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Reimagine Your Body

Help is available for cancer patients worried about how they look during and after treatment. By Melissa Weber
Illustration by Stephanie Dalton
Illustration by Stephanie Dalton

Roy Heyen lived like a recluse in 2010 after an operation to remove a basal cell skin cancer on his nose left him with a silver dollar-sized hole on the left side of his face. Reconstructing Heyen’s face required a half-dozen surgeries stretched out over a year. He kept it covered most of the time.

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“I was like a rabbit in a hole,” says Heyen, 53, a former food service manager at a South Texas prison. At first he didn’t leave the house. Then he’d venture out only at night. Heyen eventually summoned the courage to go outside in daylight. Yet even the most casual encounters with friends and neighbors tormented him as he strategically positioned himself to conceal the left side of his face.
More than two years since his last surgery in March 2011, Heyen still catches himself mentally choreographing where to stand or how to sit when talking to someone. People who caught a glimpse of Heyen’s face swore they couldn’t tell he’d had the surgeries. “But I could tell,” Heyen says. “When it’s you, it can’t get any worse.”
Body image is often an overlooked dimension of the cancer experience—considered an unfortunate side effect, like nausea or fatigue, and met more with sympathy than science. But some doctors are finally taking notice: A handful of programs now focus specifically on improving body image among cancer patients.
Body Image Therapy
A wave of research confirms just how important a patient’s feelings about physical appearance are to self-esteem and how changes to the body can bring on social isolation, anxiety and depression. In February, researchers reported in the journal Psycho-Oncology that as many as 80 percent of patients receiving chemotherapy worry about changes in their appearance. A 2011 study published in the same journal found that three out of four head and neck cancer patients undergoing surgery are embarrassed about changes to their bodies caused by cancer and treatment. Other cancer patients become so uncomfortable with scars or weight gain that they avoid being seen by other people or looking at themselves in the mirror, as a 2012 study in Psycho-Oncology found among young breast cancer patients.
Yet very few doctors ever ask their cancer patients, “How are you feeling about your body?” says clinical psychologist Michelle Cororve Fingeret, who directs the Body Image Therapy Service at M. D. Anderson Cancer Center in Houston. When Fingeret asks the question, she is often answered with tears. “No one has asked them that before,” she says.
Established five years ago to fill that void, M. D. Anderson’s Body Image Therapy Service is the first and only program in the United States to conduct research and offer one-on-one assistance exclusively for cancer patients facing body image issues. To date, more than 1,500 cancer patients have participated in the program.
Heyen was fortunate to receive counseling there for two years. Patients like him are in the bull’s-eye: Fingeret’s research shows that cancer survivors who receive facial or breast reconstruction are at very high risk for body image concerns. She is now testing a screening tool that doctors could use to identify which of these reconstruction patients are struggling and need help.
Marianne Kelly wishes she had help in 1986, when a 15-hour procedure to remove a hemorrhaging benign tumor from her brain left her with stitches that stretched from the top of her head to the base of her neck. Forced to wear an eye patch to correct double vision, and with acne caused by steroid treatments blanketing her face and shoulders, the then-39-year-old Baltimore native says she barely left the house for eight months after surgery. One day her husband took her out to shop for a wig. She ducked down in the back seat for the entire ride so no one would see her.
Today Kelly is the founder and director of Image Recovery Centers, in-hospital services that go beyond the usual beauty salon treatments. At her centers in 15 hospitals nationwide, trained staff members help cancer patients enhance their appearance through skin and scalp care, wigs and hats, cosmetics and breast prostheses. “Many patients just want normalcy,” Kelly says. “They want to do the things they did before without there being this neon sign that says ‘I’m sick.’ ”
One day Marianne Kelly’s husband took her out to shop for a wig. She ducked down in the back seat for the entire ride so no one would see her.
Look Good Feel Better—a similar program offered at no cost by the Personal Care Products Council Foundation, the American Cancer Society and the Professional Beauty Association—conducts about 16,000 workshops each year across the country. Stacey Moore, who is living with stage IV breast cancer, attended a class held in February near her home in the San Francisco Bay Area. She learned how eyeliner applied just right could fool passers-by into thinking she still had her eyelashes. But the best part for Moore was watching a newly diagnosed woman realize she could still look like her old self for her 10-year-old son. “You could just tell her heart opened up,” Moore says. “That was good for me—to see people find joy in their experience.”


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