Coping With Your Body After Treatment
- A woman, 41, with a family history of breast cancer, was diagnosed with the disease. After undergoing initial treatment, she received a double mastectomy (removal of both breasts) and reconstruction to reduce her chances of cancer returning.
- The woman’s breast reconstruction left her with much smaller breasts than before.
- A double mastectomy is a procedure that removes both breasts. Some women choose this procedure to reduce their risk of cancer, especially if they have a family history of cancer or possess the BRCA1 and BRCA2 gene mutation, which also increases their risk.
- A major health challenge can impact your body physically and emotionally, causing noticeable changes to your appearance. Dr. Marianna Strongin encourages cancer warriors to take ownership of the part (or parts) of their bodies impacted mainly by cancer treatment.
A woman with an extensive family history of cancer says she wasn’t surprised the day she found herself diagnosed with breast cancer. However, what she didn’t expect was the grief she felt after undergoing treatment, which changed her body forever.
“The idea of dropping a handful of bra sizes seemed like a fair and equitable trade-off for my future health,” Kristie McCrum, 41, said in an essay on Wales Online.
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Her relatives were treated with chemotherapy and radiotherapy. Their experience prompted McCrum to stay current with annual mammograms, which screen for breast cancer. However, when McCrum was 36, a tumor was discovered in its early stages.
WATCH: Standard treatment for early-stage breast cancer.
Early-stage breast cancer means there is a small tumor in the breast, and no lymph nodes are impacted.
Treating cancer in this early stage usually involves removing the cancer through surgery with the possibility of radiation. Of course, various factors influence how each cancer is treated, including a woman’s overall health and how the tumor is behaving.
When McCrum was diagnosed, she said she wasn’t totally surprised. However, the thought of her having cancer still made her feel “numb.”
Some cancers can be tied to family history. People who carry the BRCA gene mutation get it from one or both parents. The BRCA gene mutation increases your chance of getting breast and ovarian cancer. However, genetic testing revealed McCrum did not have this gene.
After undergoing treatment, McCrum said, “Because of the family history, it seemed fairly likely it [the cancer] could come back, and the consultant told me the best course of action for a healthy cancer-free future would be a double mastectomy with a full reconstruction – in essence, I was going to get ‘fake boob.’”
WATCH: Understanding a double mastectomy.
When a woman decides to have a mastectomy, several factors go into that decision. Among things to consider is whether to have breast-conserving surgery such as a lumpectomy. These decisions should be made alongside your doctor by openly and candidly discussing risks vs. benefits.
“Risk-reducing mastectomies are an operation where we take women at, usually, very high-risk for getting breast cancer for genetic mutation carriers, who are the ones at the highest risk; there’s unfortunately only one way to actually prevent breast cancer,” Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, tells SurvivorNet.
It usually takes surgeons about two hours to remove the cancer during a double mastectomy.
“The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has,” Dr. Port adds.
Other factors that weigh into the decision to get a mastectomy are the size and features of the tumor and your family history. However, the gravity of your decision comes into full view, especially if you choose to get a mastectomy and remove both of your breasts.
The benefits of a prophylactic or preventative surgery are:
- Significant reduction in cancer risk (from 80-90% to 1-2%)
- Nipples can often be spared
- Women can get reconstruction at the same time
- What Goes into Deciding to Get a Mastectomy?
Helping Patients Cope with Early-Stage Breast Cancer
Preparing for Long-lasting Change
McCrum discussed the long-lasting impact a mastectomy would have on her long after the procedure with her doctor.
“I had worn a G cup bra since I was in my 20s, but the consultant told me somewhat sheepishly that the largest implants the NHS uses are a C cup,” McCrum explained.
WATCH: Regaining your sense of self after reconstruction.
RELATED: Did You Know Most Health Insurers Are Required To Pay For Breast Reconstruction Surgery?
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.
Dr. Port added that most women do opt to have some reconstruction. The length of these surgeries can vary a great deal.
There are many different options and techniques available for reconstruction, from implants to using a woman’s own tissue and choices about when to get the reconstruction, meaning immediate (at the time of mastectomy) or delayed (which could be months or even years later).
Immediate reconstruction can produce better-looking results than delayed reconstruction, resulting in fewer surgeries overall. However, it may require a longer initial hospitalization and recovery time. This long surgery may also have a higher risk of complications, such as infections, than two separate surgeries.
It may be worth noting that “Delayed reconstruction has fewer complications than immediate reconstruction,” Dr. Terry Myckatyn, a plastic surgeon specializing in breast reconstruction, tells SurvivorNet.
When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). During reconstruction, one can also take one’s own tissue (usually from the belly area) and transfer it into the breast area.
McCrum was left weighing the short and long-term effects of treatment.
“Of course, being cancer-free was the most important thing, and I was lucky that, post-surgery, I would have no need for chemotherapy or radiotherapy, which can have such a devastating effect,” McCrum said.
“I had read about people who were having mastectomies and ‘grieving’ for their bodies,” McCrum said.
Coping With Your New Body After Cancer Treatment
After the procedure, the reality of McCrum’s new body set in.
“I found that my blouses and shirts from before my operation were far too big across the bust. In fact, I dropped a dress size on top now that I had what in my mind were ‘petite’ breasts,” McCrum said.
“Changes to your body may be temporary or permanent. They include changes that others can see, such as hair loss or weight gain,” MacMillan Cancer Support says, noting physical changes.
“Changes that are not obviously visible to others, such as infertility, can also affect your body image and make you feel vulnerable about your body,” MacMillian Cancer Support added.
One way to prepare yourself for possible body changes during cancer treatment is to understand that changes are possible but also temporary. This can also help build up your self-confidence. Your support group, filled with loved ones, can help you during this stage of your journey.
Psychologist Dr. Marianna Strongin shares with SurvivorNet some additional tips cancer warriors can explore to help manage the emotional toll body changes can have during treatment.
Dr. Strongin encourages cancer warriors to take ownership of the part (or parts) of their body impacted mainly by cancer treatment. She says although they may represent “fear and pain,” they also represent “strength and courage.”
“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 causes us to have a negative self-view and lower self-esteem. Therefore, I would like you first to spend time gazing at the parts of your body you love, give them time, honor them, and then thank them,” Dr. Strongin said.
Dr. Strongin then suggests looking at the part or parts of your body impacted by the cancer or cancer treatment. She recommends creating a regular practice of accepting your body image because it helps you accept your cancer journey emotionally and physically.
“As you allow yourself to spend more time looking at all of you, you will begin having a new relationship with your body. It may not happen immediately, but with time, you can begin honoring and thanking your new body,” Dr. Strongin added.
It’s been three years since McCrum underwent her double mastectomy and breast reconstruction, and she says she is now fully comfortable in her body.
“I am cancer-free and healthy and happy,” McCrum said.
Questions to Ask Your Doctor
If you’re facing the option of having a mastectomy, here are some questions to consider asking your doctor:
- What can I do to prepare for a double mastectomy?
- What happens before and after the procedure?
- For reconstruction, what are the benefits of using implants over my own tissue and vice versa?
- What should I know about implants? Should I opt for preventative surgery?
- What will recovery look like after the procedure?
- What are the benefits of a watch & wait approach vs. preventative surgery?
- What kind of surveillance is required after the surgery?
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