Self-Image

This can be a confusing and difficult time. Cancer presents physical, psychological, social and spiritual challenges that can test your resolve. A positive self-image is important, particularly during times of illness, when we tend to feel less good about ourselves. Cancer and cancer treatment may cause changes to a cancer patient’s physical appearance … some temporary, some permanent … which can impact self-esteem.

Please remember that some cancer patients you minister to may be trying to understand who they were before becoming a “cancer patient,” and who they are now. When all they may want is for life to go back to normal, physical changes may be a daily reminder of their struggle. Also, when changes to their physical appearance become apparent to others, it can be difficult. They may be faced with questions about their situation they aren’t prepared to deal with yet.

Physical Changes Associated with Cancer and Cancer Treatment

Cancer and cancer treatment may change how a person’s body looks, feels and performs. The following are some physical changes associated with cancer and cancer treatment which may impact self-image:

• Changes in weight (i.e., loss or gain)
• Thinning or loss of hair
• Changes in skin tone/color (i.e., blotchy skin) and nails
• Physical changes from surgery (i.e., scarring, loss of limb or part of the body)
• Changes in posture (i.e., Kyphosis, or hunchback)
• Changes in physical performance/abilities
• Changes in bodily, reproductive functions (i.e., incontinence, infertility)
• Swelling in the limbs (i.e., lymphedema)

These physical changes may affect self-image in different ways. Cancer patients may feel self-conscious or embarrassed about their body and appearance. Even if they don’t look different to others, they may feel that others see them differently. A good self-image may help them feel more confident, help reduce depression and anxiety and improve their emotional well-being.

Tips for Adjusting to Changes in Physical Appearance
When you work with cancer patients, suggest they:

Know what side effects to expect by learning more about their cancer and treatment options Suggest they help prepare themselves by asking the doctor ahead of time what side effects they can expect during cancer treatment and then think about a plan for possible side effects. For example, if the doctor anticipates hair loss, a cancer patient may want to cut his or her hair very short before it begins to fall out.

Allow themselves time. It may take time for cancer patients to adjust to how they look and feel about themselves. Help them try not to become discouraged. Give patients time to grieve physical losses. As they get well, they will feel and look better. Also, understand that many of these changes in appearance may be temporary and will go away after treatment is completed.

Ask about reconstructive or cosmetic options.
Reconstructive surgery, prosthetic devices and cosmetic solutions may help with many of the physical and emotional side effects of cancer treatment. If this is of interest, suggest discussing these options with the doctor.

Adjust expectations. If the physical abilities of cancer patients aren’t the same as they used to be, help them not to be hard on themselves. They may feel frustrated that their body has "let them down,” particularly if treatment is postponed because their body is unable to handle any more. These are all normal feelings. Understand that as they heal, they will probably feel stronger and less fatigued.

Find new activities of interest. If cancer patients you serve are unable to participate in some of their former activities or sports, suggest they try to find a new activity that interests them. Learning a new physical skill can help them regain confidence in their body. They may actually discover something they enjoy doing that they never tried before.

Seek support from friends and family. Advise them to let friends and family offer love and support. Having a support system can help them work through self-image issues.

Prepare ahead for reactions from others. If changes to appearance are apparent to others, cancer patients may be asked about it. Think about how they will respond ahead of time so they’re prepared to handle it.

Talk to other cancer survivors. Reaching out to others who have been in similar situations can be helpful. Talking with other cancer survivors about how they coped with changes in their appearance may help a cancer patient going through these changes feel less alone and provide new understanding and hope.

Seek professional help if needed. It’s normal to have feelings of anger, sadness, fear, frustration, anxiety, and/or lack of control about changes to body or physical appearance. If concerns about physical appearance become overwhelming, a cancer patient may want to ask his/her doctor for a referral to a counselor.

Tips to Share with a Cancer Patient for Improving Self-Image
Remind the cancer patient:

Remember you are still you. Healing involves an ability to accept change. While your body may look and feel different, remember you’re still the same person on the inside. Your personality, interests and character are still the same. Look within yourself and celebrate the person you are.

Keep up with routine health and hygiene activities. Remember that looking your best enhances your general feeling of well-being. Continue your routine grooming activities, even if you’re confined to bed. Maintain regular dental care.

Practice good nutrition. Maintaining a healthy, well-balanced diet can be a challenge during cancer treatment. You may be experiencing weight changes due to changes in appetite, activity, etc. A dietitian may be able to help you stay nutritionally fortified so that you look and feel better.

Stay active. Many people find that fatigue or loss of energy is the most challenging aspect of cancer treatment. Staying active can help you feel better about yourself and support a positive body image. If you're able, try to fit in light exercise or stretching each day, or as much as you can manage comfortably. A physical or occupational therapist may be able to help you deal with your physical limitations and improve your quality of life.

Take time for yourself. Pamper yourself. Read the paper, keep a journal, go for a swim, have a manicure, pedicure, facial, or a massage (if your doctor permits), etc. Remember to plan ahead for the downtimes when you may need to rest.

Try mind-body techniques. Physical and emotional issues may arise during cancer treatment. A mind-body specialist may be able to teach you techniques such as relaxation, guided imagery, humor therapy and stress management to help you cope with these issues.

Take part in activities outside of your home. If you’re physically able, get involved in activities in your community. Social activities are important in helping you focus on something other than cancer. They also reduce a sense of isolation and improve self-esteem.

Experiment with ways to enhance your appearance. Caring about your appearance may help you feel more confident and in control. Use makeup, wigs, headscarves, or other ways to enhance your appearance. If you lose or gain weight, have your clothes altered.

Take care of your skin and nails. During cancer treatment (i.e., chemotherapy, radiation therapy), you may notice changes in your skin and/or nails. Some skin reactions, which may be temporary, include redness, rashes, peeling, thin or fragile skin, very dry skin and/or increased sensitivity to sunlight. Your fingernails may become weak, break or lift off, or develop ridges.

Tips for caring for your skin

• Wash with warm water and a mild, unscented soap
• Consider using a non-allergenic deodorant
• Use an electric razor for shaving to avoid cuts
• Avoid tight clothing or irritating fabrics (i.e., wool)
• Protect your skin from sunlight, or extreme cold
• For dry skin, use creams that soften skin and moisturize (avoid perfumed or scented lotions)
• Drink 8-10 glasses of non-alcoholic fluid a day

Tips for caring for your nails

• Keep your hands moisturized and your nails cut short (avoid cutting cuticles)
• Avoid using artificial fingernails (which can harbor bacteria)
• Wear gloves to protect your nails when doing housework or gardening
• You may want to use nail polish to give your nails extra strength
• Soak your nails in (or massage with) vegetable or olive oil
• If your nails break or lift off, try to keep them clean and protected
• As always, inform your doctor at first signs of infection

NOTE: THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH PROVIDER PRIOR TO STARTING ANY NEW TREATMENT.

Dealing with Hair Loss during Cancer Treatment

Some cancer treatments may cause cancer patients to lose some or all of their hair (alopecia). For instance, while chemotherapy attacks rapidly-growing cancer cells, some chemotherapy drugs may also damage healthy cells, such as hair follicles. Some people experience hair loss and others do not, or to varying degrees, even when they are undergoing the same treatment.

If hair loss does occur, it usually begins within two weeks of starting chemotherapy and gets worse one to two months after the start of therapy. It’s normal to feel distressed about hair loss. However, it helps to know that hair will almost always grow back after treatment is complete. In fact, hair re-growth sometimes begins even before therapy is completed. It’s common for hair to grow back a slightly different color and texture (i.e., curlier) at first. If a cancer patient is concerned about hair loss during cancer treatment, suggest he/she ask the doctor if it’s expected.

Tips to Share for Dealing with Hair Loss
You can suggest to cancer patients:

• If you decide on a wig or hairpiece, have it ready in advance. This way, you can match it to your natural hair color, style and texture.
• Try scarves, caps, turbans, hats, or simply leaving your head uncovered
• If you have long hair, consider getting a stylish short cut.
• Use a soft bristle brush and avoid too much brushing or pulling of hair (avoid braiding or placing hair in a pony tail).
• Use mild, gentle shampoos and conditioners.
• Avoid coloring, perming or relaxing the hair.
• Avoid using hair dryers, electric rollers, or curling irons.
• Use sunscreen/sunblock, or wear a hat/scarf, to protect your scalp from the sun.
• In cold weather, wear a hat/scarf outdoors to prevent loss of body heat.
• Sleep on a satin pillowcase.