Breast cancer: Survival’s only half the battle
More and more people are surviving breast cancer, but the challenges don’t end there. As Breast Cancer Awareness Month approaches, Lisa Salmon looks at the disease’s impact on body image and confidence
Breast cancer survival rates in the UK are higher than ever.
Around 55,000 people are diagnosed each year (the majority being women, although the disease also strikes around 400 men a year), but fewer than 12,000 now die from breast cancer annually.
Naturally, cancer survivors have a lot to be thankful for, but that doesn’t mean that life after breast cancer is problem-free.
Women may have undergone mastectomies, or lumpectomy surgery, plus there’s the weight gain and hair loss associated with the treatments, and the possibility of early menopause.
Coming to terms with these physical changes can be extremely difficult, but many survivors feel unable to discuss their feelings, often because they’re so grateful to be alive that they think they have no right to complain.
For this year’s Breast Cancer Awareness Month, in October, Breast Cancer Care is aiming to highlight the body confidence problems that are so common for people overcoming the disease, and the help that’s available to them.
A new survey by the charity found that the overwhelming majority (88%) of people who’ve had breast cancer say the disease and its treatment have had a negative impact on the way they feel about their body, with 68% saying it’s affected their sexual and intimate relationships too.
“The physical and emotional impact of this disease and its treatment cannot be underestimated or trivialised,” stresses Samia Al Qadhi, chief executive of Breast Cancer Care.
“Breast cancer can deal a crushing blow to a woman’s self-esteem, body image and relationships when she may be at her lowest ebb, and this can persist for many years.”
The charity’s poll of more than 600 people also found that 68% said weight change made them feel less confident.
Talking about these issues can be a crucial step in dealing with them, but 62% of respondents also reported not feeling able to talk to their healthcare professional about the disease’s impact on their body, and only 25% had been told about support and information related to body image, intimacy and sex.
“Many people tell us they’re shocked by the impact but feel they can’t talk about this aspect of their cancer, and simply don’t know where to turn,” says Al Qadhi.
“We want to bring this issue to light and get people talking about it. It is possible to find confidence after a breast cancer diagnosis and treatment.”
Ismena Clout has had breast cancer for nine years, and for much of this time she suffered in silence about the huge changes to her body.
Diagnosed at the age of 29, she underwent a single mastectomy but didn’t have reconstructive surgery as her cancer was aggressive and she urgently needed chemotherapy, and then “I just wanted to get on and live”.
Afterwards, she kept her angst about her altered appearance to herself.
“I didn’t make the most of the help that was on offer, and that affected me quite heavily afterwards,” she explains.
The treatment had also caused her to gain weight, and she adds: “I’d also lost my beautiful long hair that I’d had my entire life, so everything had gone.
“I went into a big depression, and I can attribute a lot of that to needing to find who I was again.”
Nearly three years ago, after more than six years in remission, Clout, who lives in London, found she had secondary breast cancer. It’s in her bones, liver, and a lymph node in her chest.
Although it wasn’t in her remaining breast, she elected to have it removed 18 months ago, because she “wanted to be even”.
She doesn’t wear a prosthesis, and says she picks clothes to distract from her chest.
“A bit of fantastic jewellery, a brightly-coloured scarf, a well-structured dress, and people don’t notice,” she says.
She’s also had her left mastectomy scar tattooed, to cover it up and make it “more interesting”.
“Being feminine is about highlighting what’s best in yourself, it can be everything. It’s so much more than just a pair of boobs. We have to make the most of who we are and what we have,” she adds.
Full of positivity and life, despite being on strong painkillers and just having started another round of chemotherapy, former facilities manager Clout, now 39, has even begun a new career as a motivational speaker.
She urges anyone dealing with the aftermath of breast cancer to use all the help available, and explains that while of course she’s very glad to be alive, the illness is more than just a life or death issue.
“Quality of life is important too,” she stresses. “I want to be able to enjoy the life I have. I want my confidence back, I want to go out and look fabulous, I want to feel like I’m a woman and have my femininity.
“It’s so hard because breast cancer affects all the main areas classed as the most feminine – your hair, weight, breasts. Saying ‘Aren’t you just happy to be alive?’ is far too simple.”
Secondary breast cancer like Clout’s is also being highlighted during Breast Cancer Awareness Month, particularly on Secondary Breast Cancer Awareness Day (October 13).
It occurs when cancer cells spread from the primary tumour in the breast to another part of the body. It can be treated and controlled, but is incurable.
Breast Cancer Care lead clinical specialist Rachel Rawson says: “As treatments get better, people can live for many months and years with secondary breast cancer, and they need to get the most out of life during that time, when they’re dealing with the side-effects of treatment.”
Secondary breast cancer commonly occurs in the bones, liver, lungs, and sometimes the brain, or near the original primary cancer site.
“It’s often in areas of the body that we need to live, and once you’ve got it in those organs, you can treat it and damp it down but you can never completely eradicate it,” explains Rawson.
However, if it recurs near the location of the primary cancer, it can be treated with a view to getting rid of it again.
“It’s very much a disease that you live with these days,” stresses Clout. “Here I am, three years after the secondary cancer diagnosis, and I’m doing really well, completely defying the statistics.
“Of course, my main priority’s staying alive, that the treatments work, being able to walk confidently out the door and not worry that I’ll be in pain or fall over.
“But I want to look good doing it too – I still want people to look at me and say, ‘She’s a hot woman’.
“Femininity is what’s inside, it’s who you are. Don’t let the disease take that away from you.”
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