• Changes in weight (i.e., loss or gain)
• Thinning or loss of hair
• Changes in skin tone/color (e.g., blotchy skin) and nails
• Physical changes from surgery (e.g., scarring, loss of limb or part of the body)
• Changes in posture (e.g., Kyphosis, or hunchback)
• Changes in physical performance/abilities
• Changes in bodily, reproductive functions (e.g., incontinence, infertility)
• Swelling in the limbs (e.g., lymphedema)

These physical changes may affect your view of yourself in different ways. You may feel self-conscious or embarrassed about your body and appearance. Even if you do not look different to others, you may feel that others see you differently. A good self-image may help you feel more confident, help reduce depression and anxiety and improve your emotional well-being.

Tips for Adjusting to Changes
in Your Physical Appearance

• Know what side effects to expect.  Learn more about your cancer, your treatment options and any possible side effects. To help prepare yourself, ask your doctor ahead of time what side effects you can expect during cancer treatment and think about a plan for possible side effects. For example, if your doctor anticipates hair loss, you may want to cut your hair very short before it begins to fall out.
  
  
• Allow yourself time.  It may take time to adjust to how you look and feel about yourself. Try not to become discouraged. Give yourself time to grieve physical losses. As you get well, you will feel and look better. Also, understand that many of these changes in your appearance may be temporary and will go away after you complete treatment.
  
  
• Ask about reconstructive or cosmetic options.  Reconstructive surgery, prosthetic devices and cosmetic solutions may help with many of the physical and emotional side effects of cancer treatment. If this is of interest to you, you may want to discuss these options with your doctor.
  
  
• Give yourself a break.  If your physical abilities aren’t the same as they used to be, don’t be hard on yourself. You may feel frustrated that your body has "let you down,” particularly if your treatment is postponed because your body is unable to handle any more. These are all normal feelings. Understand that as you heal, you will probably feel stronger and less fatigued. 
  
  
• Find new activities that interest you.  If you are unable to participate in some of your former activities or sports, try to find a new activity that interests you. Learning a new physical skill can help you regain confidence in your body. You may actually discover something you enjoy doing that you never tried before.
  
  
• Seek support from friends and family.  Let your friends and family offer love and support. Having a support system can help you work through your self-image issues.
  
  
• Prepare ahead for reactions from others.  If changes to your appearance are apparent to others, you may be asked about it. Think about how you will respond ahead of time so you are prepared to handle it.
  
  
• Talk to other cancer survivors.  Reaching out to others who have been in similar situations can be helpful. Talking with other cancer survivors about how they coped with changes in their appearance may help you feel less alone and give you new understanding and hope.
  
  
• Seek professional help if needed.  It is normal to have feelings of anger, sadness, fear, frustration, anxiety, and/or lack of control about changes to your body or physical appearance. If concerns about your physical appearance become overwhelming, you may want to ask your doctor for a referral to a counselor.
  
  
  

Tips for Improving Your Self-Image
as You Cope with Cancer

• Remember you are still you.  Healing involves an ability to accept change. While your body may look and feel different, remember you are still the same person on the inside. Your personality, interests and character are still the same. Look within yourself and celebrate the person you are.
  
  
• Keep up with routine health and hygiene activities. Remember that looking your best enhances your general feeling of well-being. Continue your routine grooming activities, even if you are confined to bed. Maintain regular dental care.
  
  
• Practice good nutrition.  Maintaining a healthy, well-balanced diet can be a challenge during cancer treatment. You may be experiencing weight changes due to changes in appetite, activity, etc. A dietitian may be able to help you stay nutritionally fortified so that you look and feel better.
   
• Stay active.  Many people find that fatigue or loss of energy is the most challenging aspect of cancer treatment. Staying active can help you feel better about yourself and support a positive body image. If you are able, try to fit in light exercise or stretching each day, or as much as you can manage comfortably. A physical or occupational therapist may be able to help you deal with your physical limitations and improve your quality of life.
  
  
• Take time for yourself.  Pamper yourself. Read the paper, keep a journal, go for a swim, have a manicure, pedicure, facial, or a massage (if your doctor permits), etc. Remember to plan ahead for the downtimes when you may need to rest.
  
  
• Try mind-body techniques.  Physical and emotional issues may arise during cancer treatment. A mind-body specialist may be able to teach you techniques such as relaxation, guided imagery, humor therapy and stress management to help you cope with these issues.
  
  
• Take part in activities outside of your home.  If you are physically able, get involved in activities in your community. Social activities are important in helping you focus on something other than cancer, reduce a sense of isolation and improve your self-esteem.
  
  
• Experiment with ways to enhance your appearance.  Caring about your appearance may help you feel more confident and in control. Use makeup, wigs, headscarves, or other ways to enhance your appearance. If you lose or gain weight, have your clothes altered.
  
  
• Take care of your skin and nails. During cancer treatment (e.g., chemotherapy, radiation therapy), you may notice changes in your skin and/or nails. Some skin reactions, which may be temporary, include redness, rashes, peeling, thin or fragile skin, very dry skin and/or increased sensitivity to sunlight. Your fingernails may become weak, break or lift off, or develop ridges.
  

Tips for caring for your skin

• Wash with warm water and a mild, unscented soap
• Consider using a non-allergenic deodorant
• Use an electric razor for shaving to avoid cuts
• Avoid tight clothing or irritating fabrics (e.g., wool)
• Protect your skin from sunlight, or extreme cold
• For dry skin, use creams that soften skin and moisturize (avoid perfumed or scented lotions)
• Drink 8-10 glasses of non-alcoholic fluid a day

Tips for caring for your nails

• Keep your hands moisturized and your nails cut short (avoid cutting cuticles)
• Avoid using artificial fingernails (which can harbor bacteria)
• Wear gloves to protect your nails when doing housework or gardening
• You may want to use nail polish to give your nails extra strength
• Soak your nails in (or massage with) vegetable or olive oil
• If your nails break or lift off, try to keep them clean and protected
• As always, inform your doctor at first signs of infection

NOTE:  THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH PROVIDER PRIOR TO STARTING ANY NEW TREATMENT.

Dealing with Hair Loss
During Cancer Treatment

Some cancer treatments may cause you to lose some or all of your hair (alopecia). For instance, while chemotherapy attacks rapidly-growing cancer cells, some chemotherapy drugs may also damage healthy cells, such as hair follicles. Some people experience hair loss and others do not, or to varying degrees, even when they are undergoing the same treatment.

If hair loss does occur, it usually begins within two weeks of starting chemotherapy and gets worse one to two months after the start of therapy. It is normal to feel distressed about hair loss. However, it helps to know that hair will almost always grow back after treatment is complete. In fact, hair re-growth sometimes begins even before therapy is completed. It is common for hair to grow back a slightly different color and texture (e.g., curlier) at first. If you are concerned about hair loss during cancer treatment, ask your doctor if it is expected.

Tips for Dealing with Hair Loss

• If you decide on a wig or hairpiece, have it ready in advance. This way, you can match it to your natural hair color, style and texture.
• Try scarves, caps, turbans, hats, or simply leaving your head uncovered
• If you have long hair, consider getting a stylish short cut
• Use a soft bristle brush and avoid too much brushing or pulling of hair (avoid braiding or placing hair in a pony tail)
• Use mild, gentle shampoos and conditioners
• Avoid coloring, perming or relaxing the hair
• Avoid using hair dryers, electric rollers, or curling irons
• Use sunscreen/sunblock, or wear a hat/scarf, to protect your scalp from the sun
• In cold weather, wear a hat/scarf outdoors to prevent loss of body heat
• Sleep on a satin pillowcase

Image Enhancement at CTCA

At Cancer Treatment Centers of America (CTCA), we aim to bring you total care as we help you fight cancer. We understand that changes in your physical appearance, such as hair loss and changes to the skin and body can be upsetting side effects of cancer and cancer treatment. Promoting your self-image may help you feel more confident and empowered, and give you an overall sense of well-being. We offer image enhancement services at our hospitals to help you look and feel better so you can focus on healing. Our goal is to find ways to boost your self-esteem and improve your quality of life.

Our image enhancement services include several different areas of support. One area is plastic and reconstructive support. Our surgical oncologists work with our plastic and reconstructive surgeons to perform restorative procedures during or after your cancer surgery. Another area of support is cosmetic image enhancement. Our staff helps you prepare for hair loss and other cosmetic changes that may occur with cancer treatments, such as chemotherapy and radiation. We provide classes and seminars on various topics, such as the connection between looking good and feeling better and image enhancement techniques.

Aside from image enhancement services, we also provide several other sources of support at CTCA. Here, your care team works closely with you to deliver personalized, integrative cancer care. This means we supplement your traditional cancer treatments with complementary therapies to treat your whole person, not just the disease. We offer nutrition therapy to keep you strong and nutritionally balanced to ensure that your traditional cancer treatment is not interrupted. We offer oncology rehabilitation services to help you regain your functional independence, and to enhance your self-satisfaction with your physical abilities. We also offer mind-body medicine to help you deal with the physical and emotional issues that may arise during cancer treatment so you can feel better about yourself.

I hope this information has helped you in some way. I will check in with you again next month.  In the meantime, stay strong and hopeful.