Body Image: Detailed Information

This information is meant to be a general introduction to this topic. The purpose is to provide a starting point for you to become more informed about important matters that may be affecting your life as a survivor and to provide ideas about steps you can take to learn more. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Suggestions and Additional Resources documents for questions to ask and for more resources.

Many survivors experience physical changes in their bodies as a result of cancer or its treatment. Each survivor may react to physical changes in a different way. It may be very difficult for you to accept the changes to your body. On the other hand, you may think the physical changes don't really affect the way you feel about your body.

It's also possible that your body didn't change as a result of cancer, but you still feel differently about the way you look to other people. If you feel negatively about yourself or your body after cancer, you might want to consider ways to improve your body image.

Your body image is what you believe about your own appearance, even though other people might see you differently. A poor body image may cause you to feel ashamed, self-conscious and anxious about your body. If you have a poor body image, you might think that your body size or shape makes you unattractive to other people.

Cancer can affect your body image by:

• Changing your physical appearance
• Damaging how your body functions
• Challenging your self-worth

If you have experienced changes to your body as a result of cancer or treatment, you might feel less confident about your physical appearance. However, it is important to remember that your body is only one part of who you are as a whole person. If you focus only on what your body looks like, you might overlook the strength of your personality, your interest in life and the talents you bring to many areas of your life.

Physical changes can be difficult to accept, and they may be a temporary or permanent part of who you are. Being a cancer survivor may also seem like a big change in how you see yourself. Finding your personal way of dealing with these changes may improve your quality of life and help you feel more confident during your survivorship.

Who might be at risk for having a poor body image?

Survivors who experience temporary or permanent physical changes to their bodies may be at risk for having a poor body image as they learn to adjust to changes in their bodies. The effects of a temporary physical change on your body image may last for a short time. A permanent physical change may have a more lasting effect on your body image.

Examples of temporary changes that can affect your body image:

• Hair loss
• Weight loss
• Weight gain

Examples of permanent changes that can affect your body image:

• Amputations, such as, limbs or mastectomies where prostheses can be fitted
• Permanent stomas, e.g. colostomy or ileostomy (an opening on the abdomen created surgically to empty contents of bowel into a bag)
• Infertility
• Scars from surgery or tattoo markings from radiation fields

Both permanent and temporary physical changes may or may not be visible to other people. When physical changes aren't visible to others, you may not notice any changes in how you feel about your body. However, even changes that no one else can see can affect you because body image relates to how you feel about your body, not how it actually looks to others.

Many people think that the only survivors who are at risk for having a poor body image are survivors who experience temporary or permanent physical changes to their bodies. This is not true. Even if you do not experience any physical changes from cancer, you might still feel that others see you differently. You may think that others don't understand you or can't relate to you now. Feelings of insecurity and uncertainty may affect your body image, even if your body looks exactly like it did before cancer.

What are some signs that a poor body image is affecting a survivor's quality of life?

• You don't want to leave your house because you don't want people to see you.
• You don't want to date or meet new people.
• You shy away from intimacy or sex with your current partner.
• You are afraid to undress in front of your spouse.
• You won't let your partner see your scars.
• You are embarrassed because you lost or gained weight.
• You feel ashamed for having cancer.
• You are unable to accept yourself for who you are now.

Why can cancer affect a survivor's body image?

Cancer and its treatment affect each survivor differently, and physical changes caused by cancer are unique to each survivor. Sometimes physical changes caused by cancer prevent you from working or doing the things you used to enjoy before cancer. This can be very difficult to accept. Even small changes in your body may seem overwhelming.

Your physical changes may also affect how others react to you, which can affect your body image. Not everyone knows how to react to people who have had cancer or who have physical changes from cancer or its treatment. Some people will react negatively, and that can cause hurt feelings and discomfort. Having a strong, positive body image may help you worry less about how other people react to your physical appearance.

After treatment ends, many cancer survivors want their lives to return to the way they were before cancer. If you have a permanent physical change, it can seem like a constant reminder that life is different. Also, if you see yourself differently after cancer, you may worry that your life will never be normal again. All these things can affect how well you feel about yourself and your body. You might want to consider giving yourself time to adjust to changes in your body or changes in how you feel about yourself. In time, your body image may improve as you start to adjust to life after cancer.

Are survivors always going to be at risk for having a poor body image?

If your body image didn't change right after you finished treatment, it's still possible for an aftereffect of treatment or a change in how you feel about your life after cancer to affect your body image. If you had problems with your body image before cancer, you may see your problems become worse over time if you don't address them. On the other hand, you may also see an improvement in your body image. You may think that cancer changed how you feel about certain things in your life. You may think that what others think of you isn't as important anymore.

Anytime you experience a major change in how you look or how you feel you look, you might be at risk for having a poor body image. Doing your best to remain positive and recognize your strengths beyond your physical appearance may help decrease your risk for having a poor body image.

What can survivors do to improve their body image?

All survivors deal with changes in body image in their own way. It is a personal experience. However, there are some general approaches that may help you improve your body image and begin to better understand your body after cancer.

Below is a brief list. For more information, see Suggestions.

• Talk to other survivors who have had similar struggles with their body image.
• Gain confidence in your appearance.
• Seek out professional counseling, either for yourself or with a partner.
• Include a healthy balance of exercise and good nutrition to improve how you feel after cancer.

This document was produced in collaboration with:
Susan Leigh, RN
Cancer Survivorship Consultant

Body Image: Suggestions

Talk to other survivors who have had similar struggles with their body image:

Support groups provide a safe environment to share experiences with other survivors, learn new ways to handle difficult situations and talk about emotions. You will see different styles of coping with stress and adjusting to life as a cancer survivor. If you are uncomfortable talking about certain subjects with your family or friends, a support group offers you a place to talk freely about what is important to you.

Cancer support groups exist in most communities.

Some ways to find out more about support groups in your area:

• Ask your health care team for suggestions. Some cancer programs offer support groups for cancer survivors and their family members right in the clinic or hospital.
• Call a nearby cancer center or university hospital and ask about support groups.
• Call the American Cancer Society at 1-800-ACS-2345 (1-800-227-2345) and request a list of support groups and cancer centers in your area.
• Visit LIVESTRONG SurvivorCare at www.livestrong.org/survivorcare, or call 1-866-235-7205 for information on support groups.

• Dress in clothing that makes you feel good.
• Spend time with people who make you feel good about, and accept you as you are
• Find a Look Good...Feel Better program through the American Cancer Society.

Seek out professional counseling, either for yourself or with a partner:

Ask a member of your health care team for a referral to a therapist who works with other cancer survivors. Most cancer centers employ oncology social workers who are specially trained to work with cancer survivors and their families. Even if you are not a patient at a cancer center, the oncology social worker may meet with you or refer you to someone else in the community.

It is important to interview the therapist to find out if he or she is the right professional for you. Speak honestly with the therapist and let him or her know your reasons for wanting to work with a therapist.

Examples of questions to ask the therapist:

• What type of education background do you have?
• What license do you have?
• What is your experience working with people with cancer?
• What do you understand about the emotional response to this illness?
• Do you take my insurance?
• Do you work with people who are anxious? Depressed?
• Do you know community resources for people with cancer?

Include a healthy balance of exercise and good nutrition to improve how you feel after cancer:

• Work with your health care team to develop an exercise program that fits your specific recovery needs.
• Talk with your health care team about ways to improve your diet and experiment with new recipes.
• Ask a member of your health care team to refer you to a rehabilitation specialist that can help you adjust to physical changes in your body.