Your feelings about body image and cancer
At first, body changes can seem overwhelming. The feelings around ‘losing a part of yourself’ after a physical change to your body can be similar to the feelings of losing a loved one. You may have feelings of anger, anxiety, sadness and depression.
Feelings and emotions can come and go quickly. At times you may feel fine, but then suddenly you can feel overwhelmed, tearful or frightened. It’s perfectly natural to feel like this after a major change to your body, and it’s part of adapting to the way you see yourself after treatment.
There’s no set time or method for this process of adapting; everyone does it at their own pace and in their own way. For some people it may take weeks, for others it may take months or even years.
However, for some people, getting to grips with a physical change to their body can feel overwhelming. They may feel that they will never be able to come to terms with what has happened. If this is the case, it may be helpful to look at your feelings and to share them. Perhaps write them down or speak to family or friends about how difficult you’re finding it.
You may experience many different emotions. We mention some of them here.
All of a sudden I felt like a wreck, I was not looking the best and that made me angry. I liked my long hair and wearing push-up bras and making the best of myself. I didn’t feel like me.
It’s natural to feel angry when coming to terms with a loss such as a permanent physical change to your body. Even though it can feel uncomfortable, talking about it can often help people accept changes.
You may feel angry about the unfairness of your cancer and the change treatment has caused to your body. You can sometimes feel angry towards your doctor or nurse for what has happened.
We all have our own ways of dealing with anger. If you struggle to talk about anger, it might help to explore different ways of dealing with it:
You may want to go to a space where you feel able to scream, shout and cry as loud and as much as you want.
Some people take up boxing or exercise classes to get anger out of their system.
Music or other creative activities like painting, drama or dancing can also be useful to allow feelings of anger to be expressed.
We often feel anxious about situations that we think are unpredictable or dangerous. This causes the release of the hormone adrenaline, which results in a ‘fight or flight’ response to help us tackle or escape from the perceived danger.
When coming to terms with a body change, you might experience either the change itself or talking to other people about it, as a ‘perceived danger’. You may worry that people will laugh at you or comment on your appearance when you go out in public. This can make you feel anxious. Anxiety is one of the most common emotions felt by people with body changes.
Although some anxiety can improve our performance at times, such as during a job interview, too much anxiety is unhelpful. It can be an unpleasant feeling and can cause physical effects, such as:
a sensation of your heart beating too fast (palpitations)
needing to use the toilet more often
These unpleasant effects can cause you to avoid anything that you think will make you anxious. For example, if someone’s anxious about their appearance, they might avoid looking at a scar after an operation or in a mirror after they’ve lost their hair. When you start to wear a wig, going to the supermarket or meeting new people may be frightening. Some people may avoid anything to do with their colostomy bags.
This is a normal response for some people when they feel anxious about something. There is no set time for facing a physical change to your body. You will know when you feel ready to do it.
However, family, friends or healthcare professionals may confront you if they feel you may be avoiding the change in your body, which can be upsetting. It may be helpful to tell them how you feel about the change.
One way of dealing with avoidance, is to face the change in your body gradually. This is often done best with someone you trust, such as a relative, friend or healthcare professional, at a time when you feel ready.
For example, someone that had a mastectomy may first want to become comfortable with the idea of having lost a breast. Once they’re okay with this idea, they may want to touch the area where the breast was. And when they are comfortable doing this, they may want to remove the dressing next time and look at the scar. This can happen over a period of time that is acceptable to you and in as many sessions as you need.
Fear is often bigger than the reality and you may find that your fear was completely unnecessary.
Anita's experience of body changes
Anita’s hair was growing back after treatment. She planned to meet a friend for lunch, but she was anxious about going out for the first time without her wig. She chose a quiet hotel and agreed to meet her friend in the hotel lobby. However, Anita didn’t know that the hotel was holding a big event that day and people she knew were going.
When Anita saw lots of people in the hotel, her initial response was to leave as she was worried about their reaction to her short hair. But she didn’t want to let her friend down so she waited in the lobby. She noticed that her feelings of anxiety quickly passed as everyone she knew was so glad to see her, they didn’t appear to notice her hair. Other people she didn’t know just seemed to go about their business. This experience increased Anita’s self-confidence.
What might help
It might also help to think about the advice you were given as a child: ‘if you fall off your bike, get straight back on’. This positive approach lets you confront your fears, which usually reduce or go away.
There are many other things you can do to help you manage your anxiety and to get back in control:
Talk about how you feel with someone you trust.
Keep a diary to express your feelings and worries.
Use visualisation - for example, put together a picture in your mind of a place you like and where you feel relaxed, safe and comfortable. Take the time to think about this picture when you feel anxious.
Try meditation, which helps to calm your mind and be more focused.
Use complementary therapies such as aromatherapy, reflexology, acupuncture or massage.
Practise abdominal breathing - see below.
Abdominal breathing exercises
These exercises are very useful as they can be done anywhere. They work quickly and can help control feelings of anxiety. At first, you should practise them regularly when you aren’t anxious. They can be performed lying down, in a chair or standing up.
Breathing should be slow and gentle but not ‘deep’ as this can result in light-headedness.
Step 1 - make sure that your shoulders, head and neck are relaxed, and supported if you’re sitting or lying down.
Step 2 - place one hand on your chest and one hand just below your ribcage.
Step 3 - slowly and gently breathe in (inhale) through your nose and feel your stomach and diaphragm move out.
Step 4 - when you have taken in a full breath, pause for a moment. Slowly and gently breathe out (exhale) through your pursed lips or nose.
Repeat this process for five minutes, three times a day for a few weeks.
Our section about cancer and complementary therapies describes breathing techniques in more detail. You can also speak to an occupational therapist at the hospital who can show you breathing techniques to help you relax. They can often provide a DVD or CD to help guide you at home.
Problem solving, thinking about awkward questions that might come up and setting goals can also help you manage anxiety.
Sadness and depression
When something unpleasant or difficult happens that changes our lives, it’s natural to feel sad or low at times. But if this low mood continues or gets worse, then it may mean that you’re depressed. Sometimes, it can be difficult to know if you’re depressed or not. It may be other people who notice symptoms and suggest that you might need help. Symptoms of depression can include:
a low mood that’s worse in the mornings and gets better during the day
feeling tearful (but sometimes finding it difficult to cry)
a sense of guilt
feeling like you’re a burden to other people
losing interest in things around you
unable to feel pleasure
finding it hard to concentrate
feeling that you want to hide away from other people.
Occasionally, people may have thoughts about taking their own life. Samaritans has a 24-hour confidential helpline on 08457 90 90 90 that provides support to anyone in emotional crisis.
You may also have physical symptoms of depression like weight loss, poor appetite, trouble sleeping or waking up early in the morning, tiredness and even pain.
If you find any of these feelings particularly difficult to deal with, speak to your GP, specialist doctor, nurse or other healthcare professional at the hospital. They can listen and offer advice or refer you for professional support with a counsellor.
You may also find it helpful to read how your thoughts can affect the way you feel about yourself - see the section on taking control.