Coffee Conversation: Body Image & Breast Cancer

Forge recently sat down with Dr. Christina Wilson for a Coffee Conversation on Body Image and Breast Cancer. We’ve recapped the highlights below, but if you have a few minutes be sure to check out her full interview by clicking here.

What is “body image,” and why is it an important topic for breast cancer patients?

While there are multiple definitions of body image, Dr. Wilson prefers to describe it as “the way one feels about oneself.” It is not about how others see you or their perception of you. It is about how you perceive yourself and how that affects who you are. When battling cancer, you may undergo procedures, testing, and treatments that can change who you are internally and externally as well as impact your relationships with others.

What are the different types of body images? How might body image be impacted after a breast cancer diagnosis?

From an inward perspective, there are three main types of body image. The first one relates to internal body factors and how internal changes may affect how you view your body. For example, anxiety and depression may affect the way you once viewed yourself. The second one is external body factors. This can include how you feel about yourself after loss of hair or scarring from a mastectomy or lumpectomy. Third, there is a psychosocial body image or interpersonal body image. This is how you feel about your body in a social or interpersonal relationship, whether that be in a sexual context or friendship context. Perhaps you are going to the beach with someone and wearing a swimsuit. You might be more self-conscious about your body image while in the swimsuit. This is an internal body image effect that it is more heightened because of the social context of being in public.

External body image is something that might affect you as a new breast cancer patient. For example, surgical removal of your breast or part of your breast, radiation causing skin changes, and hair loss from chemotherapy are common during treatment. These external changes may impact breast cancer patients’ body image and how they view their bodies. Questions may come up like “Am I depressed because of how I feel about my body?” or “Am I anxious about losing my hair or breast(s)?” These external and internal body images can often go hand in hand. 

Experiencing issues with body image can affect intimate relationships with a partner as well as friendships. A strain is often placed where an individual undergoing treatment may not want anyone to see her after all the external body changes because she no longer looks and feels the way she did before. This can lead to feeling socially isolated or may leave you without your support system.

What resources are available for individuals wanting to improve their sense of body image? 

Dr. Wilson says that the first step, which is always easier said than done, is to redefine your body image yourself and not let cancer itself define you. Counselors and psychologists can be very helpful in helping you redefine yourself. There are also many research-based exercises you can do to help you do this. For example, use a mirror to identify the positive aspects of your body after undergoing a traumatic event, like breast cancer. 

Research also shows that yoga, stretching, and other energetic activities can help with both external and internal body image. Be sure you check with your doctor first to make sure any exercises are right for you. Journaling and art therapy can help you express how you feel about yourself and allow you to exude outward expression of the feelings that may be consuming you inside about how you look and feel. Dr. Wilson also recommends talking to someone. This can be with peers, support groups, counselors, or anyone you feel comfortable with. Having someone to talk to will keep your emotions from bottling up without a release outlet.

Is it common for individuals who are going through these transitions to feel defined by what they see on the outside or what they feel about themselves?

It is not uncommon for this to happen. Dr. Wilson shared that she has personally seen many breast cancer patients that feel like their cancer has changed or defined who there are. It is a reflective process of going through these elements and re-establishing trust in yourself and in your body that will help. Feeling defined by what you see on the outside or what you feel about yourself as a breast cancer patient or survivor should not be a long-term consequence that you suffer with. To feel better, different things work for different people. 

For example, Dr. Wilson has had patients who thought reconstruction was appropriate for themselves while others decided that reconstruction was not for them. Dr. Wilson has also seen patients who felt like getting a tattoo highlighting their breast cancer scars would help them feel more empowered. One specific patient, Dr. Wilson shared, had a bilateral mastectomy and got a scar line tattoo of what looked like ivy growing from the scar. She chose this design to symbolize herself growing into a new person. It is important to think on your own about what decisions might help you positively impact your personal body image and how you feel about yourself. As Dr. Wilson likes to say, “You’re not a breast cancer patient. You are an individual who has had breast cancer. You are one of many, but you are more than a statistic.” This is a process where you get to figure out what works for you because what works for you might be different than what worked for the last person and what will work for the next person. 

How do individuals recognize they are having issues with their body image?

Noticing that you’re uncomfortable in a circumstance in which you may have been comfortable in before or if you’re finding yourself becoming upset when thinking about the changes in your body are signs that you are having issues with your body image. You may become upset thinking about your loss, and that is normal to feel that way and important that you talk with your medical team about it. In Dr. Wilson’s opinion, she believes that conversations with your providers about body image should happen at the time of diagnosis. Just like patients are told about potential hair loss and nausea from chemotherapy, issues with body image may be something you experience throughout and after treatment. Recognizing from day one that you may have these feelings or experiences will prevent individuals from wondering if what they are experiencing is “normal.” When those feelings then come up (if they do), then individuals will know that it is time to talk to their doctors about it and that their medical team is there to support them.

Do you have any other suggestions for those struggling with body images that don’t know where to start with getting help?

Talk to your medical team – whoever you feel most comfortable with. This is your health and your body and how you’re feeling. Don’t worry about whether you might make your provider feel uncomfortable. Dr. Wilson hopes to empower you right now to just say “I’m worried about my body image” or “I don’t like the way my body looks anymore.” Say something along these lines to bring it to your provider’s attention. This gives your team the responsibility, as providers, to help find you a resource that allows you to work through your struggles with your body image. Think about discussing body image the same way you would discuss nausea with your provider. You would discuss nausea with your provider so that they can address it immediately so you’re not feeling sick all the time. Think about discussing body image in the exact same way. This is your body and your life, and you can advocate for yourself and the things that are bothering you.  

Is there anything else you would like to share with Forge?

Dr. Wilson concluded the conversation wanting patients to feel empowered and confident in bringing up how they feel whether it relates to body image or not. As a patient, every experience is different, and by telling your provider about your experiences, they will be able to better help you and what you’re going through. 

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