Author: Laurie Wertich
Like it or not, we live in a culture obsessed with beauty. We are constantly bombarded with images that tell us how we’re supposed to look - and nothing short of perfection will do. But beauty is not perfection, despite what the advertisements try to sell us. Real beauty radiates from within. It is a smile, a twinkling eye, a sense of confidence, a warm demeanor, a positive attitude, a kind heart and so much more - which is why cancer can’t take it away.
Cancer may zap your energy and your appetite. It may take your breast or your hair. But it cannot claim your essence and does not have to crush your confidence. Cancer and its treatment can result in temporary or permanent changes to your appearance; and, yes, those changes can be disappointing and frustrating - but there are a variety of ways to cope with those changes and look and feel good.
Attitude is everything
When Heather Holladay was diagnosed with stage IIB breast cancer in September 2012, she made some decisions - namely that she was not going to let it get her down and that she wasn’t going to stop doing all the things she loved, including teaching Zumba® classes.
“I decided that I don’t have time for cancer and I don’t have time to sit around and sulk,” Heather explains. “Once I got past the sadness, it was just an attitude adjustment. I decided that I’m not stopping my life. I have two children and a husband and family and friends and a life to live.”
When Heather says she did not have time for cancer, she isn’t kidding. The busy mom from Montgomery, Alabama, also works as a community and economic development research analyst, is finishing a master’s degree and teaches Zumba in her spare time. Cancer changed none of this - but it did change her appearance, and Heather had to adjust.
“It didn’t take me more than a few weeks to figure out that I may be a patient, but I am certainly not going to act like one or feel like one,” Heather explains. “This is just a bump in the road, and then I am moving on.”
Heather had a strategy in place before she lost her hair, eyebrows and eyelashes. Having spent 20 years participating in theater productions, she knew she did not want to wear a wig because she found them too hot and itchy, so she decided that she would wear hats. “I decided that I was going with what I’ve got - makeup, cute little hats and cute outfits,” Heather says. For her, it worked.
When she lost weight, Heather went shopping and bought a few new dresses and suits, and her husband encouraged her to get some hats to go with the suits. “Wearing makeup and getting a few new outfits really helped me feel better,” she recalls. In fact, Heather used false lashes and makeup so artfully that none of her regular Zumba students even realized that she had lost her brows and lashes.
But there was another key component to Heather’s sense of confidence and wellbeing: exercise. “Exercise made me feel better, mainly because it gave me energy,” Heather explains. She continued teaching Zumba because it brought her joy and made her feel good. When she realized that the exercise was helping energize her, Heather started walking and biking too.
Despite the false eyelashes, makeup, manicures, new clothes and exercise, Heather says, “It’s really all about attitude. You can’t continue to care about what other people think; you have to deal with you and what you are facing. It does get better.”
Heather is a big proponent of any tools available - prosthetics, fake eyelashes, fake eyebrows, wigs and anything else that might be helpful. “I would say that if something helps make you feel better, use it. It is all about attitude and how you are going to accept what you’re dealing with,” she says. “Do what is best for you. If you feel comfortable in a hat or wig, go for it. If you are strong enough to walk around without it, go for it. But it’s all in the attitude.”
Coping with changes
Heather had the right idea - and she was also gifted with an extremely positive outlook, or what professionals might call a sense of resilience. Kurrie Wells, PhD, Director of Mind-Body Medicine at Cancer Treatment Centers of America® (CTCA) in Philadelphia, Pennsylvania, explains that one trait associated with human resiliency is the ability to spontaneously reframe. For example, a person might think, Maybe I don’t have my right breast anymore, but I also don’t have cancer anymore. Dr. Wells explains that this is realistic rather than Pollyanna thinking, and she says people who are able to spontaneously reframe like this often have an easier time navigating the changes that can come with cancer treatment.
But what about those who can’t spontaneously reframe? That is where coping strategies come into play. Dr. Wells recommends a variety of strategies for navigating change.
- Support. It is important to find and utilize a support system, which could include talking with a mind-body therapist or a loved one. “It can be uncomfortable to talk about the physical side effects, but the first step is to talk about how we feel,” explains Dr. Wells. “Once you talk to someone, you realize that you don’t have to carry that burden alone, which can be very therapeutic.”
- Reframe. Dr. Wells says it is important not to invalidate how patients feel, but she does try to help them reframe the changes they might be experiencing. For example, she will remind them that the chemotherapy is targeting rapidly dividing cells, which includes the hair, so hair loss is an indicator that the medicine is working. This shift in perspective can help patients learn how to reframe.
- Compassion. “It is a lot easier to show compassion for others, but we are often our own worst critics,” Dr. Wells says. “I encourage patients to have a lot of compassion for themselves and to be their own best friend.” We would never be critical of our best friend’s appearance changes during cancer treatment, so why not extend that same courtesy and compassion to ourselves?
- Acceptance. Dr. Wells says it is important to foster a sense of acceptance for the way things are right now. “Just because things are the way they are right now doesn’t mean they won’t change in the future,” she says.
- Shift expectations. Cancer treatment can result in permanent changes to our appearance, and sometimes it is not realistic to expect to look the same as before. “We talk a lot about embracing the new you—not just what you look like but what the functionality of your body is. What can your body do?” Dr. Wells explains. “Celebrate that and focus on the body’s capabilities as opposed to its limitations.”
- Practical solutions. “There are many creative ways to help people feel better about body changes,” Dr. Wells explains. She recommends using any available tools, such as prosthetics, makeup, wigs and hats. “Go for a prosthetic consultation, wear clothes you feel really good in or get a makeover. I encourage people to think outside the box,” she says. “Men can be self-conscious about their appearance, too. There is no rule that says men can’t use makeup or wigs to feel better if that is what helps.”
- Enjoy life. Sometimes it seems easier to stay at home when we feel self-conscious about our appearance, but this often leads to a vicious circle of social isolation. “I always try to encourage people to engage in pleasurable activities,” Dr. Wells says. “It can be really easy to start to withdraw and socially isolate, and that is the worst thing you can do.” It is alright to decline social invitations if you aren’t feeling physically up to it or occasionally if you are not in good spirits. But in general the more you can stay active and social, the better you will feel emotionally.
While attitude is important, simple strategies for improving appearance can go a long way, too. Many hospitals, including CTCA, now offer a variety of image enhancement services to help patients look and feel their best, thereby reducing stress and improving overall quality of life. Image enhancement services may include plastic and reconstructive surgery, prosthetic fitting experts, wig and accessory boutiques and cosmetic and spa services.
Caring about your appearance and looking your best can improve your self image, which in turn can help you feel more empowered and provide an overall sense of well-being. Meg Hart, lead salon technician at CTCA in Zion, Illinois, says, “Appearance is important. If I am sick but I look in the mirror and I have a little makeup on and a little color on my face, I may feel sick, but I don’t look as sick as I feel.” She says that makes a big difference in serotonin and endorphin levels and can help people feel better.
Hart offers a variety of services to patients in the salon, including wig fittings, makeup instruction and transition haircuts. She instructs patients on creating the appearance of eyelashes and eyebrows and gives transition haircuts prior to hair loss to make the transition as easy as possible. “People go through many changes during treatment,” Hart explains, “and we try to help ease their stress by listening compassionately and helping them look and feel the best they can. A lot of our job is to take care of the outer beauty and also the inner peace. People come to us not only to look better but to get encouragement and rejuvenation of spirit.”
Mary Ellen Pruett, RN, a certified mastectomy fitter at CTCA in Tulsa, Oklahoma, echoes this sentiment. Although she is a pro at prosthetic fitting, she believes her real role is to encourage patients and enhance quality of life: “I think the biggest thing we do is help patients overcome fear and regain their self-esteem by empowering them with knowledge. The more knowledge they have about products that are available to help them cope, the less anxiety they are going to have through all stages of treatment.”
Pruett offers a variety of prosthetics along with clothing that accommodates them, and she delights in fitting women and helping them look and feel great. “We try to have fun and make it an enjoyable experience,” she says. “I like showing women how sassy they can look.”
She works with women both before and after surgery to ensure a smooth transition, and she assures women that they can maintain their profile 24/7 if they want to. “For an untrained eye or the general public, no one has to know you are wearing a prosthetic unless you choose to tell them because the softness and the profile are there,” she explains. “The saleslady bringing you sizes in the dressing room would never know.”
In addition to the prosthetics, Pruett maintains a retail space full of many fun items, including hats, scarves and headbands. She enjoys helping women spruce up their look. “I wish that all I had to do all day was spend time with the ladies and be a fashion consultant and show them how they can be lovely,” she says.
Looking good and feeling well
Image enhancement can boost self-confidence and help us feel better during treatment, but Dr. Wells also says it is important to keep an eye on the big picture. “At the end of the day, what is the biggest goal? It is to fight cancer, get better and take it one day at a time,” she says. “The most important thing is to stay engaged in the fight, and for everything else just cope with it one day at a time.”
Or, as Heather would say, “Attitude is everything.”
No case is typical. You should not expect to experience these results.