Body Image after Breast Cancer – What is Visible to the World



In my last blog post, I gave an overview on body image after breast surgery and radiation. I invited you to befriend your breasts and come to accept them as they are. This takes time. When you’ve reconciled this loss, breast prostheses, mastectomy bras or reconstruction is the icing on the cake, rather than the cake itself.

Now, while it is devastating to lose a boobie or two, it is something private and can be covered up. What about the body changes that scream, “Cancer!” to the rest of the world? Treatment will lead to body changes that are visible to all. How do you involuntarily give yourself away?

Hair on your head

A study done by Dove in Dec 2015 found that only 11% of women love their hair as is. The rest of us wish that it was less wavy, more fine, less grey, more thick or, just fill in the blank. You never come to appreciate your hair as much as you do, until it starts falling off in clumps. In the shower, as you’re brushing it, while you’re going about your life: you’re shedding everywhere.

Some women choose to shave their heads early on to avoid the pain and the clean up of such a visible loss. Others choose to keep every strand of their hair until chemo is over and then get the shave to ready for new hair growth. Often times, patients speak to how difficult it is to face hair loss: there is no hiding that you have cancer and you’re going through treatment. A scarf or a wig simply don’t do the job of your own hair.

Overtime, if you are able to adorn beautiful head scarves, find a wig (or two) that lets you be yourself or wear your bald cut with pride, kudos to you sister! Whatever you choose, women can look amazing without long, thick, and shiny Pantene hair! But, what about other facial hair you had taken for granted?

Hair on your face

Brows look better thick and lashes long and thick, so says society. Regardless of whether you’ve totally bought into that message, we can’t argue the fact that your brows do help to shape your face and your lashes emphasize your eyes. When you’re going through chemo, your brows will likely thin out and your lashes fall out. These small changes can make you look and feel more vulnerable.

Let’s take a step back from these aesthetic features. Did you know that brows and lashes have actual functions? Brows help keep sweat and moisture out of your eyes while lashes protect your eyes from debris. Sensitive to the touch, lashes will also trigger the eyes to shut when there’s a foreign object near the eye. In light of that, can you imagine coming to appreciate why we have these hairy facial features? And, the next time you look into the mirror, remind yourself that these features have a purpose before the definition of beauty find them lacking and needing “modifications”.

Weight gain

Aside from hair loss, the other most noticeable change to the body during breast cancer treatment is weight gain. Perhaps you used to be active and lived a busy life. You might not have been training for a triathlon (or maybe you have been), but your schedule was full. During chemo, you inevitably experience early menopause and a drop in metabolism. Feeling tired and nauseated, you become less physically active and your previous lifestyle seems miles away. Side effects of meds can also cause increase in appetite and weight gain.

What to do about visible body changes

What would be giving and nurturing to you? Would you enjoy going for a makeover? Donning ginormous earrings? Loving your beret turban? Going for a head massage? Whatever it is, I invite you to be gentle with yourself. Your body needs A LOT of comfort and care, not a focus to return to status quo. Just as treatment is for a period of time, so some of the side effects of treatment will also be.

There is no returning to what is normal; rather, it’s about establishing a new normal. While it’s wise to have less on your schedule, you might try to slowly phase in a physical activity or two while on hormone therapy. Start with short walks and lengthen them with time. Be around good company for accountability sake. Above all, listen to your body; it has a lot to tell you.

If you need help reconciling these changes during and post treatment, let me know!

Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps distressed couples and breast cancer patients. That can also mean couples distressed by a partner’s cancer diagnosis, or couples wishing to use their marriage as a resource during their cancer journey. When she’s not at work, she has found yoga to be a wonderful practice to nurture self-compassion.