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After the treatment finishes then what? (Dr Peter Harvey)

12 Dealing with a changed body

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One of the many possible consequences of treatment for cancer is a changed body - either temporary or permanent. Such changes can be very obvious - such as hair loss during chemotherapy, the loss of a breast; less obvious to others - a reconstructed breast, a colostomy, a scar hidden under clothing, loss of a testicle, erectile difficulties; or essentially hidden - and internal - removal of a woman's reproductive organs.

All such changes are likely to affect how you feel about yourself and how you relate to your body and to the outside world. How you react to these changes will depend on a number of factors - how permanent the changes are, how obvious to others, how embarrassing you find them, how important your looks are to you generally - the list is long and individual. But there are some general issues that might be important to deal with here.

It may be helpful to emphasise that whilst much of the research in this area has concerned women, how we look and how we feel about our bodies and ourselves applies to men as well.

• Firstly, it is not ‘mere vanity’ to be worried about how you look. How we see ourselves and how we feel about how we think others may see us matters. And whilst we may not like it there is a strong tendency these days to be over-concerned with looks - you only need to scan the covers of the so-called celebrity magazines to see this. So to be worried about wearing a wig or a headscarf or a prothesis makes sense - it’s about how we see ourselves and about how we present ourselves to the outside world.
• Secondly, it’s more about what you feel than about what others say. Your partner may express no concerns about your surgery scars, but if you feel that it is disfiguring then that feeling will over-ride any reassurance that others may offer.
• Thirdly, some people struggle with the issue of a part of their body not being ‘theirs’. This is fairly obvious when it comes to wearing a wig, however life-like or true to your own hairstyle it is. You are always aware of it, it may be uncomfortable in hot weather, you may worry about it blowing off in a wind or being awry so people notice it - you are never as relaxed with this addition to your head as you will be with your own hair. But what about other additions - a breast prothesis or reconstruction, for example? This is more difficult because it may be permanent and, in the case of a reconstruction, part of your body being used to replace the removed tissue. For some women the new breast may not feel as if is is part of them, even if it is a part of their own body that has been used. It may feel just a little bit unnatural, especially at the beginning. This is not altogether surprising and may be a lot more common than we think - because it may be something that is not talked about very much.

An unwillingness to talk about these issues is sometimes felt to be a sign of feeling ungrateful or over-complaining. After all, a great deal of effort has been put into saving your life by a team of skilled and dedicated professionals. To say that you are somehow dissatisfied suggest that you may be criticising their efforts to help you.

You may also feel that the changes may be a small price to pay to a life-saving intervention - and this is something that you may have been told by others. It is quite possible to feel gratitude for the care you have received at the same time as feeling unhappy about the results. The two are separate issues.

You may well wish that you were not in the position where surgery had been necessary and regret the consequences. You can still be grateful for the skill of the surgeon and the care of the staff in looking after you despite what they had to do.