No matter how unselfconscious we try to be, the fact remains that our looks matter. Even in the best of circumstances, the least vain people have days when they don’t feel great about how they look.
Add a breast cancer diagnosis and treatments that can visibly alter aspects of our identities such as the breasts and hair, and concerns about body image and beauty are only heightened. Patients who undergo surgery for breast cancer are left to deal with the loss of either a significant portion of a breast or all of one or both breasts. Some patients will be left with visible scars that can be a constant reminder of the cancer and their own mortality.
But Kristen Carpenter, clinical psychologist and director of Women’s Behavioral Health at the Ohio State University Wexner Medical Center, says the body image issues a breast cancer patient may experience aren’t confined to feeling badly about changes in the appearance of the breast or breasts. “The breast changes can be distressing, but there are a lot of physical changes, and changes to a women’s physical body as a result” of various treatments and side effects.
[See: 16 Health Screenings All Women Need.]
Some treatments for breast cancer, most notably chemotherapy, are well known for causing outwardly visible side effects, such as hair loss. Anti-estrogen therapies can cause some patients to enter early menopause, which alters not only how the body works but can also cause some women to gain weight. Other changes resulting from breast cancer and its treatment may include weight loss, a loss of muscle mass and function, a change in hair texture, fatigue and a sense of being betrayed by the body. These feelings can lead to depression, which is also quite common among breast cancer patients and survivors.
Although these concerns would seem to pale in comparison to the lifesaving treatments that might cause them, Claire Weiner, a social worker in the University of Michigan Comprehensive Cancer Center‘s PsychOncology Program, notes in a story on the center’s website that they are completely normal. “Our looks are part of our identity. Give yourself permission to feel what you’re feeling. Even if the loss may have saved your life, you can still grieve it.”
Still, if you’re struggling with how you look as you undergo treatment for breast cancer, you may find solace in undergoing a makeover — changing the way you dress or do your makeup to alter the way you look.
The American Cancer Society offers the “Look Good Feel Better” program to help cancer patients cope with some of the appearance changes that can accompany their treatment. The program connects patients with hairstylists, wig experts, makeup artists and other cosmetic professionals to give free makeovers to cancer patients. Other nonprofit programs such as EBeauty supply breast cancer patients with free wigs to help with one of the most visible signs of illness, hair loss.
These efforts can be very valuable in helping patients and survivors feel beautiful or at least more normal again in the face of what can often be a terrifying treatment process. Sylvia Caruso, owner of The Hair Studio and Wig Salon in Saugus, Massachusetts, works with many breast cancer patients and was recently named to Massachusetts General Hospital Cancer Center‘s The One Hundred list for cancer advocates. Since getting into the wig business in 1972, Caruso has worked with hundreds of breast cancer patients and says that “there are two kinds of women who come in here: women who are extremely strong and positive and look at it as part of the process. They’re just looking forward, and they’re going to lose their hair and get through it and get to the other side. And then you have the women who are full of fear.”
[See: A Tour of Mammographic Screenings During Your Life.]
Caruso, who started out as a hairstylist and barber before transitioning into the wig business when she was 16, says “women place such value on their hair and how they look. When that’s taken away, that makes the disease real.” She says many women tell themselves, “‘I can handle anything, but when I look in the mirror and I see myself with no hair, then I know I’m sick.'”
The 67-year-old Malden, Massachusetts, resident is also a breast cancer survivor herself, diagnosed with hormone-positive invasive ductal carcinoma in 2011. She had a mastectomy and reconstruction, and when she learned she would have to undergo four rounds of chemotherapy, she says her first question “was not ‘am I going to live?’ It was, ‘Is it the hair-losing kind?’ That’s how important it is.” Caruso says she wore a wig until her hair had grown out about an inch, and “then I styled it in a cute pixie cut.”
The wigs that Caruso sells range in price from less than $200 for a synthetic wig to more than $3,000 for a top-of-the-line human hair wig. She says cancer patients typically opt for the less expensive wigs because in most cases, their hair will grow back within a few months of completing chemotherapy treatments. “If they have other issues like alopecia, they’ll go for the more expensive wigs.”
Insurance may cover the cost of a wig for some patients, on average about $350, but Medicare does not include a benefit to cover wigs, a point of contention for Caruso. “If you’re 65 or older, you’re not getting a wig,” she says, unless you’re able to pay for it yourself. Caruso doesn’t think this is fair to patients who may be less affluent.
If you can’t afford a wig, a hat or scarf could be a good option for you, and there are lots of different styles and ways to wear these head coverings that might help you feel less obviously ill. The Dana-Farber Cancer Institute in Boston has filmed YouTube videos on how to style a chemotherapy head scarf. Similarly, a simple indulgence like treating yourself to a new outfit, having a friend help you try a new way to do your makeup or getting a manicure or pedicure might help boost your mood if you’re feeling down about how you look.
[See: 10 Lessons From Empowered Patients.]
If you do decide to get a wig, ask a member of your care team if they can refer you to someone who has experience working with cancer patients, and look for a professional who can show you how to wear and style it in a way that feels natural for you. For Caruso, her own experience dealing with cancer means that she understands the concerns breast cancer patients are dealing with and the support they need. “I know exactly what you’re going through, and it really sucks,” she says. “You’ve just got to look forward and get through it and move on. And hopefully that support and that strength that I impart during the consultation helps these women.”
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What’s the Value of a Makeover for Breast Cancer Patients? originally appeared on usnews.com
