Body Image/Self Image Health Article

Description

Body image refers to a person's internal picture of his or her external physical appearance. Self image is a broader category that refers to one's inner perception of his or her physical, mental, interpersonal, and spiritual characteristics and abilities. The distinction is important because cultures vary significantly regarding the amount of emphasis given to body image as one aspect of self image. In Japan, for example, body image is a much smaller part of most people's self-image than it is in the United States. Both forms of self-perception, however, may be affected by cancer treatment.

Specific body image or self image concerns vary according to age and gender. Children being treated for cancer have different issues from adults because their self and body images are still being formed. Children and adolescents with cancer sometimes internalize a picture-of themselves as disfigured or unattractive, or as physically weak and incompetent. Even when the cancer has been successfully treated, the child's self image may still reflect feelings of being "sick" or "damaged." A distorted self image in turn can cause difficulties in social relationships as the child grows older. The Candlelighters programs offer practical advice and social support for children with cancer and their families.

Self image problems in adults tend to reflect (and reinforce) American society's patterns of gender socialization. Studies indicate that many women tend to be openly concerned about damage to their external appearance caused by cancer treatments. For many women, anxiety about losing their looks is directly related to fear of losing their husband or partner. Men's concern about outward appearance is less obvious but may be expressed as a need to look "healthy" in order to keep their job. Although there are not as many studies of men's reactions to cancer treatment as there are of women's, recent research indicates that men are still more concerned about losing physical strength or specific physical abilities required by their work than about their looks as such.

Causes

Cultural context

It is important to situate body image/self image issues related to cancer treatment within the larger context of contemporary emphasis on physical perfection. Advertising in the mass media encourages people to feel dissatisfied with their bodies. One study of the effects of television advertising on college youth found that as little as half an hour of ideal-body commercials has a negative impact on a person's body image. Another study found that a majority of American adults, men as well as women, believe that people are judged on the basis of appearance first and talent or personality second. In a cultural setting in which healthy people often feel they cannot measure up to media standards of attractiveness, it is not surprising that cancer patients are concerned about the effects of therapy on their appearance.

Surgery

Surgery on the face or the parts of the body associated with sexual performance or attractiveness has a more severe impact on self image than surgery on the hands, feet, or back. Breast surgery in women and surgical treatment of prostate cancer in men are often accompanied by changes in the patient's self image, particularly with respect to sexual relations. Sexual responsiveness can also be affected if the surgeon has had to remove tissue containing nerve endings that are sensitive to touch.

Radiation and chemotherapy

Radiation and chemotherapy can affect a cancer patient's body image because they often cause hair loss, radiation burns, and unattractive changes in the patient's complexion. While hair loss caused by chemotherapy is usually a temporary condition, hair loss caused by radiation treatment may be permanent. In addition, both radiation and chemotherapy can cause nausea, vomiting, fatigue, depression, and other reactions that affect the patient's sense of competence as well as their relationships with others. Self image often suffers when a person feels that job performance and valued relationships are being strained by these side effects of cancer treatment.