Barely there…

Tracey Derrick - breast cancer - self portraiture: hair - Advocates For Breast Cancer in South Africa

After chemo, Tracey wrote in her seminar paper about her hair:

“Then the hair dies. Initially, it feels as if one’s scalp is burning as the roots die, then the hair falls out. The first handful is an alarming relief; it is happening as you have been dreading that it would. The boundaries between public and private begin to melt, for all to see. My hair had been a physical, public security – it identified me and I felt naked without it. Then one experiences the head sweating constantly with no layer of hair to absorb it; the body chills quickly with no hair to warm it. As the hair on the rest of the body slowly falls too, all borders between inside and outside are laid bare.

Stacey describes it well, “the loss of pubic hair reveals what has remained hidden for years. Returned to pre-adolescence and yet prefiguring an aged body, time has nothing to tell. The nose runs without any tiny nostril hairs, sweat runs into eyes without eyebrows or eyelashes to catch it. Ears are tunnels for flies and insects to enter at their ease. The hairless body is uncannily silky smooth to touch, a familiar, yet strange state. A return to childhood and yet an inevitable ageing. A big bald baby but with adult organs”. (1997:84).

Physically and emotionally this “was me” but when I looked at myself in the mirror – was it me? I photographed myself repeatedly during this vulnerable time as an attempt to regain some power over my situation.”


TAKEAWAY: How & Why Hair Loss Happens Because of Chemotherapy

To Reconstruct or Not?

If the first stage of a mastectomy (or indeed a lumpectomy in many cases), is to surgically dismantle the breast then it follows that the second stage is to reconstruct it again. Or is it?

The decision to reconstruct is a complex and deeply individual one with many factors to consider.

There are various options available for breast reconstructive surgery, some of which start during mastectomy and can include additional procedures post mastectomy.

Viability for surgery most often depends on a patient’s type of cancer and treatment plan or even the side effects of a patient’s treatment. But it also depends on her circumstances. A women’s entire breast reconstruction surgery is not always covered by medical aids in South Africa and can be an expensive and lengthy process.

Some women don’t feel they can face more surgery.

Some feel guilty for putting their families and possibly employers through another period of lessened productivity and recuperation.

Others are sure that reconstruction is the clear path for them, and involve a plastic surgeon from the first talk of surgery.

Still others hold off on deciding for a while, seeing instead how they, and their bodies, adjust to life without breasts before deciding whether to get new ones.


Sure or unsure, many women are surprised to find appointments with plastic surgeons and discussions around reconstruction to be intimate and discomforting. Some say they were able to talk about their breasts quite objectively while undergoing treatment, but discussing the size and shape of their new nipples with a surgeon feels much more personal.

Many are stumped by the question: ‘How would you like your new breasts to look?’

‘Like they did before,’ is generally the most common answer.

And possibly this is the biggest factor to consider. Are we doing it because we want to reconstruct the ‘Before’? Will straightening the furniture and re-hanging the drapes help us forget an earthquake passed through?

Will new breasts help us heal?

Recommended reading:

Have you had reconstruction? Decided against it? We’d love to hear your views.

Later this month we will tell the story of someone who chose reconstruction. Would you like us to tell the story of your choice? Send an email to

Sex, Sexuality and Breast Cancer

This image is from a Breast Cancer Foundation awareness campaign We all know that sexuality is a feeling, and sex is a physical act. The relationship between the two is complex, multi-dimensional, unique and intensely individual.

And delicate.

A vast range of different life events can impact on one or the other: having a baby, physical trauma, depression, weight gain or loss, stress and most significantly here: medical treatment. Breast cancer can affect ones sex life in so many ways.

There’s the initial stress and shock of diagnosis, launching an adrenalin-fuelled mode of coping and comprehending which can place sex on the backburner – filed away with ‘dancing’, ‘laughing’ and ‘feeling good’, things one imagines one will get back to one day, after cancer. Then there’s chemotherapy and the chance of early menopause, loss of libido, vaginal dryness, discomfort and just being too tired and ill to contemplate sex.

Hormonal changes can be an added factor in reducing sexual drive and needs to be discussed with your oncology team as there are many ways of addressing this issue;  don’t keep quiet reach out and ask for help !

And then there’s surgery. Mastectomy, lumpectomy and possibly the slow process of reconstruction, all of which taking place in an area of a woman’s body inherently associated with sex.

It’s a whole bunch of hard knocks for something as ethereal and complex as our sexuality to endure. Every person is different, every couple too. Some breast cancer patients say they had sex regularly immediately post-diagnosis – that it became a reassurance, a stress inhibitor or a way of bonding with their partner through this devastating time. Others say they didn’t have sex once through diagnosis and treatment, and only slowly started reawakening their sex lives well after remission.

But a complaint that many breast cancer patients share, and this is a group comprising largely of women, is the difficulty in discussing sex with their doctors. Female sexuality can be undervalued, there’s a notion that women won’t ‘miss sex’ as much as men and so the topic is often avoided by oncologists altogether.

There may be some discussion about freezing ones eggs and the chances of conception post-cancer, but while there are a plethora of pamphlets in the waiting room on dealing with hair loss, and a vast amount of available information on breast reconstruction or prosthesis, there’s often very little comfortable space to talk about sex. And talk we must. With our doctors, our partners, our changed selves. Talk to your body in the mirror, find ways to communicate your concerns and desires with your partner, and talk to your medical team.

Reach out for help as soon as possible you don’t have to journey alone.

Click here 

and here

for recommended reading