Back to 'normal': Looking and feeling good after cancer

Women who have been through the rigours of cancer treatment and beaten the disease know that this is not the end of the story; rather it can be beginning of another. Cancer is, by its very nature, invisible to other people – a disease wreaking havoc far below the surface. It is the ensuing treatment that usually causes the visible side effects, and these can significantly hamper a woman’s psychological recovery following their illness.

The side effects of treatments such as chemotherapy and radiotherapy, as well as surgery in some cases, may mean what women see in the mirror during or after treatment is quite different. For many, these changes in appearance can be one of the worst aspects of treatment.

Yet concerns about appearance may seem secondary for those on the outside. For those who haven't been through it, they may not understand how difficult this can be for these women, says Naomi Fitzgibbon, cancer nurseline manager with the Irish Cancer Society.

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Eyebrows before the ‘embrowdery’ treatment.

“You can’t separate the physical from emotional or the psychological impacts of treatment. Side effects such as losing your hair, or getting lymphedema, are difficult side effects for women to get used to and many will never get used to it. It is different for everybody but nobody is the same after breast cancer treatment.

“Women need help with whatever it is they are dealing with, whether it’s getting mobile again with pilates, or getting their eyebrows done, it’s whatever helps them.”

As women try to adjust to life after cancer, how they look and feel is a major part of the journey back to normality.

It isn't quite "normality", however, says Roseleen Flaherty, oncology nurse counsellor with the society. "It is in fact the 'new normal'. Many women feel that they've had this experience, they have thankfully come out the other side of treatment – but now what? Women think they should feel lucky and shouldn't be complaining about how they look."

She agrees that people do not realise the severe impact the visible side effects of cancer treatment can have on a woman’s recovery. “Where the focus has been on the cancer, and getting rid of it, what remains afterwards is this deep sorrow about the changes that have occurred in their body and their feelings about their own attractiveness and the strength of their body.”

Here are some of the services making women feel like themselves, before, during, and after cancer treatment:

Mastectomy bras and prostheses

Mastectomy, where there is removal of one or both breasts, can be one of the most difficult implications of breast cancer treatment for women, although the emotional response is highly individual.

Women may choose to have a reconstruction or may wear a prosthesis, but practically speaking, specialised lingerie is required, and Bravelle in Co Limerick has been providing specialist post-mastectomy bras and swimwear to women in the Midwest and southern regions for over 11 years.

Kate Conway, who runs the business with her mother Pauline, a breast cancer survivor, explains that they see women at all stages of their breast cancer journey.

“We see them before surgery or after it, and we see ladies where it’s 20 years after they first had their surgery. We build up a strong relationship with our customers as they come back every year for their bra fittings, just like anyone buying bras regularly.” Customers tend to be anxious at first; “they are still coming to grips with this new challenge”, says Conway. Thankfully, the choice and availability of post-mastectomy wear has improved dramatically in recent years.

‘More at ease’

“Women become much more at ease when they see the lovely range of products that are now available. Before the choice was very limited and they were quite old-fashioned and ‘fuddy duddy’, for want of a better word,” she says.

Swimwear is crucial, as this may be one of the lower impact exercises women opt to engage in when recovering from surgery.

“Many women may have issues with mobility after surgery, or have lymphedema, so swimming is a nice gentle exercise.

“All the swimsuits we stock are pocketed so that women can wear their breast prosthesis in the pool; a regular swimsuit is not going to work, it has to be secure.

“In addition, they are higher cut if needed to conceal scarring.”

According to Conway, what many women do not realise is that they are entitled to two new bras a year with their medical card, and a prosthesis when they need a new one. “We are trying to highlight that as many women are not aware of this.”

Wigs

Hair loss as a result of chemotherapy is undeniably one of the most distressing aspects of undergoing cancer treatment.

Bernie Murray

of Wigs Medical in Waterford city wears a wig herself having suffered from alopecia for 17 years. “Because I wear a wig myself I feel I have an awful lot to give to someone. When I see a bad wig I think ‘that could happen to me’ . . . women are so vulnerable during this time.”

Women should get fitted for a wig before they begin treatment. This helps in choosing one as similar to their own colour and style as possible, but also makes the hair loss process somewhat less upsetting as their wig is ready to be worn.

She says it is crucial for women to call the wig “their hair”. “Wig is a terrible name for it because we tend to think of only bad wigs, whereas hair is a natural part of us.”

Murray has over 80 different styles in stock, meaning women immediately realise it will be possible to get a style similar to the one they had. “All women want to do is look normal and looking normal for them means looking like themselves. A woman needs to look in the mirror with her new hair on and see herself looking back.”

A major fear for women would be that the hair might blow off, adds Murray. “I assure the client once we have the correct fit that will not happen – I tell them how I play golf, tennis and go to the gym with my hair.” The power of a well-fitted, good quality wig cannot be underestimated for women going through cancer treatment, she says. “I love being able to help every woman get back a part of themselves that they are losing, to regain a confidence and to look forward positively to the future when treatment is finished and when their hair will come back in all its glory.”

Headwear

Ursula Haney

, of Ursula’s Headwear in Athlone, designs and makes headwear for women who have had hair loss as a result of chemotherapy or alopecia. She was inspired by her sister, who had been given two headscarves to wear when she lost her hair during treatment for breast cancer.

“I will never forget them, they were hideous. Women had no choice. I realised there was a market out there for nice headwear.”

She now sees about three customers a day, on average. Hanley says that while most women will have a wig, when they are relaxing at home or if they are too hot, they prefer a head covering of some sort.

Her designs, which include turbans, bandanas and scarves, can even be made to order for special occasions. “The aim is to make them both glamorous and comfortable,” she says.

Brows

The concept of permanent makeup to replace eyebrows has been around for a long time, but the harsh tattooed lines of yesteryear have been replaced by a novel technique known as microblading or “embrowdery”. This delivers fine strokes that exactly mimic separate eyebrow hairs, and as a result look infinitely more natural.

While it is available as a cosmetic treatment for anyone wanting to improve their brow shape and thickness, it is in women who have lost their brows due to cancer treatment or alopecia that this technique has its most valuable application.

This has been "a godsend" for those who lost their eyebrows during chemotherapy, says Sherise Reed of Contour by Sherise in Waterford city. She believes the loss of eyebrows is more significant than people realise.

“I think it is almost, if not just as important, as a wig. Many women are not accustomed to drawing on their eyebrows, plus makeup tends to slide off where there is no hair. I can see it in the women I treat, they’ve lost confidence in themselves, and are desperately trying to hide their eyes and their face. Eyebrows frame the face and having none really upsets women who’ve lost them.”

It’s ideal if women come in before they start treatment, as the technician can then follow the shape of their natural brow, and also because procedure is not recommended during chemotherapy because of the risk of infection.

The embrowdery must be topped up every 12-18 months, and Reed finds that all women tend to keep this up, as they love their new eyebrows so much.

“It’s so rewarding. I have had women cry in front of me when they see their new brows - I’ve cried with them,” admits Reed.