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When most oncology patients begin radiation therapy, feeling “pretty” or “attractive” is a low priority. The focus is, understandably, on beating the disease.

But as you undergo treatment, it’s important to be aware of how radiotherapy can affect your physical appearance, both in the short- and long-term. Anticipating these changes can help you combat depression, social anxiety, and other mental health issues related to body image.

Below, we discuss some of the ways radiation may change what you see in the mirror. We also offer tips for coping with your new appearance.

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How Radiation Therapy Can Change Your Appearance

So, how does radiation therapy change your body? Depending on the type, location, and intensity of your radiotherapy treatment, you may experience:

Skin Damage

Radiation dermatitis is the most commonly reported side effect of radiation therapy. This is most common when the target is close to the skin. For cancers that are deep in the body (prostate, many brain tumors, many lung cancers, pancreas, liver, bladder, etc.), skin damage usually does not occur. This condition arises within a few days or weeks of starting radiation therapy, and can cause symptoms like:

  • Skin redness or pinkness, known as erythema
  • Dry, peeling skin
  • Blisters or skin ulcers

Though radiation dermatitis typically clears up within a few weeks after treatment ends, it can infrequently cause permanent discoloration and cosmetic changes such as red spidery marks on your skin caused by small broken blood vessels.

Hair Loss & Graying

Radiation therapy can cause hair loss on the part of the body that’s being treated. In other words, if your scalp is not being treated, you will not lose hair on your scalp.

For some patients who receive high doses of radiation therapy, hair loss is permanent. But for most patients, hair usually grows back a few months after treatment has finished. However, it may be thinner or have a different texture. Your doctor can give you a sense of whether to expect hair loss and whether it is expected to be temporary or permanent. For patients receiving chemotherapy, certain drugs are more likely to cause hair loss which should be discussed with the medical oncologist.

Eyelash Loss

Damage to the eyelashes from radiation occurs only in the rare circumstance when radiation is delivered very close to the eye and it depends on the specifics of the radiation being delivered. Your doctor can tell you whether this would be an expected side effect from treatment and whether it is expected to be temporary or permanent.

Weight Fluctuations

Patients undergoing radiation therapy may experience nausea, vomiting, and diarrhea, typically only when the radiation is directed at the abdomen or portions of the pelvis. Weight loss can also occur in patients whose sense of taste is affected which typically only occurs in patients receiving radiation to the mouth and throat.

These side effects can contribute to unintentional weight loss. Infrequently, radiation oncology patients gain rather than lose weight usually due to inactivity related to fatigue. Weight gain can also occur from medications such as steroids, often used with surgery or cancer therapies.

Vision Changes

Another rare event is visual change or damage from radiation. This is seen only when treatment is required in or around the eye, or in associated neurologic structures. Your radiation oncologist will use special techniques to minimize such risks.

Swelling

Swelling, also known as lymphedema, occurs when there is impaired flow of lymph in the body. Lymphedema is rarely a result of radiation alone and can be associated with pain, skin changes, and decreased range of motion.

Lymphoedema is characterized by chronic swelling in the arms or legs. If left untreated, it can cause:

  • Itchy, red, warm skin
  • Rashes
  • Wounds that won’t heal
  • Thickening or hardening of the skin
  • Hair loss

Lymphoedema may occur during radiotherapy. Or, it may occur years after treatment has ended.

Tooth Decay

When patients with head and neck cancers receive radiotherapy (often given with chemotherapy), there can be damage to oral tissue, salivary glands, and bone. This can happen in the form of irritated mucosa and a reduction in the amount of salvia present. These changes can alter the healthy balance of bacteria in the mouth and can contribute to tooth decay. Radiation can also increase the risk of delayed or impaired healing following dental surgery later in life.

Good dental hygiene, fluoride use, and regular cleanings can reduce the risks of long-term dental issues.

The Connection Between Body Image and Mental Health

“Body image” refers to the thoughts and feelings you have about your body. Unfortunately, the physical changes you experience during and after your cancer therapy can negatively skew these thoughts and feelings.

Being dissatisfied with your body can have far-reaching consequences, contributing to a number of issues like:

  • Poor self-esteem
  • Social isolation
  • Eating disorders such as anorexia or bulimia
  • Depression
  • Anxiety
  • Body dysmorphia
  • Muscle dysmorphia
  • Poor job performance
  • Academic difficulties
  • Reduced libido

To avoid these issues and generally feel happier in your day-to-day life, it is important to try and nurture a positive body image.

Tips for Fostering a Positive Body Image After Radiation Therapy

After finishing cancer therapy, you may catch a glimpse of your reflection in a mirror and not recognize or like something you see, whether that’s due to a change in weight, asymmetry, redness, or swelling.

It’s important to give yourself time to mourn these changes. But you also need to adjust your thought patterns to accept and love your body — even if it doesn’t meet typical beauty standards.

Here are some tips for doing just that:

Focus on the Positives

Rather than nitpick your flaws, celebrate your strengths. You may even write a list of things you like about yourself. This list can include physical qualities — your dimples or eyes, for example — as well as personality traits like loyalty and humor.

Respect Your Body

To cultivate a positive relationship with your body, you need to respect it. This looks different for different people. You may choose to respect your body by feeding it nourishing foods, exercising, meditating, or taking time away from social media and television.

Remember Your Journey

Before admonishing your body for gaining weight or losing muscle definition, remember what it’s been through. Your body has fought a life-threatening disease and endured months — possibly even years — of intense treatment. Doesn’t it deserve some slack?

Let Go of the Past

In the wake of radiotherapy, many patients tend to compare their current bodies to their pre-cancer selves. But rather than focus on what you’ve lost, you need to focus on what you’ve gained during your cancer journey — whether that be mental strength, spirituality, or a closer relationship with your family.

Silence the Negative Self-Talk

Though it can be hard to stop negative self-talk altogether, mindfulness goes a long way. Whenever you notice yourself dwelling on negative thoughts, remember to pause and reframe your internal dialogue by using positive, forward-focused language.

Nest Steps

If you’re struggling to love and accept yourself after radiation therapy, know that you’re not alone.

  • There are other oncology patients you can meet through support groups who know and understand your pain firsthand.
  • Your SERO cancer care team can also connect you with mental health resources when you’re ready.

At SERO, our kind and compassionate providers are here to help you navigate your cancer journey, from diagnosis to remission. Though we specialize in offering high-quality medical support, we can also provide the emotional support you need to heal both your mind and body. To learn more about SERO, call us at 704-680-6570.