Cancer is not just life-changing; it can be body-altering as well. We lose body parts to surgery and our hair with chemo. We acquire scars, develop lymphedema, and experience weight fluctuations. We might have to get used to prostheses, ostomy devices, or central venous catheters. And while some of these changes to our appearance are easily noticed, other things may not be as obvious to outsiders. For example, perhaps you have persistent fatigue, chemo brain, chronic pain, or neuropathies. Or maybe you’re dealing with symptoms of premature menopause, or your fertility has been impacted. But no matter how easily seen or how invisible, any of these alterations in how our bodies look, feel, and function can affect our body confidence.
As cancer survivors, we often feel dissatisfied with our physical appearance. We report embarrassment, lower self-esteem, and feeling less attractive and less desirable than our peers without cancer. These attitudes matter! How we relate to our image in the mirror influences the connections we have with others, including our romantic relationships. Our interest in being sexual is closely associated with how we feel about our bodies. If we are uncomfortable with or self-conscious about certain features, it can be really hard to share those parts of ourselves with another person, and to experience pleasure and satisfaction in doing so.
Growing body confidence after cancer requires not only coming to an acceptance of the changes we’ve endured, but also finding ways to appreciate and celebrate what we are capable of. There is no quick fix for bruised body confidence. It takes time to heal and get used to some of the changes that occur with cancer. But we are inhabiting the only body we will ever have, and it’s definitely worth the effort to work toward making peace and finding joy in it.
So, where can we begin?
10 Steps to Building Body Confidence
What’s good for your physical health is also good for your mental (and sexual!) health. Exercise can combat fatigue and weight fluctuations, increase muscle tone, and boost your mood. Eating balanced, nutrient-rich foods provides sustainable energy (versus the less reliable, caffeine-fueled kind…) and helps control weight changes. Getting enough sleep can improve your ability to deal with stress and other challenging emotions in a constructive way. And pursuing hobbies that you enjoy can help you feel accomplished, by shifting your focus from what your body looks like to what it can do.
Our body image is based on how we feel about the way our body looks and functions, as well as our thoughts on how others perceive us. Interestingly, it appears that body confidence is not so much based on possessing certain “ideal” physical traits. Rather, it seems to be related to believing that the traits you do possess are valuable and acceptable, regardless of whether they fit the ideal or not. In other words, people with positive body image choose to be happy with what they’ve got, no matter what it is!
This is the power of perception at work. The mental image we carry with us about what we think we look like encompasses so much more than what can be captured on camera or in the mirror. We scrutinize ourselves through a lens that is tinted with the emotional context of our experiences, and we interpret what we see based on how we feel about it. Perception is a powerful thing, and we can learn to use it to change how we feel about what we see.
If your bestie confided in you that they were feeling really down about some aspect of their post-cancer body, what would you say to them? Chances are, you’d have an honest, compassionate response. You would probably acknowledge the changes they’ve gone through as being really hard. You might remind them that they are not their cancer, and list some examples of what makes them a beautiful human and a great friend.
Now, how often do you react in a similarly caring way when confronted with your own perceived imperfections or shortcomings? Typically, we are much less likely to extend the same kindness and comfort to ourselves that we would offer to others. In fact, we can be pretty cruel. But what if we treated ourselves like we’d treat a good friend?
Choosing to utilize the Friend Lens is a great example of practicing body self-compassion. Being self-compassionate means recognizing negative self-talk, self-criticism, and self-judgment, and actively replacing these thoughts with kindness and understanding. It might feel unnatural at first, but stick with it. Self-compassion is a skill that you can strengthen; and with practice, it becomes habit. Check out the work of Dr. Kristin Neff to get some great ideas on how to get started.
If it’s hard for you to look at yourself in a mirror and identify things you feel positively about, enlist some help! We are poor interpreters of our own reflection, because we tend to break ourselves down into body parts and focus on what’s changed or what we’ve lost. Other people, though, recognize and take into account the whole picture.
To do this exercise, sit in front of your partner or a friend, and allow him or her to reflect back to you everything they see when they look at you, including what they love about who you are. We might not have control over all of our physical traits, but we can learn to view ourselves in the same ways our loved ones see us. Getting their perspective helps us reinterpret the meaning of our reflection the mirror.
If you are currently in a romantic relationship, think for a moment about your partner’s best qualities. What’s at the top of the list? Is it their straight teeth, or their nipples, maybe? Or are you more apt to consider their humor, kindness, generosity, or confidence? Finding someone attractive goes far beyond the physical. And if we are taking into account so much more than physical attributes when we look at our partners, can we appreciate that they are also taking into account so much more than our body parts when finding beauty and value in us?
Your partner is actually quite likely to be unconditionally accepting of your changed body. Where you see imperfection, they find strength and resilience. With this in mind, consider resisting the urge to go behind closed doors. When you (consciously or unconsciously) hide yourself in the bathroom or closet to dress or undress, you are depriving your partner of the opportunity to show and tell you that they still find you (the whole you!) amazing, and that they love you just the way you are. Give them the chance to do so!
Receiving treatment for cancer often requires us to expose private, intimate parts of ourselves. I mean, I have never had so many people interested in my pooping habits in my life! Not to mention the eyes and hands of so many strangers on my chest. One way of coping with these uncomfortable or distressing situations is to subconsciously disconnect from our bodies. But once treatment is over, it can be hard to reverse this protective mechanism.
Doing so requires relearning your body as a source of pleasure. Start by taking some time to get reacquainted with what feels good and how your body responds to touch. Explore for yourself what’s changed about your body, without the pressure of performance that might be felt in the presence of a partner. When you are ready to connect again physically with your partner, you can share what you’ve learned during your self-study. Sensate focus exercises can also help you and your partner work together find pleasure, enjoyment, and connection through touch.
Grief is a natural reaction to loss, and acknowledging losses can be a healthy route to healing. Consider saying good-bye to the things or body parts you’ve lost during your cancer journey. It could be in the form of a good-bye letter to a lost or altered body part, or to your pre-cancer self. In the spirit of moving forward, consider writing a welcoming letter to the new you.
Negative emotions are an inevitable part of our cancer experience. We may feel anger, fear, frustration, resentment of our bodies, or jealousy of our healthy peers, just to name a few. We may try to find someone or something to blame, and often times it ends up being ourselves (“Maybe I should have eaten organic/exercised more/skipped college keggers/stayed away from hormonal birth control/fill-in-the-blank…”). Coming to the understanding that sometimes blame cannot be placed gives us a pathway to move beyond negativity. Give yourself a chance to realize that it’s not your fault.
It’s true that cancer changes us, but isn’t it also true that we would be changing even without that diagnosis? We’ve been growing and aging since we were born, and our life experiences will continue to transform us in mind, body, and soul. Finding value in the ways that change breeds discovery and growth can help us renew our sense of who we are, what we stand for, and how we wish to move through this world. Our bodies adapt to help us accomplish new things every day. Honoring this remarkable ability to change and thrive in the face of adversity is just one of the ways we can find pride in who we are, and who we are becoming.
We are only given one body, and we have the power to choose to accept it for what it is, with all its quirks and limitations (remember, we all have them!). Taking care of ourselves includes making the deliberate decision to nurture a healthy relationship with the person we see in the mirror every morning.
In the words of the unapologetically-original Lady Gaga, there’s nothing wrong with loving who you are…
So, own it!
If you are dating someone new, you may be wondering how to bring up some of the body changes that you’ve experienced with cancer. It can be helpful to acknowledge anything noticeably different about your physical appearance right off that bat. Alopecia (hair loss), visible scars, the presence of a central line (PICC line or infusaport), and lymphedema are a few examples. Stick with the basics and be honest. Using humor helps! Showing that you’re ok talking about it will help them feel comfortable, too.
On the other hand, some physical changes aren’t as immediately noticeable, like the loss of a testicle or breast, a scar usually hidden by clothing, or the presence of an ostomy. This can make the idea of getting physical especially nerve-wracking, since it means having to figure out how to provide an explanation at a time when you’re already feeling a little exposed. If you think things are moving in that direction, consider bringing it up before you’re in a clothes-coming-off situation. You might also offer to show them what you are talking about. This will temper the element of surprise, and it can help both of you gauge how you feel about it before you’re in the heat of the moment.
Further still, there are some things that your partner wouldn’t know at all, unless you told them. Trouble with fatigue, muscle and joint aches, chronic pain, and positioning problems are some common examples. Also, changes in how your body functions sexually, such as changes with ejaculation, or the need for personal lubricant due to vaginal dryness, may require some head’s-up. Explaining the what and the why of things can make them less intimidating to your partner, and offering ideas on how activities may need to be altered (if any) for success can help put your partner at ease.
Remember, you are an awesome catch! It’s ok to take things slowly, but don’t let fears or doubts get in the way of finding and enjoying the physical and emotional connections you deserve.
All of the posts written for Elephants and Tea are contributed by patients, survivors, caregivers and loved ones dealing with cancer. If you have a story or experience you would like to share with the cancer community we would love to hear from you! Please submit your idea at https://www.elephantsandtea.com/contact/submissions/.