While her friends were starting new jobs, dating and getting married, Steph Gilman underwent a double mastectomy, chemotherapy, radiation treatment, breast reconstruction and hormone therapy that she’ll continue to endure for the next decade.
While breast cancer and the treatments that go along with it take a toll on anyone, they have a particularly devastating effect on young women battling an illness typically associated with those over 50.
“I looked in the mirror and didn’t only not feel like a woman any more – I didn’t feel like a human,” she recalls. “It was like I was staring at an alien.
That’s not unusual for women diagnosed with the disease when they’re young Gilman was diagnosed when she was 28. Because breast cancer in young women tends to be more aggressive, it’s treated more aggressively, according to MJ DeCoteau, founder and executive director of Rethink Breast Cancer, a Canadian charity that’s rebranded pink ribbon awareness and advocacy for a new generation.
“I’ve met young women whose fingernails have turned black, they have mouth sores, their hair is gone, they’ve had a breast or both breasts removed and they’re gaining weight from the hormones. Obviously, they’re facing a life-threatening illness, but one of the hardest things is the effect on their body image.”
“I was bald and lost my breasts, so it’s impossible not to be drastically affected by that,” says Gilman, who now also works with Rethink and runs a blog about her recovery. “There were times when it wasn’t so hard and times when it was awful – particularly by the end of chemo, when I’d lost every trace of body hair and felt bloated and gross and my breasts weren’t fully reconstructed yet.”
New York-based fashion photographer David Jay has witnessed – and photographed – such transformations for his ongoing portrait series The Scar Project. The collection of raw, topless pictures features young breast cancer survivors after they’ve undergone mastectomies. Jay began the world-famous project over 10 years ago when one of his good friends was diagnosed with breast cancer in her late 20s. He’s since photographed over 100 subjects.
“The shoots can be very emotionally challenging for everyone involved. The women are in the worst physical and emotional state they’ve ever been in. There’s a lot of insecurity and fear,” says Jay.
The series’ tagline is Not Another Pink Ribbon – for a reason.
“A lot of women feel the pink ribbon campaign diminishes the reality of cancer and turns it into a walk, pink Kentucky Fried Chicken baskets and pink teddy bears rather than looking at the real thing. I never wanted the pictures to be pretty I just wanted them to be raw and honest.”
Young women often feel lost and alone when it comes to addressing the appearance-related effects of cancer. But they don’t have to. Toronto is a hotbed of organizations and services dedicated to addressing the illness from a beauty standpoint.
“I was 26 when I was diagnosed, and I felt really singled out,” says make-up artist and cancer survivor Agnes Fallen.” That changed when she discovered Look Good Feel Better, a Canadian non-medical, brand-neutral charity that teaches women how to cope with the appearance-related effects of cancer. “There were other young women there, and I felt really strengthened by the fact that I wasn’t alone.”
Look Good Feel Better workshops take place across the country and are broken down into two parts: how to do your makeup, and how to do your hair.
Even Fallen, an experienced makeup artist was surprised by some of the tips.
“I asked if I could wear false eyelashes to a wedding, but they said, ‘No. Your eyelashes are already so brittle and weak that sticking anything to them can actually make things worse,’” she remembers. “You also have to keep everything very clean, so they recommend Q-tips and disposable stuff instead of brushes, so you don’t contaminate anything. It’s important because your immune system is totally stripped.”
Look Good Feel Better also teaches women how to mimic lost eyelashes using eyeliner, how to even out skin tone with concealer and foundation, how to choose moisturizing lipstick to comfort dry lips, the importance of sun protection and how to pamper and protect brittle nails.
From a beauty perspective, one of the most serious challenges women face during treatment is excessively dry, cracking skin. Often, normal moisturizers just won’t cut it. Bill Baker, CEO of local all-natural skin care brand Consonant (2479 Yonge, 416-925-2855) recalls that several years ago a woman undergoing chemotherapy asked if the company could develop a new hydrating product.
“She was a little desperate because she was in so much discomfort,” says Baker. “I think she thought we were going to come back with something that was loaded with butters and cream, but we did just the opposite.”
HydrExtreme, now one of the brand’s most popular products, is a lightweight serum that contains two simple ingredients: Cassia Angustifolia Seed Extract (a natural alternative to hyaluronic acid) and vegetable glycerin. Any beauty geek will want to use this for daily hydration, soothing post-waxing irritation and diminishing eczema.
The best part? It’s completely toxin-free. “I was shocked to learn that some oncology departments recommend products made with synthetic chemicals, including parabens.” Baker tells me. “These women are at their most vulnerable. They may have skin irritations, which act as a gateway for chemicals into your bloodstream.”
Yorkville salon Winks Eyelash Boutique (70 Yorkville, 417-777-9465) often sees customers looking for eyelash or brow extensions post-hair-loss. Explains owner Urla Duncan. “They usually ask for the natural set – nothing flamboyant. They want to look like they did before.”
Winks is hopeful their newest service – semi-permanent eyebrow sculpting gel – will fill a void for cancer patients. It’s a textured gel that’s painted onto the skin and lasts longer than extensions.
Continental Hair operates on Yorkville (92 Avenue Rd, 416-923-7747) and inside Sunnybrook Hospital (2075 Bayview, 416-480-5175). Both have become must-visit destinations for cancer patients, as many as 1,000 a year at Sunnybrook alone.
“Chemotherapy hair loss can be particularly traumatizing,” says Continental president Michael Suba. “Not only are you dealing with the cancer itself, but you’re also dealing with identity and privacy.”
The salon stocks a wide variety of wigs at different price points and materials. They offer synthetic hair, processed human hair, virgin human hair, handmade wigs and machine-made wigs. Prices can range from hundreds of dollars to over $5,000.
“Of course, human hair is much more comfortable and natural than the synthetic, but not everyone can afford it, so we try to make sure we have a good range of everything in stock,” explains Suba. “It’s important to have a good amount of inventory because you don’t have a lot of time to have anything made, which can take two to three months.”
He recommends patients come into the salon before they start losing their hair so stylists can see how they wear it normally and like it styled. Sometimes insurance will cover the cost of a wig, or at the least it can be written off as a medical expense come tax season.
“A lot of women continue to work and socialize through treatment,” he says. “They don’t have to be fearful of having something that doesn’t look right there are a lot of options and they can maintain their privacy.”
Mastectomies are one of the most obvious appearance-affecting parts of breast cancer treatment, followed by breast reconstruction, which is not as simple as inserting an implant. There can be complications and long-term psychological effects.
“My breasts, even though I have implants, are not at all perfect,” says Gilman. “I don’t love the way the implants look or the way clothes fit on me, and it’s a reminder every single day that I don’t have breasts.”
Sean Rice of Rice Cosmetic Surgery (1333 Sheppard East, 416-391-4048) has 15 years’ experience with reconstruction. He says most women want to return to the breasts they had pre-mastectomy, but that’s not always possible.
“You can recreate a breast that’s firm and perky, but it’s very hard to recreate a pendulous breast,” he explains. “So let’s say you had a DD cup on one side that was pendulous. When you recreate the new breast, it’s uneven, so now you have to do something with the pendulous side.”
Another issue for many women is the radiation tattoos they receive during treatment. These are permanent small blue or black marks that help doctors target radiation treatments so they hit exactly the right spot each time.
“People used to ask if I could cut them out,” says Rice, “but then we became the first plastic surgery clinic in Canada to get PicoSure the latest technology for tattoo removal – and I realized we could do this in seconds.”
Rice now offers the removal procedure to breast cancer survivors free of charge every October in honour of Breast Cancer Awareness Month. Last year his team treated over 150 patients. PicoSure takes only one or two minutes and is practically painless. The only requirement is that you’re cleared by your oncologist before treatment.
While local options for women to address the appearance-related effects of breast cancer are certainly on the rise, there’s still a lot left to be desired. For one thing, wait times for breast reconstruction can far exceed the government’s own acceptable time frames in Ontario.
“Research shows that breast reconstruction can reduce the long-term impact of losing your breasts in a mastectomy,” says Rethink’s DeCoteau. “In Ontario, the government has set a benchmark for reconstruction surgery of 26 weeks, but the wait times are substantially longer… one year, sometimes up to two years. Reconstruction has to be part of the treatment plan. We’re going to push the government to increase surgical resources.”
sabrinam@nowtoronto.com | @sabrinamaddeaux
