Coping With Breast Cancer

Body Image and Self-Esteem

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Coping with breast cancer has many layers of complexity. While you will undoubtedly get strategies on dealing with the physical aspects, body image is one that doesn't get talked about enough. Whether you are preserving your breasts, removing them, or reconstructing them, learning to accept and even love a post-treatment body can be a process.

Everyone, of course, is different. Some women may feel treatment-related scars or their new breasts are visible reminders of beating their disease that, while perhaps not desired, are appreciated. Others may struggle with their body image as a result of breast cancer, feeling like the disease has attacked what she and others associated with her femininity. It's also not uncommon to feel both of these things or various others in between.

Never be afraid to talk about how you are feeling, including body image issues, with your doctor(s). Studies show that they often fail to bring up this important subject, but that doesn't mean you don't deserve to have the conversation (or that they can't be of assistance when it comes to these concerns). You might also consider speaking with a therapist.

Emotional

Expect a variety of emotions over the course of your breast cancer journey—some that may even conflict and some that may wax, wane, or completely change over time. This can leave you feeling scared, confused, depressed, and more.

The physical changes you may experience, in particular, can take a toll on your overall happiness, body image, self-esteem, and sense of self. Mastectomies leave scars. Radiation can lead to redness and soreness in the affected area. Chemotherapy often causes hair loss and weight gain. You may struggle with these, even feeling like the body you now have is unfamiliar.

Research has shown that these changes take a bigger emotional toll on younger women than they do on older women. The medical community is beginning to recognize and address the special issues faced by younger patients.

Some women find that they begin to avoid intimacy, dress alone or in the dark, or even limit bathing as they cope with this. These behaviors are common but should lessen and improve with time.

It can be difficult to express the sense that your body has betrayed you or that the loss of one or both of your breasts might feel like an end to being female. If you or a loved one needs help coping with body image issues, talk to a physician, support group, or trusted counselor.

Depression is extremely common in people with cancer and is not something to be ashamed of. Don't hesitate to get treatment for depression if you feel you need it.

Physical

If you are to have breast cancer surgery (lumpectomy, partial mastectomy, or mastectomy), the most important considerations to weigh when making a decision will be your type of cancer, physician's recommendations, family history, and the risk of recurrence.

There is no definitive research on how these surgical treatments affect self-esteem and body image. And while body image post-surgery should not be the factor that sways you one way or another, keeping it in mind can help you better plan for procedures that can restore your breast(s), if desired.

Don't be afraid to ask other breast cancer survivors, whether online or through a local support group, how the surgeries affected their self-esteem. Make sure to talk to several people, as each woman's experience is different.

Distortions

Though a lumpectomy or partial mastectomy does preserve the breast, some women who choose these procedures will end up with what plastic surgeons call distortions in the appearance of the breast. These distortions can include scarring or significant changes in breast size. However, severe distortions are uncommon.

Some women will choose to use a prosthesis, which fits inside a bra, to fill out clothes and avoid questions.

Reconstruction

Countless medical studies talk about the psychological benefits of another option—reconstructive surgery. Some studies report that women who chose reconstructive surgery experience a healthier body image than women who do not.

Reconstruction surgery can be done at the time of your breast cancer surgery or later on, especially if you're having post-surgical radiation treatments. Women do generally adjust better with immediate reconstruction, but this is not always possible. Several medical realities may cause a delay, and it can also be difficult to schedule both a cancer surgeon and a plastic surgeon for the same time.

However, other studies suggest that women tend to be satisfied with their reconstruction-related decisions regardless of what they decide.

Follow your instincts. Don't opt for reconstruction if you don't think it'll make you feel better just because a study says so. If you are struggling with this issue, reach out to the many support services available for women with breast cancer so you don't have to go through the decision-making process alone.

It's also important to have realistic expectations about breast reconstruction. Some women are disappointed when their reconstructed breasts don't look like their original breasts. To others, though, a silver lining is the opportunity to have the breast size they've always wanted.

It's important to remember that breast reconstruction does not restore sensation to the breasts. Open communication with your intimate partner is very important if you choose this route.

Social

Just as with any psychological issue, women with breast cancer can benefit from engaging in an honest conversation about their cancer-related body image issues. This can be with friends and family, a support group (local or online), or with a mental health professional, depending on your individual situation and needs.

If your partner is going through or recovering from breast cancer treatment, know that your love and support—however inadequate they may feel to you—are invaluable to her. Expressing your acceptance and encouragement as she makes changes in her wardrobe, hairstyle, or even lifestyle can make the transition from a pre-cancer body to a post-cancer body a little easier.

One study found that sex therapy and couples counseling improved self-esteem among women with cancer. Keep in mind that good communication helps in rebuilding intimacy and may take patience, persistence, and a little creativity.

Practical

You can do several things to take charge of your life and health, which can improve your self-esteem and how you feel about your body.

Eating a healthy diet and taking time to exercise not only helps with body image but may lower the risk of recurrence, which can give you added peace of mind.

Accept help and support from the people around you, and if you need something you aren't getting, ask for it.

Give yourself time to recover and to learn and get comfortable with the changes in your body. You're likely a different person inside and out after going through breast cancer treatment. Celebrate the inner strength that got you through it and know that you now have a new, healthier body to love.

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