Managing Body Image Difficulties of Adult Cancer Patients


Every person has their own body image – not only does it include aspects of one’s appearance, but it is a multifaceted construct and thereby contains the perception of one’s own body, but also thoughts, feelings and behaviours that related to one’s body. When people suffer or have suffered from cancer, they often experience physical changes that result from the disease and treatment: Hair loss, weight changes, scarring, numbness in parts of the body, difficulty swallowing and impotence are some examples. That these changes can also affect the body image of (former) patients is obvious.

This article reports on scientific findings regarding the connection between cancer and body image, on interventions that can be helpful to improve body image and summarises tips and recommendations on how to communicate and interact with people affected by cancer.

Most research has focused on patients with breast cancer, however, other types of cancer have also been studied in terms of body image. Most concerns about body image are experienced by patients immediately after surgery or shortly after completing treatment. Younger patients, those with a high BMI and those who have had further complications after surgery are particularly likely to experience body image concerns. Taking special care of these patients is crucial to promote their quality of life in the best way possible.

Certain forms of therapy are promising, most notably cognitive behavioural therapy, a psychotherapeutic approach that focuses on dysfunctional thoughts, emotions and behaviours and aims to improve them through specific techniques. Other helpful interventions are for example Psychosexual Therapy, Education Interventions, Cosmesis-Focused Interventions or Massage, Yoga or Strength training and physical exercise to regain physical fitness.

However, prior to initiating special interventions, open communication with the patients about their body image, their complaints, concerns and thoughts is particularly important. It would of course be advisable to talk to every patient specifically about their body image – but in the often stressful daily routine in clinics, this is not always possible due to lack of time. Therefore, special attention should be paid to those patients who undergo major visible and perceived physical changes as a result of their illness and treatment. Because patients often feel ashamed of their physical changes and do not address them by themselves, it is crucial to address them proactively – with caution, empathy and patience. The following 3 Cs should be considered:

1. Common: Making it clear to patients that physical changes are common and frequent, therefore they are not alone.
2. Concern: Directly asking what exactly the patient’s concerns are.
3.Consequences: Directly asking what the direct consequences of their concerns might be in daily life, in social, professional and emotional situations and aspects.

Finally, we will summarise the five most important principles from the article that healthcare professionals should especially keep in mind – they focus on body image, but they are also fundamentally applicable to appropriate communication with patients. These principles should help them to not feel alone with their concerns.

1. Informing patients about what to expect in terms of changes in their physical appearance and functions, so that they are aware in advance.
2. Listening well, carefully and patiently as a particularly important part of communication – communicating often means simply letting the other person speak.
3. Asking open questions and formulations that invite patients to tell what is most important to them
4. Allowing silence and giving space to conversations, which can then often reveal particularly important information about the patient’s feelings, fears and goals – allowing sufficient time for this is crucial.
5. If necessary, referring patients to a psychological or psychotherapeutic practitioner for more intensive reflection on their concerns in order to promote their mental well-being in the best way possible.