Living with and beyond cancer

Body image

Cancer treatments such as surgery, chemotherapy, radiotherapy and hormone therapy can change the way a person’s body looks, works or feels. Such changes can affect self-confidence and interactions with other people, particularly where the affected parts of the body are associated with a person’s sense of masculinity or femininity, or are highly visible to others, such as the face. People may feel unhappy about their body during cancer treatment but for many these feelings resolve as they recover. However, for others the effects are longer lasting.
Some women, and most men, who are treated for breast cancer have to have the whole of the affected breast removed (mastectomy). This can result in a feeling of lop-sidedness and some women may feel their womanhood has been damaged. Wearing a prosthesis inside a bra can overcome women’s fears about their altered appearance, or reconstructive surgery may be an option for both women and men. Most women we spoke to had come to terms with losing a breast and had no long-term issues surrounding their femininity as a result, although one woman said that finding suitable clothes was a problem.
Of the men we spoke to who had had a mastectomy, most said they were not bothered by the scars or the change in shape of their chest. However, others felt self-conscious and were reticent about exposing their chest in public, such as when swimming; some would have liked to be offered reconstruction. Bill had all the breast tissue removed from both sides of his chest because of cancer and had new nipples tattooed onto his chest so he looked the same as before. He felt he had been ‘reborn as a man’.
Similarly, women who had treatment for gynaecological cancers could feel less of a woman as a result, but many we spoke to said that because the effect on their reproductive organs was not visible it was easier to cope with. While some said it was not a problem for them once the operation scars had faded, others said they felt different inside although the change was not outwardly apparent. After having radiotherapy for cervical cancer when she was 42 years old, one woman said she felt less of a woman because her ovaries no longer worked, even though the results were not visible. Older women sometimes mentioned that losing their reproductive organs did not have an impact on their feelings of femininity.
Men diagnosed with testicular cancer often have to have the affected testicle surgically removed (orchidectomy). The men we spoke to said that although they had felt a short-term sense of loss, they were now satisfied because they could function normally with only one testicle and it was not visibly obvious that they were missing one.
Reconstruction using a prosthetic testicle is possible either at the same time or in a separate operation later. Those who had been offered later reconstruction declined it because they did not want a second operation and possible complications from it. One said he would have had a prosthesis if it had been offered at the same time as the orchidectomy.
Others did have the procedure done; one man said it had been a very straightforward operation and he was very happy with the cosmetic result. Another had doubts about whether it had been the right decision.
Cancer of the penis is rare and tends to occur in older men. It is usually treated by surgery, and the extent of surgery depends on the size and position of the tumour. Reconstructive surgery may be possible. Les had a small area of his penis removed and was worried that it might not work properly afterwards, but his worries were short-lived.
Surgical scars, rather than losing a part of their body, were a source of distress for some people, but their feelings changed as scars faded over time. Having had a partial circumcision and radiotherapy for penile cancer, a man said, “I look OK but it can be frightening if I take my clothes off”. Julie was glad that her chemotherapy central lines had been inserted into her groin rather than her chest as the scars in her groin were only visible to her and her husband.
Other unwelcome body changes caused by cancer treatment that people mentioned included the menopause (see also Hormone changes) and weight gain. Sandra said she feels fat and sweaty and has been robbed of her femininity. Another woman said her weight gain was probably due to several factors and she hoped it would sort itself out in time. Pauline said that she also lost some teeth; tooth decay or loose teeth can be a side effect of certain drugs or radiotherapy to the jaw. Radiotherapy or hormone therapy can also affect hair growth, and some people said that no longer having hair on certain parts of their body was an advantage of their cancer treatment. Claire also liked the softness of her skin after radiotherapy.
Having an understanding spouse or partner was very helpful in enabling people to overcome their feelings about unwelcome body changes after cancer treatment. Some women who had surgery for breast or ovarian cancer said that their husband still loved them the same as before and made them feel no less womanly as a result of their loss. A man who had to have both testicles removed said he had felt emasculated at first but that he had overcome his feelings thanks to having a caring partner. A man who had to wear an ileostomy bag after colorectal cancer surgery felt unclean and believed that his stoma must be off putting for his wife, but that she hadn’t allowed it to affect their sex life (see Sexual functioning and intimate relationships). Women who felt tired and lacked energy due to chronic leukaemia often said that they made more of an effort to dress up and look good to overcome how they were feeling.

​Last reviewed October 2018.
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