Editorial: Body image following cancer treatment

Abstract

Significant medical advances in screening, prevention, and successful treatment in recent decades have increased the number of people living with and beyond cancer worldwide every year (Hulvat, 2020). Many of these people are recommended to receive aggressive treatments in order to prevent metastasis and improve survival (Shrestha et al., 2019). The aggressive nature of these treatments can often lead to significant changes to an individual's body. This includes, but is not limited to, changes to their appearance (e.g., surgical scars, removal of individual body parts, limb swelling, anorexia, and hair loss), sensory changes (e.g., pain, numbness, tingling, burning), functional changes (e.g., changes to speech, swallowing, hearing, eyesight, bowel/bladder incontinence), sexuality/fertility effects, weight gain or weight loss, loss of mobility, and the need to use of prosthetic devices (Fingeret, 2011). These changes to an individual's body resulting from cancer treatment...

Full text

TYPE Editorial
PUBLISHED 07 November 2022
DOI 10.3389/fpsyg.2022.1068977
OPEN ACCESS
EDITED AND REVIEWED BY
Anja Mehnert-Theuerkauf,
University Hospital Leipzig, Germany
*CORRESPONDENCE
Simon Dunne
simon.dunne@dcu.ie
SPECIALTY SECTION
This article was submitted to
Psycho-Oncology,
a section of the journal
Frontiers in Psychology
RECEIVED 13 October 2022
ACCEPTED 18 October 2022
PUBLISHED 07 November 2022
CITATION
Dunne S, Fitch M and Semple C (2022)
Editorial: Body image following cancer
treatment. Front. Psychol. 13:1068977.
doi: 10.3389/fpsyg.2022.1068977
COPYRIGHT
©2022 Dunne, Fitch and Semple. This
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Editorial: Body image following
cancer treatment
Simon Dunne1*, Margaret Fitch2and Cherith Semple3
1School of Psychology, Faculty of Science and Health, Dublin City University, Dublin, Ireland,
2Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada, 3School of
Nursing and Paramedic Science, Institute of Nursing and Health Research, Ulster University,
Coleraine, United Kingdom
KEYWORDS
body image (MeSH), cancer survivorship, psycho-oncology, patient—centered care,
health related QOL
Editorial on the Research Topic
Body image following cancer treatment
Significant medical advances in screening, prevention, and successful treatment in
recent decades have increased the number of people living with and beyond cancer
worldwide every year (Hulvat, 2020). Many of these people are recommended to receive
aggressive treatments in order to prevent metastasis and improve survival (Shrestha et al.,
2019). The aggressive nature of these treatments can often lead to significant changes to
an individual’s body. This includes, but is not limited to, changes to their appearance
(e.g., surgical scars, removal of individual body parts, limb swelling, anorexia, and
hair loss), sensory changes (e.g., pain, numbness, tingling, burning), functional changes
(e.g., changes to speech, swallowing, hearing, eyesight, bowel/bladder incontinence),
sexuality/fertility effects, weight gain or weight loss, loss of mobility, and the need to use
of prosthetic devices (Fingeret, 2011). These changes to an individual’s body resulting
from cancer treatment can have a substantial impact on their everyday life, particularly
in relation to their body image.
Body image is a multidimensional construct describing an individual’s mental
representation of their body, including their total concept of conscious and unconscious
feelings, thoughts, and perceptions about their bodies, as well as their awareness of how
others perceive them (Alebachew and Ashagrie, 2017). In the context of cancer treatment,
it has become common to examine body image as it relates to body image disturbances
and associated distress. For instance (Rhoten, 2016) has identified the following core
attributes of body image disturbance in adults who have undergone cancer treatment: (1)
dissatisfaction with a perceived change in appearance resulting from cancer treatment;
(2) decline in function relating to some aspect of one’s body; and (3) psychological distress
regarding these changes.
Body image disturbance and distress are known to affect a range of psychosocial
factors for individuals following cancer treatment. In particular, heightened concerns
relating to a changed appearance following cancer treatment may lead some individuals
to avoid contact with others altogether and become isolated (Fingeret et al., 2014;
Fingeret and Teo, 2018). Changes in body image resulting from cancer and its treatment
may also have deleterious effects on other aspects of a person’s daily life, such as their
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Dunne et al. 10.3389/fpsyg.2022.1068977
experiences of sexuality and relationships (Pelusi, 2006;
Sacerdoti et al., 2010;Faria et al., 2021). However, while some
studies have shown a direct relationship between self-reported
dissatisfaction with body image and emotional, functional,
physical, and social wellbeing following cancer treatment, such
findings have been inconsistent in the literature, particularly in
relation to cancers such as head and neck cancer (Howren et al.,
2013).
The potential complexity of the relationship between body
image and wellbeing following cancer treatment has been
underscored by a diverse literature which has examined how
socio-demographic and clinical factors can influence this
relationship. For instance, a recent systematic review of older
breast cancer survivors found that older women, particularly
those who are post-menopausal, may be less affected by changes
to their appearance following breast cancer treatment (Davis
et al., 2020). In addition to these variables, other socio-
demographic and clinical factors which have been demonstrated
to affect the relationship between body image and wellbeing
following cancer treatment, include gender, marital status,
income, education level, cancer stage, treatment type, and many
other such variables (Rezaei et al., 2016;Albert et al., 2022).
This demonstrates the need for a nuanced understanding of
the complex inter-relationship between body image and clinical,
demographic, functional, and psychosocial variables. However,
there is still a limited literature base examining the impact of
such relationships longitudinally.
The inherent subjectivity in the experience of body image
following cancer treatment has also been noted in the literature.
It is increasingly recognized that sensitivity toward bodily
changes following cancer treatment varies among those affected
and is not necessarily proportional to the amount of change
experienced (Rhoten, 2016). A growing body of research
has begun to examine the differential subjective impact of
body changes following cancer treatment by investigating the
mediating or moderating influence of particular variables on the
relationship between body image and wellbeing. For instance,
investment in appearance has been identified as a variable
that may have a particularly important moderating effect on
the relationship between body image and emotional wellbeing
(Helms et al., 2008;Sherman et al., 2017). There is a need to
continue this work of disambiguating the subjective experience
of body image following cancer treatment through examining
possible mediating and moderating variables, and through
qualitative research examining the subjective experience of
living with a changed body following cancer treatment.
The increasing use of body image screening and
interventions in oncology settings also underscores the
importance of this topic. Body image measurement and
screening is particularly important to allow health professionals
and intervention developers to identify at-risk individuals who
may be targeted for tailored interventions that ameliorate the
deleterious effects of cancer treatment on body image among
cancer survivors. However, there is a growing recognition of the
lack of gold standard approaches to body image screening and
measurement (Covrig et al., 2021). In relation to body image
interventions, systematic reviews have highlighted the potential
usefulness of cognitive-behavioral therapy, social interaction
skills training, and physical activity interventions in promoting
positive body image (Lewis-Smith et al., 2018). Nevertheless,
there are inherent methodological limitations and limited use
of randomized controlled trials in this work, which make it
difficult to draw definitive conclusions about the efficacy of such
interventions (Lewis-Smith et al., 2018). There is also a need for
more tailored interventions that focus on developing positive
body image in relation to men or for cancer populations beyond
breast cancer (Esplen and Fingeret, 2021).
The articles presented in the current collection go some
way to addressing core issues in the literature base, which
we have identified above. The collection brings together
quantitative research exploring the longitudinal relationship
between body image and wellbeing and mediating factors
involved in this relationship, qualitative research, and patient-
driven perspectives which spotlights cancer survivors’ body
image needs and intervention preferences following cancer
treatment, and reviews of the literature and commentaries which
synthesize important learnings from research on body image in
specific cancer groups. We also present some exciting new work,
involving the validation of novel scales addressing body image
and formal evaluations of interventions designed to improve
outcomes among cancer survivors who are impacted by body
image changes.
Author contributions
SD: conceptualization, original manuscript preparation, and
writing—review and editing. MF and CS: conceptualization,
manuscript review, and editing. All authors contributed to the
article and approved the submitted version.
Conflict of interest
The authors declare that the research was conducted in the
absence of any commercial or financial relationships that could
be construed as a potential conflict of interest.
Publisher’s note
All claims expressed in this article are solely those of the
authors and do not necessarily represent those of their affiliated
organizations, or those of the publisher, the editors and the
reviewers. Any product that may be evaluated in this article, or
claim that may be made by its manufacturer, is not guaranteed
or endorsed by the publisher.
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