Physical changes The actions you take to beat your cancer may affect how you look or how your body functions. Some of those effects will disappear when treatment finishes, others are permanent and will take some getting used to.
Skin You may find that your skin gets very dry, even itchy, when you’re undergoing chemotherapy or radiotherapy.
Drink water Up your water intake. If you let your body become dehydrated, your skin’s condition will get even worse.
Take showers Soaking in a bath can make your skin dry out even more, so instead take short showers or a sponge bath. Use a moisturising soap.
Avoid irritants Friction can irritate dry skin. Try to get in the habit of patting yourself dry with a towel instead of rubbing yourself down. Alcohol-based perfume, colognes and aftershaves will also irritate your skin. If you want a little fragrance, choose a scented oil instead.
Shaving Shaving is another irritant so, if you can, stop shaving for a while.
Moisturisers Body lotions, particularly those with oil-rich lanolin, are good for dry skin. The oil forms a protective layer on the surface of the skin that prevents the skin beneath from drying out.
Weather watch Be even more diligent than usual about applying a sunscreen with a high sun protection factor (SPF30 is ideal) and reapplying it throughout the day. Use a lip balm to protect your lips. If it’s excessively cold or hot or dry or windy, stay indoors as much as you can.
Hair During treatment you may find that your hair gets thinner, you go bald, or you have no hair loss at all. Your care team can give you an idea of what you can expect from the drugs you’re taking.
Here, there, everywhere If you do start losing your locks you may also notice you lose hair elsewhere. You could lose eyelashes and eyebrows, beards and moustaches. And, of course, pubic hair may go, too.
Take control You might find it easier to adjust if you take it in stages, cutting long hair shorter before treatment begins. You might even want to go the whole hog and shave your head before the hair starts to fall out.
Softly, softly Take it easy on your hair during treatment. Don’t dye or bleach it, hold back on hair products such as gel, and choose a mild shampoo and conditioner. Buy yourself a soft hairbrush, too.
Wear a wig Modern wigs are so authentic you’d be hard pressed to know what’s real hair and what’s not. Think about shopping for a wig before you lose your hair so you can make the transition as soon as you’re ready.
Scarves, turbans and hats If a wig doesn’t feel right, try wearing hats or scarves or getting handy with a turban. Remember, too, that your scalp is not used to being exposed. In winter, you’ll need scarves and beanies to keep your head warm. In summer, always wear sunscreen and shade hats.
Eyebrows A cosmetic eyebrow pencil usually does the trick for thinning brows and can camouflage missing eyebrows, too. If your hair loss is likely to be permanent, consider having replacement eyebrows tattooed on.
Eyelashes You can pick up a set of false eyelashes at a pharmacy or at beauty counters. Simply stick them in place using the adhesive provided.
The new you Your hair will start growing back a month or two after you finish treatment. But you can expect to wait at least six months before you need your first haircut – a year or more if you want longer hair. It’s not unusual for the hair that grows back after treatment to be quite different from your old hair. It could be curlier or straighter – or even a different colour. On rare occasions, mostly associated with very high dose chemo, hair loss is permanent.
Lymphoedema Sometimes your lymph glands are damaged by radiotherapy or removed during surgery. If the lymph glands get blocked, you can experience a build-up of lymph fluid that leaves your limbs swollen. That’s called lymphoedema. Once you have lymphoedema, you have it for life, but you can keep the condition under control.
Look after your skin Infections make lymphoedema worse, so do what you can to avoid scrapes and scratches. Keep your skin clean and moisturised so it doesn’t crack or peel. Wear gloves when washing up, gardening or looking after pets. And wear long sleeves and long pants to avoid cuts and grazes.
Be alert to infection Early treatment with antibiotics can clear up an infection before it begins to put pressure on your lymphatic system. If you notice heat, redness, swelling, pain or discomfort in the limb affected by lymphoedema, get to your local doctor straight away.
Protect your limbs To avoid swelling you need to discourage fluid from collecting in your limbs. Rest your arm on a pillow when sitting or lying down. Don’t carry heavy loads with the affected arm. Avoid activities that require a pumping action. Always use a footrest when you’re sitting. Avoid sitting or standing still for long periods; move around every hour or so. Talk to your care team about an exercise program to help you process excess lymphatic fluid.
Get the gear Compression garments stop a build-up of fluid and redirect it to where your body can drain it away. Speak to your care team for advice.
Peripheral neuropathy Peripheral neuropathy occurs when a cancer or cancer treatment damages the nervous system. If you have peripheral neuropathy you may find that you’re extra sensitive to touch or temperature, or messages get mixed up so that something hot feels cold, and vice versa. You may experience numbness or pain. You may have difficulty with fiddly tasks like doing up buttons, or motor actions like keeping your balance while walking. If your neuropathy is caused by chemotherapy drugs, you may find the symptoms fade once your treatment finishes.
Managing pain If you’re in pain you may need pain-relieving drugs. Acupuncture can also be very effective. Get advice from your care team.
Dealing with wobbles Physiotherapists can help when you’re having trouble with coordination, muscle strength or balance. If you’re struggling to manage activities like dressing or cooking, an occupational therapist may be able to recommend some techniques or some equipment that can improve things.
Avoiding mishaps If your sensory perception is affected, you may have to develop some new habits so you don’t accidentally hurt yourself. Always use pot holders or oven mitts. Always wear gloves when you’re working around the house. Keep clutter off the floor and give up walking around barefoot.
Surgical changes Advances in surgery mean that physical disfigurement after a cancer-related operation is less likely than it once was. But there are occasions when significant physical changes are a necessary part of treatment.
Prosthetics Prostheses take the place of missing body parts. There are prosthetic limbs, hands and feet, penile prosthetics and prosthetic breasts. The government provides a reimbursement for breast prostheses. See “More help” below.
Reconstruction Sometimes surgery can be used to restore your appearance. Breast reconstructions are an option for women who have had mastectomies. Reconstructions are also used to repair damage to the head, face or neck.
Stomas Some types of surgery close off the body’s natural pathway for bowel motions. In those cases, the surgeon will make a small hole in your abdomen and rearrange your organs so that waste passes out this opening into a discreet plastic bag. This arrangement is called a stoma and you may need it permanently or just for a short time. Your care team will be able to give you plenty of information about what it is and how to manage it.
Support Body losses can be hard to come to terms with. You will probably need emotional support as well as practical support to deal with these changes. Your care team can put you in touch with counsellors and support groups.
Words to know
Cold cap a device used to chill the scalp and restrict the flow of chemotherapy drugs to the hair follicles with the intention of preventing hair loss
Lymph nodes also known as lymph glands, these small masses of tissue make up part of the body’s immune system
Lymphatic system a network of vessels that carry lymph fluid around the body as part of the immune system
Lymphoedema swelling caused by a build-up of lymph fluid
Mastectomy surgical removal of a breast
Peripheral neuropathy damage to the nervous system outside the brain and the spine
Prosthetic devices artificial devices that help the body to function normally
Things to ask
Can I stop my hair from falling out? Chilling the scalp during chemotherapy can prevent your hair from falling out by reducing the flow of drugs reaching your hair follicles. You’ll either wear a cold cap that’s filled with gel chilled to sub-zero temperatures or one that’s connected to a refrigerated cooling system. You’ll need to wear the cold cap before, during and after chemotherapy – and that could mean several hours of chill.
Does radiotherapy cause hair loss? Radiotherapy only causes hair to fall out in the area where the radiation is directed. If you are having radiotherapy around your head, you may get a small patch of hair loss where the radiation beam hits your skull. If you’re having radiation therapy for breast cancer, you may have hair loss in your armpit.
Expert's insight: Tina Griffiths Tina Griffiths helps patients going through treatment in her work as nurse unit manager of day oncology at Austin Health Centre.
“Chemotherapy and radiation therapy bring short-term changes, one of the most common being hair loss. The person may also lose their eyebrows or eyelashes. Those are very public changes and they affect a patient’s way of thinking. They become a cancer patient.
“When you get a cancer diagnosis your sense of control goes out the window. Information provides control and a sense of empowerment. Patients may not have control over their cancer but they can contribute to their own wellbeing.
“The way they eat and drink can impact how they feel. The way they dress or apply make-up can make a difference, too. A program called Look Good… Feel Better*, which is supported by the beauty industry, teaches people about skin care, wigs, scarves and ways to dress that can help them to look better.
“People cope psychologically in all kinds of ways. There are counselling and support groups, but not everyone will want them. People’s experience with cancer is individual. Those who cope better are the ones who are able to reframe their way of thinking about what’s happening to them, and who have an attitude of ‘Yes, I can help myself.’”
* For more on Look Good… Feel Better, go to www.lgfb.org.au or call 1800 650 960.
Expert's insight: Kate White Changes to your physical appearance after cancer can sometimes be the most difficult thing to deal with. Professor Kate White, the Cancer Institute of NSW chair in cancer nursing at the University of Sydney, says it’s important to tell your care team what’s causing you concern.
“On a practical level, they may know about some special service available to you, or be able to offer you helpful advice.
“If you feel there is never enough time to discuss something personal, ring in advance and ask for an extra 10 minutes with your doctor. Telling the nurse what it’s about may also be helpful as he or she may be able to lay the groundwork for you.
“Loss of self-esteem or self-confidence is common after cancer treatment. For example, women who have had a mastectomy may no longer feel like dressing in nice clothes. In the short term, seeing someone who is skilled in fitting the appropriate bra and prosthesis is important. So is wearing a nice bra. It’s a simple thing but it can make you feel better. You’re reaffirming your femininity.
“Partners or families should be careful of saying that these physical changes don’t make a difference to them. They may be trying to be supportive, but if the person who has gone through cancer treatment would really like a breast reconstruction, for example, then it is not very encouraging for them.
“To restore self-confidence and self-esteem, it’s important for those who have been through cancer treatment to get back to doing the pleasurable activities they used to do before they had cancer.”
DONNA BUSS On a Wednesday in November 2010, Donna Buss felt a lump in her left breast. By the Friday she knew she had cancer.
On the following Monday, she launched her new business, The Natural Canine, as planned. In the months between then and now, Donna has had a partial mastectomy, a round of chemotherapy, gone through early menopause – and seen her pet treats introduced into two supermarket chains.
Donna tried ‘cold cap’ treatment to minimise damage to hair follicles, but could not continue it and subsequently lost her hair. Recently she attended a Look Good… Feel Better workshop*.
“The cold cap is minus 27 degrees and, when you think your freezer is only minus 16 degrees, it’s very cold. It’s like a big head-guard they strap over your head very tightly. It’s quite painful, but I went through two sessions of chemo with this hat on, then in the third one I ended up with a migraine so they couldn’t put the cap on my head. Now my hair has fallen out. I was heartbroken.
“I’d been thinking, ‘I’m a strong independent person. I don’t need any extra support.’ But I think the reality hit when the hair came out. Even though I have incredible, supportive friends and family, nobody really knew. So my main reason for going to the workshop was actually just to go along there and feel normal with a bunch of ladies in exactly the same position as me. I felt completely normal. I wasn’t the different one.
“When you register they ask you your hair colour, your skin colour and so on and try to match products as best they can. And they have all the trained beauty consultants who go through the step-by-step of things like, if you lose your eyebrows, being able to draw those on correctly and not have one up and one down. You get to take all the products home. And you feel spoilt. It just makes it easier to get through. It was a good fun day. We all had a laugh, and that’s what you need.”
* For more information about Look Good ... Feel Better workshops, go to www.lgfb.org.au or call 1800 650 960.
Photo by Randy Larcombe
JON DEGNER Jon Degner was successfully treated for advanced mantle cell lymphoma, but is now learning to live with nerve damage, most likely brought on by the radiation treatment.
When Jon was diagnosed, his spleen was so enlarged it filled his whole abdominal cavity. Yet he’d only sought a medical opinion because he was struggling to keep up with his cycling companions on their weekly ride through the Adelaide Hills.
The cancer treatment was aggressive and has left him with peripheral neuropathy – damage to the nerves outside the brain and spinal cord. In Jon’s case the nerves in his feet and lower legs are most affected.
“When the neuropathy first presented I’d stagger around like I was drunk, almost walking sideways instead of forwards. I was determined to push through it and keep walking. Eventually my fitness picked up.
“Until recently it was painful, but I’ve managed it with exercise. The doctors were surprised at my functionality given the amount of damage I sustained. They talked about pain medications, but I found that when it started to hurt, I’d exercise more and the pain would go away. Exercising the damaged area has been beneficial to me.
“The reason I have the condition is because of my aggressive treatment. The chemo drugs could’ve triggered it, but the likely culprit was the TBI (total body irradiation).
“Your hospital should be able to sort you out with rehabilitation exercises. They could be as simple as some light resistance work, to walking on the treadmill or cycling.
“As much as it’s had an impact on my life, it’s not something I’d ever change. It might sound a bit strange, but the whole process is something I almost cherish. I have a lot more confidence in my ability to face problems. I’m calmer, friendlier, more open, and my self-esteem has improved. I’m much more comfortable in a variety of situations now.”
