Treatment adverse events (AEs) can affect patients’ self-esteem, but oncology nurses can help.
A cancer diagnosis usually means a whirlwind of changes and challenges that were unexpected. This can include long-term or short-term treatment for adverse events (AEs). Some AEs include hair loss, fatigue, weight changes, surgery scars, loss of body parts, rashes, or the need for an ostomy.1 These physical changes can affect the way patients feel about their appearance and body image.
The realization for patients that their look is going to be altered for a short period of time or for the remainder of their lives can cause a decrease in self-esteem. One of the things we hear, specifically among women, is how unprepared they are to lose their hair due to their treatment regimen. For AEs like hair loss, there are options such as wigs and other head coverings to mediate the change. But there are also other changes caused by cancer that are not as easy to hide, such as an ostomy or scars from surgery.
Self-esteem is defined as “the confidence in one’s worth or abilities”2 and is one of the many aspects of a patient’s life that is affected by cancer treatment. Self-esteem can be high or low and in patients with cancer, and it is important to maintain self-esteem that is closer to the high end rather than the low. Patients with lower self-esteem have been linked to having more depressive symptoms and decreased social support.3 When patients look in the mirror, they want to be happy and proud of what is staring back at them, and that is not always what happens. As a result, they need support during the times that they don’t feel like themselves, especially when their bodies start changing right before their eyes.
Nurses are in an important position to have conversations with patients about self-esteem and body image. It would be ideal to discuss body image and self-esteem with every patient during every encounter.4 Here are tips to make this more feasible when nurses see patients:
Climate also plays a part in how patients feel about body image/self-esteem. In warmer months, there is a possibility that nurses will encounter more patients with anxiety about their appearance because of increased outdoor activities when more skin is exposed. At the same time, the heat poses another layer of concern. For patients with skin cancers or who are on certain medications, they have to be mindful of sun exposure. In colder months, it is a lot easier to cover up changes to the body with a layering of clothes like turtlenecks, hats, and additional accessories to hide some side effects the treatment has had on their bodies.
When nurses speak to patients and their loved ones, remember to provide as much support as possible. Let the patients know that they are not alone and that there are people ready and willing to help. Nurses can also let patients know that organizations like CancerCare provide many free services like counseling and support groups. Patients can call 1-800-813-HOPE (4673) to speak with one of CancerCare’s oncology social workers.