Redefine Body Confidence When You Have Metastatic Triple-Negative Breast Cancer

When you’re living with metastatic triple-negative breast cancer (mTNBC), the journey is about not only managing the illness, but also navigating the physical and emotional changes that come with ongoing treatment. Hair loss, skin changes, and weight fluctuations are common side effects of treatments such as chemotherapy and immunotherapy. These physical changes can affect how you see yourself and how comfortable you feel in your own skin.

While you may think beauty shouldn’t be a high priority when you’re dealing with mTNBC, being concerned about how you look doesn’t mean you’re superficial or vain. Your appearance is an important part of your identity, your memories, and how you relate to the world. “It’s your body, and it’s changing. And the adjustment can be very hard for a lot of people,” says Mary Dev, LCSW, a senior counselor who works with women with metastatic breast cancer at MD Anderson Cancer Center in Houston. “There’s no right or wrong way to feel about those changes, and there’s nothing shallow about your feelings.”

Reclaiming body confidence while living with mTNBC is an important part of self-care. These strategies can help you feel more like yourself both during and after treatment.

• Acne-like breakouts
• Dry, tight-feeling skin
• Flaky, rough, scaly skin
  
• Hyperpigmentation, which can be especially visible and long lasting for women with dark skin tones

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• Itching or irritation
• Rashes
• Photosensitivity (when skin burns easily)
• Wounds or scars

• Take a less-is-more approach to skin care. Reach for gentle skin-care products labeled “hypoallergenic” or “for sensitive skin.” Avoid those that contain alcohol, fragrance, or harsh chemicals, as they can irritate skin and worsen symptoms.
• Pretest new products. If you add anything new to your skin-care regimen, do a patch test before using it fully, especially if your skin is more reactive during treatment.
• Step up the SPF. Your skin may be extra sensitive to the sun during treatment. Plus, ultraviolet (UV) rays can worsen hyperpigmentation and other skin reactions. Both are good reasons to apply sunscreen every day. Opt for mineral-based formulas with titanium dioxide or zinc oxide, which are gentler on sensitive skin. For added protection, wear sunglasses with UV protection, and cover your scalp with a hat or scarf when you’re outdoors.
• Stay hydrated. Apply a cream-based moisturizer daily (at the very least), as well as whenever your skin feels dry and immediately after every shower or bath (while the skin is still damp, which helps lock in moisture).

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   Hydrating sheet masks and overnight masks can also help soothe dry, tight skin.
• Avoid further irritation. Be kind to irritated or sore skin by wearing loose, soft, comfortable clothing and shoes. Avoid tight-fitting garments, very hot water, and scratching your skin, even if it itches. All of the above can make rashes and skin problems worse.
• Try a soothing soak. On days when your skin is feeling particularly irritated or itchy, try soaking in a warm — not hot — bath with baking soda, oatmeal, or bath oil.
• Address rashes. If you develop a rash after treatment, gently clean and moisturize the area. Apply a cool, damp washcloth to ease pain. If symptoms persist, talk to your doctor, because prescription treatments may help.

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• Target dark spots. If you have areas of hyperpigmentation that don’t fade after treatment, talk to your doctor about using an over-the-counter product that contains azelaic acid, glycolic acid, kojic acid, a retinoid, or vitamin C, all of which reduce the appearance of hyperpigmentation. If dark spots persist, consider seeing a dermatologist, who can offer prescription-strength treatments.

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Hair loss is one of the most visible and emotionally difficult aspects of cancer treatment. “For many women, their hair is a big part of their identity. And they worry what it will do to them and their family when their appearance changes,” says Dev.

• Experiment with head wraps and scarves. These offer style and comfort, hide hair loss, keep you warm, and protect your scalp from the sun. Look for lightweight, breathable fabrics in colors and patterns you love. Online tutorials can show you different tying methods.
• Consider a wig. A wig can provide a sense of normalcy and privacy during cancer treatment. Experimenting with different wig styles and colors can also be fun, especially now that there are more options available for women with different types of hair, including textured hair.
• Work with your stylist. If your hair is thinning or you have partial hair regrowth, a new haircut — a blunt bob, pixie, or layered look — can enhance the look of your hair and make a big difference in how you feel.
• Disguise thinning. For mild-to-moderate hair loss, consider using hair products designed to cover bald or thinning areas, such tinted or thickening hair powders.
• Try a new shampoo. Options labeled “volumizing” can make the hair appear fuller. There are also products formulated specifically for thinning hair. While not proven to be effective, they typically aren’t harmful. So it’s worth giving them a try, unless they irritate your scalp.
• Make your brows look thicker. Brow powders, gels, and stencils can help you fill in sparse areas. Once treatment is over, microblading (a semipermanent tattoo applied by a licensed technician that can last 12 to 18 months) is an option. But always check with your oncologist before pursuing any cosmetic procedure.
• Plump up your lashes. Eyeliner and mascara can make a noticeable difference. False lashes are another option, but be sure to patch-test the glue first to make sure you won’t have a reaction. Skip going to a salon for lash extensions, though, because the adhesive used to stick on individual lashes can irritate skin. Extensions can also block any regrowth of natural lashes.

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• Ask your doctor about hair treatments. For scalp hair, minoxidil (Rogaine), an over-the-counter medication that promotes hair growth, may be an option posttreatment. For lashes and brows, ask about bimatoprost (Latisse). Always get your oncologist’s go-ahead before using any regrowth products.

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• Consider supplements. Your doctor or dermatologist might recommend nutrition supplements to help speed up hair growth. If you’re thinking about taking any supplements, get the green light from your oncologist first.
  

If you’re struggling with body changes, these steps may help:

• Let go of traditional fashion ‘rules’ and prioritize comfort. Reach for clothes that feel good, rather than what’s trending. Soft fabrics, adjustable waistbands, and layered looks can help you feel comfortable and confident and still look put together.
• Choose clothing styles that reflect your personality. Whether that’s bright colors, cozy joggers, or maxi dresses, finding joy in your clothing can help you reconnect with your sense of identity. Try curating a few outfits that feel easy to wear and empowering, even on low-energy days.
• Highlight aspects of your appearance that you like. Use makeup, jewelry, or accessories to bring attention to parts of your body that you appreciate and feel good about.
• Eat sensibly. Instead of focusing on weight loss, aim for a balanced, nourishing diet that makes you feel good. Consider meeting with a dietitian or nutritionist to create an individualized eating plan.
• Find ways to be a little more active. Choose activities that you enjoy and don’t feel overwhelming, such as walking, taking a beginner’s yoga class, or light stretching. Plan to do them during the times of day when you have the most energy. Any amount of exercise can assist with weight loss, boost your body image, and improve your well-being.
• Tell your team if you have symptoms of lymphedema. Although there’s no cure for lymphedema, treatment can help improve movement and reduce pain and swelling in the affected area. Options include bandaging, compression garments, exercise, massage therapy, medication, skin care, and surgery.

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• Body changes from mTNBC treatment are common, and it’s okay to care deeply about how you look and feel during this process.
• Small acts of self-care, such as finding new skin-care routines, trying a different hairstyle, or dressing in ways that make you feel good, can help you rebuild your self-confidence.
• Support is available. Don’t hesitate to reach out to your care team, social worker, or therapist to talk through the emotional and physical effects of body changes during cancer treatment.