A: It depends. Some people have body image concerns before starting treatment. Others first bring it up with a counsellor while they are undergoing treatment. It can also emerge in survivorship. For example, someone might develop a lymphedema that becomes troubling, and thus the body image issue arises. 

A: Many people worry about other people’s reactions to them. This can include concern about how people on the street will react to, for example, the effects of facial surgery, but body changes that are not visible, like a mastectomy, can cause deep concern as well. The best place to start is acknowledging the grief and feeling of loss about the change in your body. Sometimes a ritual helps. You can release a balloon to thank and say goodbye to the previous body image. Then, have a cake to welcome the new image. It’s about acknowledging the emotion. What a person thinks about their changed image is also crucial. They should consider what sort of messages they are telling themselves – pay attention to self-talk and focus on what you love about your body. The support of partners is, of course, extremely useful. 

A: Think about it ahead of time. Have a practised response that is comfortable for you. This is private information, so you don’t need to say more than you want. When asked about hair loss, some might say, ‘Yeah, isn’t it great? My cancer is getting better.’ Others might sidestep the issue with ‘I am just glad my eyes are still blue!’ It depends on how comfortable you feel. 

A: It is never a good idea to hold it in as the pain is not going anywhere and you can become unable to move on. My advice would be to go to counselling and take your partner, a friend or family member. Don’t suffer in silence. 

A: BC Cancer Agency Patient and Family Counselling departments will see survivors up to 18 months after treatment. If more intervention is needed, we make an effort to connect the person to a long-term resource.