. You can meditate sitting, lying down and even walking.
- Massage therapy. Use a certified massage therapist who has experience working with cancer patients.
- Relaxation activities. Yoga (some types) and tai chi involve slow, meditative movements that help relax the mind and body. Look for classes with trained instructors so that you learn the proper techniques.
Available services
The Quebec Cancer Foundation supports people with cancer and their loved ones throughout Quebec, through services suited to their needs and daily concerns.
Services offered for body image
Several services and activities offered by the Quebec Cancer Foundation can be useful to help you manage your anxiety including psychological support such as guided meditation, art therapy, and telephone peer-matching. Other services such as wellness workshops, yoga and massage therapy are also featured.
The Quebec Cancer Foundation also has many documentary resources on the subject. Via the Info-cancer library, their documentalists specialized in oncology can guide you in your search for information and give you suggested readings.
Contact
1-800-561-0063
The mission of the Quebec Breast Cancer Foundation is to promote the well-being of cancer patients and their families through research, innovation, support and awareness.
It is committed to offering a range of services, including a hotline for information and resources adapted to the needs of people living with cancer.
Services offered for anxiety
Ma Santé Active – Reducing stress can help relieve anxiety. The Ma Santé Active program helps you get regular physical activity and relaxation, including oncology yoga sessions.
Soutien psychosocial et rencontres familiales – The social workers in their psychosocial support service can also help you implement strategies to improve stress and anxiety management.
Clinique virtuelle – The Quebec Breast Cancer Foundation offers a free, easy-to-use virtual clinic, accessible 24 hours a day, 7 days a week. The virtual clinic is a primary care service offered to people affected by breast cancer and their families:
- Better monitoring and screening
- Management of post-treatment side effects and those that persist long-term
- Promotion of healthy habits and lifestyles
- Coordination of care between specialists and general practitioners
You can also share your experience with others who have been there on our online communities:
Parlons cancer du sein Facebook group
Club stade 4 Facebook group
Service locators
The Regroupement des Organisations Communautaires en Oncologie (ROCO) offers a service locator resource specific to the province of Quebec. It lists support resources available by region.
Contact
514-506-3503
The Quebec Cancer Foundation offers a resources directory of community, association and public resources by region or postal code.
The foundation also has a document lending service. Their materials (books, web resources, online articles, webcasts) cover a wide range of topics related to cancer. It is free to borrow and materials are sent by mail or email anywhere in Quebec.
Contact
1-800-363-0063 (Monday to Friday, 9 AM to 5 PM EST)
Resources
For more information on how to manage your symptoms, check out the resources below.
Canadian Cancer Society – Find a Wig
BC Cancer – Hair Loss and Appearance
Canadian Cancer Society – Eating well during and after treatment
Canadian Cancer Society – Being active
Canadian Cancer Society – Body Image and Self-esteem
Canadian Cancer Society – Breast Cancer Resources
UHN – Breast Cancer: Your Emotions, Body, Image, and Sexual Health
United Ostomy Association of America (UOAA) – Ostomy information
Acknowledgement of sources
The content of this document has been adapted from the following sources:
- BC Cancer: Hair loss & Appearance. 2020.
- BC Cancer. Personal Appearance Pathfinder. 2020.
- BC Cancer. Resources for Hair Loss and Appearance Changes. 2018.
- Canadian Cancer Society. Being active. 2020.
- Canadian Cancer Society. Coping when you have cancer. 2017.
- Canadian Cancer Society. Breast Cancer: understanding your diagnosis. 2015.
- Fondation quebecoise du cancer. Beauty tips for cancer patients. 2020.
- Fondation quebecoise du cancer. Managing Side Effects. 2018.
- Leukemia & Lymphoma Society of Canada. Hair Loss. 2020.
- Nova Scotia Cancer Care Program. Patient & Family Guide: hair loss. 2018.
- UHN. Breast Cancer. Your Emotions, Body Image, and Sexual Health. 2019.
- UHN. Managing Body Image Concerns after Cancer Treatment. 2017.
- UHN. Princess Margaret. Preparing for hair loss from cancer treatment. 2017.
Healthcare professional endorsement
The content of this document has been reviewed and approved by a team of healthcare professionals and clinical experts.
Disclaimer
Please note that this fact sheet is not intended as a substitute for consultation with a healthcare professional. Rather, it was designed to complement interventions by your treating team. If you have questions about your health, or any medical issue, you should contact a healthcare professional right away. You should not delay seeking medical advice, or disregard professional medical advice, because of information in this fact sheet. Before beginning any health treatment, always consult your doctor. All care has been taken to ensure that the information contained in this document is accurate at the time of publication. e-IMPAQc is not responsible for any injury or damage to persons or property arising out of, or related to, any use of the fact sheet, or because of any errors or omissions.
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