A cancer diagnosis usually means a whirlwind of unexpected changes and challenges, including long-term or short-term treatment adverse effects on the patient. Some treatment adverse effects include hair loss, fatigue, weight changes, surgery scars, loss of body parts, rashes, or the need for an ostomy.1 These physical changes can affect the way patients feel about their appearance and their body image.
The realization for patients that their look is going to be altered for a short period of time or for the remainder of their lives can result in a loss of self-esteem. One of the comments heard, specifically among women, is how unprepared they are to lose their hair due to their treatment regimen. For hair loss, options such as wigs and other head coverings are available to mediate the change. Other changes caused by cancer, such as an ostomy or scars from surgery, are not as easy to hide.
Self-esteem is defined as the confidence in one’s worth or abilities2 and is one of the many aspects of a patient’s life that is affected by cancer treatment. Self-esteem can be high or low, and for cancer patients, keeping their self-esteem closer to the high end rather than the low is important. Lower self-esteem is linked to patients experiencing more depressive symptoms and having reduced social support.3 When patients look in the mirror, they want to be happy and proud of what is staring back at them and that does not always happen. Support is needed during the times that patients don’t feel like themselves, especially when changes in their bodies start right before their eyes.
Nurses are in an important position to have conversations with patients about self-esteem and body image. A discussion about body image and self-esteem during every encounter with every patient is ideal.4 Here are tips to make this more feasible when nurses see patients.
Encourage the patient to give themselves time to adjust to the change Certain changes are unavoidable, such as scars. Over time, many patients adapt to the new reality and a new normal. Encouraging the patient to take time to adjust allows the patient to integrate what happened. Encouragement to be kind to themselves allows patients to mourn the change so they can better integrate it into who they are now.
Suggest support services In talking with other patients who are living with cancer about how the changes affect them, patients can find support from others who have had similar experiences. Sharing feelings with other patients can provide an opportunity for hope and understanding. Talking one-to-one with a professional can provide patients a safe space to be open about their feelings and learn new ways to cope, and can help them better understand their own feelings.1
Provide alternatives Appropriate alternatives can be provided for some physical changes, such as in the case of hair loss. In the case of losing one or both breasts, patients should be informed about various prosthesis options, reconstructive surgeries, and other cosmetic solutions.