The BBC's Victoria Derbyshire has recently started chemotherapy for her breast cancer. She like many women (and men) has started losing her hair and as a result is wearing a wig. Why can hair loss be such a big deal and so traumatic, and what can we do to deal with it well? Allow me to share some of my own experience.
While every cancer experience is as unique as the person with cancer, there are some general issues for us all. There are many possible side effects of cancer treatments, which is effectively poisoning of the body in an attempt to eradicate cancer cells. We are well aware of hair loss. Others are less talked about, especially the so very real emotional impact, which can last a lot longer than treatment, which can change lives forever, and is also very real for family and friends.
Hair loss is personal and when it happens there is no (more) shying away from the reality of cancer and cancer treatment. Look at yourself in the mirror and it stars back at you. It changes the way you look, the way people look at you and possibly the way they treat you. Hair loss (not just ON TOP of our head) is difficult.
When I prepared for my cancer treatment, I decided I wanted to retain some active involvement in what has happening to me. Being giving the diagnosis and finding every single aspect of my life put into question, was a huge blow to my self-confidence. If I was not careful, then everything would end up depending on others: eg the doctors for my care and survival, the Department for Work and Pensions for my livelihood (practicing as a psychotherapist while undergoing cancer treatment was not an option). No, I needed to keep a sense of active involvement, independence and exercise choices. Which I also did by exercising my right under NHS Choices to select where I wanted to be treated, which was different to where I had been diagnosed. To this day I remain thankful to the care and staff of The Royal Marsden(Chelsea). But I digress.
For me to be an active participant meant I decided to cut off my hair before the start of my treatment, before it would start to fall out. I remember that summer's day, standing outside with my kitchen scissors, hacking away at my locks. I still have them somewhere in a bag. I could not get myself to throw them away. My hairdresser then gave me a number 1 hair cut. It was heart breaking yet exhilarating at the same time.
I decided against wearing a wig. It's not me. I would have felt even more self-conscious and I knew I would not have the energy to worry about whether it sits right, or not. The NHS wigs looked cheap and obvious and I could not afford differently-styled wigs with human hair. I opted for head scarves and hats, many colours, many styles. I needed variety. I wanted to colour coordinate, wanted to be able to express how I felt with colours. I wanted to retain a sense of individuality, of me. That also enabled me to retain an important sense of control and having a say in how I looked - hair or no hair.
In the scheme of things, hair loss was to be the least of my problems, as other more severe treatment side effects started queuing up. But hair loss was different. Especially when I lost my eyebrows and eye lashes. I felt intensely disfigured and it was painful to look at myself in the mirror. This was 'me', but I did not like 'me' - not looking like that. I could conceal the scars of my operation and choose who I wanted to share them with. My face was a different matter. Wearing make up during chemo is not recommended. The skin is too sensitive; the body is already dealing with the chemo poison and adding more harmful substances to the mix (do you know what is in your lipstick?) was not an option for me.
Losing hair in other areas of my body gradually also changed my body image. I started to look like a child, not like a woman in her late 40s, who was also being thrown into the menopause and left infertile.
As I see a picture of Victoria Derbyshire sitting in her 'chemo chair', I am reminded of my own treatment visits. Sometimes you end up seeing the same faces, the other patients, the same wigs, the same scarfs, the same real hair. You exchange words, tips, or just a nod. Over time you forget all that, and look out for other signs: How is the other person coping today? Do they look frail/er? What may have happened to the ones you no longer see? Will you see the nurse, who always makes you laugh and gives encouragement? Will the blood test results be good enough to have treatment today, or not? Will the veins in your 'good arm' stand another needle assault?
As you tick off the days and pop the anti-sickness tablets and steroids and god knows what else to cope with the side effects, you hope that it's all worth it. You hope that it works. And even when it does, what are the chances of the cancer coming back, and it all starting again, only worse? Who knows. I don't and I have learnt to stop going there. It distracts from now, from today.
And if you are lucky, the hair will grow back and the physical scars start to heal, and you may throw away your wig or keep it - but you won't take much for granted - anymore.
Losing your hair is only part of the story, part of the real loss of a life that was more care-free, than it will ever be again. Wig or no wig, the important piece is to feel you have a say and choices in how you deal with what is happening. It starts with the small things, like our hair, and will become an essential corner stone in our attitude of living with or beyond cancer.
Karin Sieger
Psychotherapist, MA (Couns.Psych.), Reg. MBACP (Accred)