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Writing Program Can Help Ease Body Concerns After Treatment

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After breast cancer treatments, which may include surgery, chemotherapy, radiation therapy, and other medicines, many women report that they don’t like their bodies and have low self-esteem, depression, and worse quality of life overall.

This is understandable. Breast cancer treatments can leave scars and discoloration, as well as cause hair loss, lymphedema, menopause, vaginal dryness, and other side effects that alter the way a woman lives her life and perceives herself.

To help address body image issues in women who have been treated for breast cancer, researchers developed a program called My Changed Body, a web-based structured writing exercise designed to promote self-appreciation and self-compassion.

A study suggests that the My Changed Body program can help ease distress related to body image and increase self-compassion among women treated for breast cancer.

The research was published online on April 24, 2018 by the Journal of Clinical Oncology. Read the abstract of “Reducing Body Image-Related Distress in Women With Breast Cancer Using a Structured Online Writing Exercise: Results From the My Changed Body Randomized Controlled Trial.”

This Australian study included 304 women who had been diagnosed and treated for stage I to stage III breast cancer and now had no evidence of disease; 98 of the women (32%) also had been diagnosed with lymphedema related to breast cancer. All the women had had at least one negative experience related to her body after being diagnosed, for example, feeling bad about the way she looked without clothes.

Before the study started, the researchers assessed the women’s negative body image distress as well as their body appreciation. The researchers repeated the assessment 1 week after the study ended, 1 month after the study ended, and finally 3 months after the study ended.

The women were randomly assigned to one of two writing programs:

  • The My Changed Body program (149 women): These women did a single 30-minute online writing activity with several sections. The first section asked the women to think about a distressing event related to their body after breast cancer and to write freely to introduce the distressing event. Next the women continued writing about how they perceived their body image after breast cancer treatment, guided by five self-compassionate prompts. The prompts helped the women to first focus narrowly on the negative feelings they had, then gradually move to a broader, self-compassionate perspective. Each prompt brought up a separate text box to help the women structure their writing.
  • An expressive writing program (155 women): The women in this group also did a single 30-minute online writing activity that started with the same prompt to writing about a distressing event related to their body after breast cancer. But these women didn’t have any self-compassionate prompts. They were simply told to describe the event further.

At the beginning of the study, both groups had the same levels of body image distress and body image appreciation.

The researchers found that women in the My Changed Body group had better body appreciation and less body image distress at the 1-week, 1-month, and 3-month assessments. Women in the My Changed Body group who had lymphedema had the greatest improvement in anxiety and self-compassion.

“Overall, these findings indicate that the [My Changed Body] writing intervention demonstrated statistically and clinically meaningful benefits compared with unstructured, self-directed expressive writing for addressing [body image-related distress],” the researchers wrote. “Importantly, the [My Changed Body] benefits were achieved independently, without clinician or other in-person support.”

While the My Changed Body program isn’t available everywhere, other research has shown that journaling -- writing down your emotions, thoughts, and experiences -- can help you feel a greater sense of emotional well-being and help you feel better physically.

If you’re struggling with body image issues related to breast cancer diagnosis and treatment, there are other programs that can help. Journaling is one. Support groups, both online and in person, also can be helpful. There are also psychologists and counselors who specialize in body image issues in people who’ve been diagnosed with cancer. You can ask your doctor or another member of your healthcare team for some recommendations.

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