Coping with changes to your body

When you are ill, or if you have chemotherapy, you may lose weight. This can make you look different.

Some people with cancer are given drugs called steroids as part of their treatment. These can make you put on weight.

You might be worried about how you will look if your weight changes. You may also be worried about what your family and friends will say or think. It might help to explain that any changes are temporary, and are caused by the drugs you are taking.

During chemotherapy, you may have a central line or portacath put into your chest, or a PICC  line in your arm. If you have surgery, you may need to have a tube or drain coming out of part of your body for a while afterwards.

Understandably, this may sound quite scary. Talking to your healthcare team and learning what the tubes are for can help you feel more confident. Your nurses will show you how to look after them. Most people get used to them very quickly.

This often happens after surgery. Whatever operation you have, the doctors will always try not to cause scarring, but sometimes it can’t be avoided. Scars always look worse straight after surgery when they are red, but they do fade a lot with time. You may also have stretch marks after surgery – these are narrow lines where the skin has stretched. But these are not usually too noticeable and they fade over time.

There are things you can do to make scars and stretch marks less visible. For example, using oils, moisturisers and camouflage make-up, which you can buy from high-street shops. Speak to your healthcare team for more information.

If you are feeling anxious or low because of scarring, talk to your healthcare team. They will be able to give you lots of support and advice. They can also arrange for you to speak with a psychologist or counsellor, if you would like to.

Sometimes people need to have a part of their body (limb) removed. For example, someone with bone cancer might have an arm or leg removed (amputated).

Surgeons always try to save a limb if possible. For example, they might remove the part of the bone with cancer in it, and then replace it with a bone graft or metal part (prosthesis). But this is not always possible, and amputation of the whole limb or part of it may be the only way to treat the cancer.

It can be very difficult to come to terms with a major change such as an amputation. Losing a limb can feel very scary and it might help to talk to your specialist nurse, doctor or a counsellor about your feelings. It is important to get all the support you need.

Cancer treatment might not affect your hair at all. However, chemotherapy and other medicines can sometimes affect the condition and growth of your hair. It might become thinner, or sometimes fall out completely.

Wearing a cold cap (a hat filled with a cold gel) during chemotherapy can help reduce hair loss. But this is not recommended if you have a blood cancer.

Hair loss from chemotherapy is usually temporary, and your hair will start to grow back after treatment. If you have hair loss from surgery or radiotherapy, you might find there are areas where the hair doesn’t grow back.

Coping with hair loss

If your hair starts to fall out, you may prefer to cut it short. If you feel more comfortable covering up your hair loss, you can wear hats, scarves or wigs. Some people prefer not to wear anything on their head – do whatever feels right to you. Some people get a wig but then decide not to use it.

Many hospitals offer a wig service. Your nurse or specialist should know about this, so feel free to ask. You may be entitled to a new wig every six months through the NHS in any style and colour you want. Real hair wigs may be available through charities such as the Little Princess Trust.

Here are some tips for wearing a wig:

• It is often better to get a wig as soon as possible. You can match the style and colour to your own hair or just get used to wearing it before you need it.
• You can take a wig to a hairdresser to be styled.
  If you do wear a wig, it is best not to keep it on at night as your scalp will benefit from being open to the air.
• Brush the wig regularly to prevent it becoming knotted.
  Wearing a wig in the summer can be hot and uncomfortable. A bandana or baseball cap can feel cooler and protect your head from the sun.
• Your hair will usually grow back after treatment, but it can sometimes grow back a different colour or texture.

Getting support

Hair loss can be a big deal for some people – both male and female. Your healthcare team knows this and will try to give you all the support and advice you need. It may help to talk to other young people who have coped with hair loss.

Talking to people about your feelings can really help. But it’s important to feel comfortable with who you talk to. If you don’t want to open up to your family or friends, you can always talk to the professionals in hospital. Social workers, psychologists and counsellors are trained to listen and help you work through your feelings.

Expressing your feelings might not be easy for you, particularly if you always try to be brave. But crying can help to release any tension and stress you are under.

You may need to go through a grieving process, particularly if you have lost part of your body.
Another way of letting out your feelings is to express yourself through writing, blogging, playing music, drawing or painting. You may not have done any drawing or painting for years, but many people rediscover the fun and enjoyment of art while they are in hospital. It is also a good way to let out anger and other emotions. Many hospitals can refer you to music or art workshops, so ask if this is available.

If you use social media and want to share how you are feeling, you could try posting on, or sending private messages to, the Facebook pages of Young Lives vs Cancer, the Teenage Cancer Trust and Teens Unite. You can also read about other people’s experiences on these pages.

Some people find that dealing with body changes makes them more determined to follow their ambitions or goals, or encourages them to think of new challenges.

Seeing and talking to your friends regularly can help you feel more confident about facing the world. They can support you, make you laugh and make things feel more normal.

But they might not always act how you would like or expect them to. Sometimes they might not give you the support you need. Remember, this is not your fault. If you can, talk to them about how you feel and what their friendship and support means to you.

It may be useful to get some practical advice about ways of coping with body changes, for example using cosmetics to cover scars. It can be difficult to have this kind of conversation, and you might feel embarrassed or self-conscious. But try to get the help you need, as it can really make a difference. The team at your hospital might organise support groups and  sessions about body image and self-confidence, so ask them what is available. You can also
get advice at your local Macmillan information centre.

You will also find chat rooms and message boards online that are dedicated to helping young people with cancer connect with each other and share their experiences.

Each treatment can affect fertility in men and women in different ways. If your fertility is affected, it is not always possible to say how long this might last. For example, you may still be able to start a pregnancy in the future.

Your cancer doctor or nurse will talk to you about your treatment options and possible side effects before you start any cancer treatment.

You may still be able to get pregnant or make someone pregnant during treatment. Some cancer treatments can be harmful to an unborn baby. If you are sexually active, it is important to use a condom or other form of contraception.

Your doctor and specialist nurse can discuss fertility with you and arrange for you to talk to a fertility specialist, if needed. You may also find it helpful to read our section on fertility for teenagers and young adults with cancer.