Cancer Survivor's Corner

Body image and self-esteem

By Geneviève Chaput, M .D.

Lolitta Dandoy was an increasingly recognized fashion blogger when diagnosed with breast cancer. At just 30 years old, Lolitta was facing the terrifying reality of having cancer. Looking back, she says her doctor’s words haunted her: chemotherapy would cause her hair to fall out. “Looking back, it felt like an irrational, shameful fear,” says Lolitta today. Her concerns about hair loss were almost as distressing as her diagnosis. She recounts the strenuous 21-day countdown until her hair began to fall. Profound sadness and loss were overwhelming but there was also confusion and embarrassment for feeling distraught about losing her hair.

Body image issues are far more than physical appearance concerns. They encompass a multifaceted construct that includes perceptions, thoughts, feelings and behaviours related to the entire body and how it functions. Although survivors are often reluctant to acknowledge body image issues, fearing they’ll be labeled as superficial or vain, studies reveal that 30 to 70 percent experience distress due to treatment- related body changes.

When Lolitta began to lose large clumps of hair, she took charge and shaved her head. No hair, she thought, was better than clumps of hair, which screamed sickness. Still, she struggled to look at herself each day. Her bald look left her feeling even more vulnerable. “I knew I had cancer, but once my hair was gone, everyone else knew it, too,” she says. The changes she saw in the mirror affected more than her physical appearance, they challenged the belief that she could still be a well-respected fashion blogger.

Concerns related to body image can occur any time during the cancer trajectory and negatively influence psychological wellbeing and social functioning. Poor body image, attractiveness, and femininity are linked to depression, anxiety, and relationship problems. The situation can worsen if these issues are left unaddressed.

Are you struggling with body image concerns? Here are recommendations to help you:

  • Educate yourself. When considering treatment options, ask your doctor about what to expect regarding appearance and functional outcomes.
  • Engage in physical activity. A growing body of evidence suggests exercising regularly can improve body image and positively impact your mood and self-esteem.
  • Connect with support resources. An exemplary resource is the Look Good Feel Better program that offers a free workshop during which you learn cosmetic techniques, skin care tips, and hair alternatives to help you manage changes in appearance.
  • Speak to your health provider. Share your concerns openly, especially if you are feeling sad or anxious.

While Lolitta readily admits that having cancer was a difficult experience, it also came with unexpected positive aspects. “I grew more confident about my appearance and professional capabilities.” She also realized her teenage dream, successfully launching her own fashion blog, which you can visit at: She is also a cancer advocate, and even shaved her head for an awareness campaign. This time around, though, Lolitta felt nothing like when in treatments. She felt beautiful and empowered. “A bald head doesn’t mean we are sick. It symbolizes that we are in full combat toward our recovery.”

Genevieve Chaput is a physician at the MUHC. She is leading the development of the Cancer Survivorship Program, which includes both clinical and educational interventions to optimize the care of people with a cancer history.


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