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When teenager Katie Darby was diagnosed with bone cancer, she began the emotional roller coaster ride of her life. In addition to the shock of receiving the diagnosis and undergoing treatment, she also had to cope with the physical effects of the tumour and treatment.
“I was upset when I found out I had cancer. When I was losing my hair, I felt worse. I felt more sick,” she says. She also felt isolated and alone.
In June 2010, The Hospital for Sick Children in Toronto (SickKids) introduced Darby to a program called Look Good Feel Better (LGFB), where she met other girls with cancer. There she learned tips on improving her appearance, and gained confidence and self esteem.
Cancer and its treatment causes physical changes that affect body image
"In some ways, teen girls with cancer are no different from other teenagers. They experience insecurity around their bodies changing due to puberty," says Deb Berlin-Romalis, a social worker with the Blood and Marrow Transplant (BMT) and Brain Tumour programs at SickKids. “Add to this their cancer perspective. In addition to all the changes of puberty, teen girls with cancer have to live with other physical changes such as skin problems on their face and the rest of their body,” continues Berlin-Romalis. These can include acne, dark circles under their eyes, and stretch marks or hair growth from steroid use. Another major problem is hair loss, including loss of eyelashes and eyebrows, due to chemotherapy.
The physical changes can be devastating to girls. “Society is way more harsh on girls. Hair loss in males and females are two different things. And the same is true of hair growth,” says Berlin-Romalis.
Having cancer leads to feelings of isolation
The changes in body image often lead teenagers with cancer to withdraw socially and have fewer friends. “When teenagers with cancer spend a long time being treated as an inpatient, they tend to become removed from their peers,” says Linda Cottell, who organizes teen and adult workshops for the LGFB program in Canada.
“Until I participated in the LGFB workshop, I hadn’t seen anyone around my age with the same thing,” agrees Darby.
About the Look Good Feel Better program
LGFB helps women and teen girls with cancer feel better about their appearance by providing free workshops on skin care and hair replacement techniques. In Canada, 10,000 women per year use the program. About 600 to 800 teen girls are diagnosed with cancer each year in Canada and approximately 80 to 100 of them are seen by LGFB.
Every workshop participant receives hypoallergenic, fragrance-free cosmetics specially chosen to help women with cancer address their skin care issues. All items are donated and LGFB does not endorse any particular brands of cosmetics. The kits are specially matched to the participant’s skin tone. Participants can choose to use as many or as few of the items as they wish. Teenagers also receive a backpack with items like lip gloss and eye shadow in more funky colours.
LGFB helps improve physical appearance
Girls with cancer need to properly care for their skin, especially since their immune system is compromised. The program teaches the teenagers skin care and sun care tips. “The program then teaches teens how to work with a variety of products to address dry, flaky skin, dark circles, skin patchiness, grey spots and puffiness due to steroids,” Cottell explains.
The girls also learn to redraw their eyebrows and eyelashes with eyeliner, using a three-dot method. Nail care is also important. “The program teaches girls not to clip their nails, but rather to file them, use a cuticle cream, and push them back,” explains Deb Hannah, director of LGFB. For hair replacement, there are a few options including wigs, hats or scarves. Generally, girls who are more “into fashion” are more likely to experiment with hats and scarves, says Cottell. Wigs can get expensive and social workers within the treatment team can help the girls and their families find insurance to cover the cost, adds Berlin-Romalis.
LGFB helps improve self image and reduces feelings of isolation
Beyond the obvious physical improvements, LGFB also helps these teens realize that there are others like themselves. They share tips and strategies. Even though outcomes may be different among participants, group support is very therapeutic, enthuses Berlin-Romalis.
“When I went to the program at SickKids, I realized I’m not alone, that there are other people doing the same things. It’s a confidence boost,” says Darby.
As Cottell puts it, “Their whole attitude changes. When they first come into a workshop, they are usually very shy, and not making eye contact. After an hour, you start to hear laughter and noise. By the time they finish a workshop, their shoulders are back and their whole demeanour has changed. It’s very rewarding to see that.”