In the western world, amongst young people, physical appearance rates very high. Advertising, boys and girls magazines, films and television all tend portray young people as having an ’ideal’ body image in which women tend to be slim, curvaceous with big breasts and hips, long legs and shiny long hair. Boys are portrayed as being ’fit’ and tall with broad shoulders, well muscled, with large ’pecs’ and relatively slim waists. These ’ideal images’ are difficult enough for young people to live up to at the best of times and frequently lead to considerable dissatisfaction and unease with what young people have actually got in the way of bodies - given the huge variation in both woman and mankind!
Add to this, the experience of cancer and it’s treatment, which can dramatically change aspects of your body causing hair loss, emaciation, changes in skin colour, surgical scars and much else besides - and the dissatisfaction, whether temporary or permanent, can come even more extreme.
Moreover, during the interviews, young people did not talk so much about feeling unhappy with their bodies but even more about how their experience of cancer treatment had left them ’not feeling normal’ or ’unable to fit anywhere’.
But many young people actually pointed out that during their treatment they were either at home with their family away from their friends, or in hospital and therefore amongst other patients who looked as ill as they did. Some, but only a few, managed to cope with their weight changes and hair loss by trying not to compare themselves with what they used to look like before their illness and its treatment.
The young people we interviewed observed that their body image only became a big issue when they had to start meeting with their peers who were neither family nor patients. It was certainly obvious that most young people were concerned about how others saw them. They felt very self-conscious and that people stared at them when they were out in public places. Not surprisingly most young people hated the idea of others feeling sorry for them. A few felt that they were unable to compete with their peers on any kind of equal basis and therefore withdrew from contact with the outside world until they were well again. As a result, during treatment, some did not want to see people other than their family and their closest friends (see 'Unwanted side effect of chemotherapy’ and ’Impact on friends’).
Others, amongst those undergoing treatment, said that they did not care much about their physical appearance. But hair loss resulting from chemotherapy was a big issue for many girls and some boys because it was such a visible sign that there was something wrong with them’, (see ’Unwanted effects of chemotherapy’) even though hair loss for most young people was a short term side effect and hair grew back both on their heads and bodies. Hair that grew back after chemotherapy was sometimes of a different colour, or was thicker, softer or curlier than it had been before. A few young males had permanent loss of hair from their heads. These said that it had been hard to get used to their baldness at first because hair makes such a social statement, but later they felt more at ease with it because it had become part of who they were, plus they did not need to pay for haircuts! Some young men felt that hair loss was less of a problem for them than for women since very short hair or shaven heads are currently fashionable amongst men.
Changes in weight were quite variable during treatment. Some young people gained weight, which they put down to treatment with steroids, while others lost weight due to sickness and changes in their appetite. Either experience (and occasionally both can happen in a single person during treatment) can modify the image that you have of your body. Some young people saw it from the point of view of how they used to look before their cancer treatment whilst others talked about it in terms of how they were seen by others.
One long-term side effect of cancer treatment is that it can leave permanent scarring from surgery, if surgery is needed. Young people can have scars that are very visible (e.g. on the face or neck), others have them on parts of the body that are normally covered up (e.g. on their back or tummy) However young people’s self confidence as a result of scarring seems to vary widely regardless of the position of the scars. Some girls said that, although they had initially been upset by the sight of their scars, their concerns had not continued. Others said that it had never been of concern. But this was not always so - for instance one young woman said she did not wear low cut tops or go swimming because of her scars, and a young man said it had taken him years to gain enough confidence to take off his shirt in public. When asked about their scars by other people there was a tendency, amongst some to make a joke about them to avoid revealing their true cause. A few talked of having been hurt by comments made by their peers, and one girl endured years of bullying at school (see ’School and work during and after cancer’). Occasionally a young person did feel that their scars affected their chances of having a relationship. The experiences of those that we interviewed who were in relationships, made it obvious that this did not have to be a concern (see ’Impact on friends’).
Young men who are diagnosed with testicular cancer have to have the affected testicle removed by surgery (an orchidectomy). Those we talked to said that in the end you get used to losing a testicle, and having a false (prosthetic) testicle helps. But initially it can be a difficult thing to get your head round.
Young people did indicate that they found it very helpful to find out things from other young people who had been through the same experience and that this had been useful when coming to terms with problems with their own feelings and ’self image’. It also helped them realise that they were not the only young person having trouble in their lives. To meet others like themselves was described as a greatly empowering experience.
Last reviewed April 2010.
Last updated April 2010.