VANCOUVER - At her lowest low in the months spent recovering from having her breasts removed and reconstructed, Carol Thorbes says she felt she had nothing left to live for.
?I was on a lot of painkillers, antidepressants,? said the Vancouver woman. ?I had to see a psychologist because I was starting to get suicidal. It was really tough.?
Emotional distress, a sense of disconnection from one?s body, and a diminished sense of femininity are shared experiences amongst many breast-cancer patients who have undergone mastectomies. Studies show that, for women who have lost their breasts to cancer, reconstruction can improve their body image and their sense of well-being.
But it?s not a magic cure for everyone.
?It?s been very hard for me to deal with not having real breasts,? Thorbes said. ?I look down, it?s kind of like a stranger that I don?t really like that?s with me.?
Some women who get reconstruction are left with mixed feelings about the surgery. They say it leaves them feeling disconnected from their own bodies, with new breasts that look, feel and respond differently. They describe battles with depression, a loss of self-esteem, and a starkly diminished sex drive.
For these women, it?s another, unexpected challenge on their breast cancer journey.
CULTURAL FIXATION ON WOMEN'S BREASTS
Throughout history, the female figure has had an almost hypnotic effect over society, with womanly curves playing the role of muse to artists, said Queen?s University art history professor Stephanie Dickey.
While the evolutionary purpose of breasts has always been to provide important nourishment to infants, their erotic nature also blossomed early on in history, said Dickey.
In Greek mythology, the goddess of love, Aphrodite, was always depicted in the nude with her breasts exposed, she said.
Over time, the female body has been ?stretched and pushed and squeezed and contorted into all sorts of ideal shapes depending on what?s the fashion of the time,? said Dickey. Society?s obsession with beauty and bra size has seemingly never been more amplified than it is today.
The world watched in awe in the 1990s as Pamela Anderson?s breasts ballooned to almost cartoon-like proportions. In 2012, bigger seemingly continues to be better as the latest reality TV stars, especially of the Real Housewives variety, appear to be going for gold in the plastic surgery Olympics.
With popular culture seemingly fixated on women?s breasts, it?s no surprise then that losing them can have a devastating effect on a sense of self-worth.
DIFFICULT DIAGNOSIS TO ACCEPT
A cancer diagnosis alone can be terrifying, but finding out that the treatment will leave behind a disfiguring scar is, for many, a difficult thing to accept.
?Breasts are a presentation of our femininity. It?s a part of the face we present to the world,? said Anne Katz, Winnipeg-based nurse, sex counsellor and author of the self-help book Women Cancer Sex.
Katz helps both men and women deal with the side effects of cancer treatment that affect their sex lives. After being poked and prodded by doctors throughout cancer treatment, many women feel exposed, vulnerable, and often dissociate from their bodies, said Katz.
?I find that women who have been through breast cancer treatment, the world and its dog has been looking at her breasts,? she explained. ?In order to survive that exposure, she kind of disconnects from her body. But in order to be sexually healthy, you have to be really connected with your body.?
Even years after their treatment has ended, Katz said she has encountered women who tell how drugs, such as Tamoxifen ? taken to reduce the risk of recurrence ? cause a host of menopause-like symptoms, including a loss of sex drive.
?For women, body image is often the problem they present with,? she explained. ?They feel guilty and sometimes say silly things like, ?I told my husband to get someone on the side.? That is heartbreaking. They don?t want that.?
Part of the problem is that women are ?socially conditioned? to believe they need to look and feel sexy in order to be desirous of sex, said Katz. Libido is a ?very fragile phenomenon,? she added.
With breast cancer patients, Katz said she works ?on reconnecting women with their body as a source of pleasure instead of a source of pain.?
?The answer is not always Victoria?s Secret,? she said.
SIX-YEAR JOURNEY
The pain of cancer, both emotional and physical, is an experience with which Thorbes, 56, said she is all too familiar.
In September 2005, she was diagnosed with breast cancer, a year after her younger sister Dawn died from the same disease. The 49-year-old opted for the most radical treatment: a bilateral mastectomy.
?My attitude was very aggressive,? said Thorbes. ?I just said, ?Screw that, take it all off.??
The silver lining, she said, was the option of immediate breast reconstruction.
Since undergoing a mastectomy and breast reconstruction, she has had ongoing issues with pain, likely from nerve damage and scar tissue buildup, she said.
?After six years, it?s still there,? said Thorbes, who has managed to keep working as a communications officer for Simon Fraser University throughout her ordeal.
The sensation of her chest being stretched over implants is also bothersome, she said.
?The implants, because they?re under the pectoral muscles, it feels like a tight band around your chest all the time,? she explained. ?That whole area, if you were to take your finger and circle it around your breast at the base, it feels like there?s a suction cup stuck to your chest 24 hours a day on both breasts.?
The pain was the worst in the first few months after Thorbes had her expanders removed and replaced with saline implants, she said.
Thorbes, who was once a CBC News journalist, said she had once reported on the U.S. silicone implant scandal and wanted nothing to do with it. In 1992, the U.S. Food and Drug Administration put a moratorium on silicone implants due to safety concerns after thousands of women complained of illness related to burst or leaky implants.
However, saline implants are much heavier than silicone, and the weight was hard to ignore, said Thorbes. She eventually opted to have the implants replaced with silicone.
?I was living constantly on a pain scale of about seven or eight out of 10,? she said.
After getting the lighter implants, Thorbes said, the pain has improved somewhat, to what she describes as a Level 4.
Aside from physical pain, Thorbes deals with emotional turmoil relating to her breast reconstruction.
For most of her adult life, she said, she has dealt with body image issues. Part of it is the result of a difficult upbringing that involved some abuse, she said. ?
Being small breasted, Thorbes thought breast reconstruction would be the single positive aspect of her cancer diagnosis.
?It was like, rightly or wrongly, maybe gullible or too wishful of me, I thought, in a funny sort of way, breast cancer was going to give me a second lease on my body,? she explained.
AFFECTS CONFIDENCE, RELATIONSHIPS
From the beginning, Thorbes said she had little support going through treatment and reconstruction.
Her partner of eight years left when she told him she had breast cancer.
?It was too much for him to handle,? she said. ?He wasn?t even with me when I went for the surgery. He was gone by then.?
Since her reconstruction, Thorbes said she has dated other men and is now in a relationship.
But the foreign feeling of her new breasts has affected her self-confidence, which she said has in turn affected her relationships.
?With these silicone implants, you touch your breast and it?s like touching a dead body,? she said. ?It?s totally cold because there is no blood flowing through there.?
When she began her new relationship, Thorbes said she didn?t inform her partner that she has no sensation on her breasts, which she described as having a ?big zipper scar that runs straight across? her chest.
?It?s very difficult for men to deal with,? she said. ?They look at you, and it?s kind of Frankenstein-like.?
About a month after her mastectomy and reconstruction, Thorbes decided to also undergo a full hysterectomy to eliminate the risk of developing ovarian cancer, in case she did carry the BRCA-1 or BRCA-2 genes that increase the risk of both breast and ovarian cancer.
That surgery catapulted her into menopause, she said. Combined with the stress of the past six years?her sister?s death, the cancer diagnosis, physical pain after the reconstruction, and the impact on her relationships?Thorbes said she feels as if she has aged rapidly.
She tries to approach the situation with a sense of humour, describing how she has to regularly self-massage, or ?manhandle,? her new breasts to prevent build-up of scar tissue and to help improve blood flow.
But at times, she said the anguish is hard to bear despite being invisible to those around her.
?It?s weird having something that is totally consuming and affecting your life in terms of pain and mental health. When people look at you, they can?t see it,? she said. ?With my clothes on I look normal.?
Although she has mixed emotions about reconstruction, Thorbes said that if she had to do it again she would likely make the same decision.
As she has a propensity toward depression?, she said she feels she would be in a worse psychological state if she had woken up from her mastectomy surgery and looked down to see a scarred, empty chest wall.
?In the grand scheme of things, all I lost was my breasts,? she said. ?I get to go on with my life.?
thandi@thandifletcher.com
Twitter.com/ThandiFletcher
Source: http://feeds.canada.com/~r/canwest/F233/~3/KT5pslWumuY/story.html
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