Working on Body Image Through Health Challenges
- Country music singer Morgan Wade, 29, underwent a preventive mastectomy (removal of both breasts) a few weeks ago, and is “still processing” the changes made to her body after the procedure.
- The “Psychopath” singer said she decided to get the surgery after learning she had the RAD51D gene mutation, which raises her risk for breast cancer.
- A double mastectomy is a procedure to remove both breasts, and it can be an emotional and overwhelming situation for a woman to deal with.
- Body image can be a particular struggle for people dealing with a health battle. Whether you’ve just underwent a preventative mastectomy, like Morgan Wade, or battled cancer, it’s important to know there are ways to help improve your relationship with your body.
- Dr. Marianna Strongin, a New York-based licensed clinical psychologist, says it can help to spend time in front of the mirror and focus on the parts of your body that you love.
- One breast cancer survivor previously told us her cancer journey allowed her to see that “femininity is a state of mind” and not tied to her physical body.
The “Psychopath” singer opened up about how she’s doing following the preventative surgical procedure in an interview with People, informing the news outlet how both her grandmother and great-aunt passed away from pancreatic cancer. She also had an aunt who was diagnosed with breast cancer at 30 years old, something which prompted her cousin to get tested for gene mutations, which ultimately revealed the RAD51D gene mutation and inspired Wade to get tested. She, too, had the same mutation.
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Following the surgery, Wade recounted the drainage tubes attached to her being the “absolute worst” part of the overall experience. However, she’s still grateful for having undergone the procedure.
During this recovery period, Wade is focusing on getting comfortable with her new body, for example, she still doesn’t have nipples on her implants. Howe2v er, she will have the option to get 3D nipples or tattooed nipples in the future.
Looking back on how she felt after surgery, Wade explained to People, “Everything was gone. That was probably the weirdest part for me. I didn’t think I would care, but then when you go and you look in the mirror at yourself, it was just a lot to take in.”
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“I’m still processing how different my body looks in that regard. As tough as it is to look in the mirror right now for me… [the scars will] heal up and it’ll be good,” she continued.
“If you would’ve asked me a day after I did this, I would’ve been like, ‘Screw all of you. Why the hell did I do this?’ But now it’s helped me see things way differently.”
During this period of recovery and self-reflection, Wade, who released her debut album, “Reckless,” in 2021, and is known for her commanding yet raspy voice, still maintains her passion for music and continues to write songs. She’s also hoping to release her third album in 2024.
Expert Mastectomy Resources
She’s also hoping to spread awareness and break the stigma on breast mastectomies, adding, “For a while, it seemed like the word mastectomy was creepy or weird. It’s not something you want to talk about like, ‘I have to go have my breasts removed.’
“We have to talk about that stuff more. The pain really is temporary. I’’s so worth it, taking control of your health.”
Gene Mutations and Breast Cancer
In understanding the role RAD51D or BRCA gene mutations play in breast cancer risk, it’s crucial to know what these gene mutations actually are.
In the case of the RRAD51D gene, the Facing Our Risk of Cancer Empowered advocacy group explains, “women with a RAD51D mutation have about a 20-40 percent lifetime risk for breast cancer with a tendency for triple-negative breast cancer.” Additionally, women with this type of gene mutation “have about a 10-20 percent lifetime risk for ovarian, fallopian tube or primary peritoneal cancer (these three cancers and their risks are related and are often referred to together as ovarian cancer),” the group says.
BRCA on the other hand, is two genes (BRCA1 and BRCA2). According to the National Cancer Institute, BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2) are genes that produce proteins that work to repair damaged DNA. The BRCA genes are sometimes referred to as tumor suppressor genes since changes, or mutations, in these genes can lead to cancer.
Everyone is born with two copies of each of the BRCA genes, one inherited from each parent. If either parent carries a BRCA gene mutation, there’s a 50-50 chance the child will carry it as well.
When BRCA1 or BRCA2 have certain mutations, or changes, men and women are at a higher risk level for several cancers, most notably breast and ovarian cancer in women.
According to the National Cancer Institute, 55 to 72 percent of women who inherit a harmful BRCA1 variant will get breast cancer by the time they reach 70 to 80 years old. Similarly, 45 to 69 percent of women who inherit a harmful BRCA2 variant will get breast cancer by that same age.
The percentage of women in the general population who will get breast cancer in their lifetime? About 13 percent.
“If a woman has one of these mutations the genetic BRCA1 and (BRCA)2 mutations, it puts her at basically the highest quantifiable risk for getting breast cancer,” Dr. Elisa Port, a surgical oncologist at Mount Sinai, told SurvivorNet. "We typically say between the 60 (percent) and 80 percent range."
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If you have a family history of cancer, like Elizabeth Kay, genetic testing could be one way for you to find out if you have harmful genetic mutations that increase your risk of developing certain cancers. Ask your doctor if genetic testing is right for you.
Dr. Port explained, “We now feel that casting a wider net with genetic testing is probably very prudent because finding out that one has a cancer predisposition gene can definitely change their course, their risk for cancer and what they might want to do about it.”
When to Consider Preventative Surgery for Breast Cancer If You Have a Gene Mutation
People who have a family history of breast or ovarian cancer may want genetic testing, especially if they have one or more relative(s) who received their diagnosis before age 50. But what do you do if you are at an increased risk for breast cancer because of a BRCA or RAD51D mutations?
Dr. Freya Schnabel, the director of breast surgery at NYU Langone Medical Center, says there are three options.
“The first option is intensive surveillance,” Dr. Schnabel told SurvivorNet in an earlier interview. “And this is an option that focuses on early detection of disease if it should occur.”
The second option comes in the form of medication to lower the risk of getting breast cancer.
“Tamoxifen is the one we use in young women, and then aromatase inhibitors can also be used in post-menopausal women, that have been associated with lowered risk for developing hormone sensitive breast cancer,” Dr. Schnabel said. “So these medications have to be taken for five years, but have a meaningful reduction in the risk of developing breast cancer, especially for BRCA2 carriers.”
Is a Preventative Mastectomy Right for Me?
Prophylactic (preventative) surgery is the third option. “This is the option that will lower a woman’s risk of getting breast cancer as low as we can get it, because the strategy here is to do surgery to remove the breast tissue as completely as we can,” Dr. Schnabel explained.
She continued, “When these operations are done prophylactically, certainly, no muscles are removed. And, in addition, there is no necessity to remove any lymph nodes, so that we take away some of the side effects and risks that are associated with that piece of the surgery. By newer surgical techniques, patients having prophylactic mastectomies will frequently have the option for having the surgery done in a way that preserves the nipple and areola.”
According to Dr. Elisa Port, preventative mastectomies are “really quite effective if done thoroughly.” She says they reduce the risk of developing breast cancer from the highest risk level of 80 to 90% down to the lowest risk level of 1 or 2%.
That being said, there are risks to consider.
According to the Cleveland Clinic, a prophylactic mastectomy has the risk of bleeding, infection, loss of sensation in the breast and dissatisfaction with your appearance post-surgery.
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Because of this, it’s important to weigh the benefits with the risks with your doctor. If you discover you have a gene mutation, your doctor can help you understand your unique circumstances and what options may be best for you.
All About Double Mastectomies
A double mastectomy is a procedure in which both breasts are removed to get rid of cancer. The procedure may also be performed as a preventative measure for women who are at a very high risk of developing breast cancer.
The procedure typically only takes a few hours, but may take longer depending on what type of reconstruction a woman has opted to get. Some women decide to have their breasts reconstructed and have implants put in right after the mastectomy, while others don’t have reconstruction at all.
“A double mastectomy typically takes about two hours for the cancer part of the operation, the removing of the tissue,” Dr. Port told SurvivorNet. “The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has.”
Dr. Port notes that these days, most women do opt to have some sort of reconstruction. The length of these surgeries can vary a great deal. When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). There is also the option to take one’s own tissue (usually from the belly area) and transfer it into the breast area, but this is a much longer procedure.
“When you take tissue from another part of the body and transfer it to fill in the empty space where the breasts are, this is a very long operation,” Dr. Port says. “It can take anywhere from six to 12 hours because it’s really like having a tummy tuck and then transferring the tissue and grafting the tissue, connecting the vessels, so those tissues have blood flow to live in.”
Getting Comfortable With Body Image
Struggling with body image is not uncommon, especially for so many people dealing with health challenges, including cancer or the aftermath of a preventative mastectomy.
And it’s important you try to work on how you view your body because it can positively impact your emotional and physical wellbeing as a whole.
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Dr. Marianna Strongin, a New York-based licensed clinical psychologist, says spending time in front of the mirror can help with body image.
Although “research has found that when looking in the mirror we are more likely to focus on the parts of our body we are dissatisfied with” which can cause “a negative self-view and lower self- esteem,” it’s important to look at the parts of your body that you love and the parts of your body that you don’t.
Eventually, Dr. Strongin says, doing so can help you create a more accepting relationship with yourself.
“Body image is both the mental picture that you have of your body and the way you feel about your body when you look in a mirror,” she said.
“As you allow yourself to spend more time looking at all of you, you will begin having a new relationship with your body.”
Celebrity Stylist Ann Caruso on Beauty and Femininity After Cancer
Whether you’ve undergone a preventative mastectomy, or not, it’s important to know you’re not alone if you’re having a hard time with how you view your body after receiving a diagnosis or going through treatment.
Celebrity stylist Ann Caruso, for instance, previously opened up to SurvivorNet about how she was never the same after her 12 breast cancer surgeries.
“You’re not the same carefree person that you once were, and it was very hard for me to look at myself every day,” Caruso said. “It was like I was a totally different person and didn’t fit into any of my clothes for so long.”
But as time went on, Caruso said the experience helped her redefine femininity and body image as she knew it.
“Femininity is a state of mind,” Caruso said. “And I think that’s something that we have to remind ourselves.”
Learn to Accept Yourself A Huge Part of Living With Cancer
Meanwhile, Dr. William Breitbart, the chair of the Department of Psychology and Behavioral Sciences at Memorial Sloan Kettering Cancer Center, previously told SurvivorNet, “Every day of our lives is really filled with uncertainty” but those facing a cancer diagnosis tend to feel that uncertainty at a more extreme level.”
Dr. Breitbart also said that learning to embrace that uncertainty is a part of living, not just for those fighting cancer, but for everyone.
“What the task becomes is having the courage to live in the face of uncertainty, realizing that you cannot necessarily control the uncertainty in life, like the suffering that occurs, challenges both good and bad,” Dr. Breitbart says.
“You may not be able to control those but you have control over how you choose to respond.”
Body Positivity & Cancer
There has been a major movement in the last couple of years praising all shapes, colors, and sizes of women’s bodies. This is particularly important for cancer survivors as well, especially breast cancer survivors who have had one or both of their breasts removed.
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Cancer can be brutal to the human body. Along with dealing with the physical side effects of chemotherapy and other treatments, there are also the emotional blows that women and men suffer from losing their hair, organs and other body parts, along with the scarring that comes with it.
Beauty can be found in all forms. No one is perfect, and we need to learn to be proud of our battle wounds. Especially after beating a disease that is trying to take us down.
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Contributing: SurvivorNet Staff
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