Online Exclusive Article
Open Access Article

Body Image Dissatisfaction in Cancer Survivors

Jessica T. DeFrank

C. Christina Bahn Mehta

Kevin D. Stein

Frank Baker

psychosocial care, perceptions
ONF 2007, 34(3), 625-E41. DOI: 10.1188/07.ONF.E36-E41

Purpose/Objectives: To explore medical and psychosocial factors associated with body image dissatisfaction in male and female cancer survivors.

Design: Secondary data analysis from the American Cancer Society's Study of Cancer Survivors-II pilot survey.

Setting: Cancer survivors were identified through two state cancer registry databases.

Sample: 165 male and 234 female cancer survivors of six cancer types (bladder, female breast, colorectal, endometrial, prostate, and melanoma) who were 2, 5, and 10 years beyond diagnosis.

Methods: Researchers notified physicians prior to participant recruitment. State cancer registries contacted potential participants via mailed letters. Participants who gave their informed consent completed a written survey.

Main Research Variables: Current body image dissatisfaction, mental and physical health, sexual functioning, and basic medical and demographic information.

Findings: Results of multiple regression analysis indicated that male survivors of prostate cancer were more likely to express positive body images than men who had other types of cancer. A composite variable that included a history of cancer recurrence, multiple cancers, or metastatic cancer was the strongest predictor of body image dissatisfaction for female survivors. Body image was not associated with age, length of time since diagnosis, or general treatment type for either gender.

Conclusions: Body image was associated with various medical and psychosocial factors, and the factors differed for male and female cancer survivors.

Implications for Nursing: An understanding of factors associated with body image is essential for the nursing care of patients with cancer.

Jump to a section


    American Cancer Society. (2007). Cancer facts and figures 2007. Atlanta, GA: Author.
    Anllo, L.M. (2000). Sexual life after breast cancer. Journal of Sex and Marital Therapy, 26, 241-248.
    Bertero, C. (2001). Altered sexual patterns after treatment for prostate cancer. Cancer Practice, 9, 245-251.
    Brown, T.A., Cash, T.F., & Mikulka, P.J. (1990). Attitudinal body-image assessment: Factor analysis of the body-self relations questionnaire. Journal of Personality Assessment, 55, 135-144.
    Carelle, N., Piotto, E., Bellanger, A., Germanaud, J., Thuillier, A., & Khayat, D. (2002). Changing patient perceptions of the side effects of cancer chemotherapy. Cancer, 95, 155-163.
    Cash, T.F. (2000). The multidimensional body-self relations questionnaire (3rd ed.). Norfolk, VA: Old Dominion University.
    Coates, A., Abraham, S., Kaye, S.B., Sowerbutts, T., Frewin, C., Fox, R.M., et al. (1983). On the receiving end—Patient perception of the side-effects of cancer chemotherapy. European Journal of Clinical Oncology, 19, 203-208.
    Cohen, M.Z., Kahn, D.L., & Steeves, R.H. (1998). Beyond body image: The experience of breast cancer. Oncology Nursing Forum, 25, 835-841.
    Ekwall, E., Ternestedt, B.M., & Sorbe, B. (2003). Important aspects of health care for women with gynecologic cancer. Oncology Nursing Forum, 30, 313-319.
    Fobair, P., Stewart, S.L., Chang, S., D'Onofrio, C., Banks, P.J., & Bloom, J.R. (2006). Body image and sexual problems in young women with breast cancer. Psycho-Oncology, 15, 579-594.
    Fobair, P.A., Hoppe, R.T., Cox, R.S., Varghese, A., & Spiegel, D. (1986). Psychosocial problems among survivors of Hodgkin's disease. Journal of Clinical Oncology, 4, 805-814.
    Ganz, P.A., Coscarelli, A., Fred, C., Kahn, B., Polinsky, M.L., & Petersen, L. (1996). Breast cancer survivors: Psychosocial concerns and quality of life. Breast Cancer Research and Treatment, 38, 183-199.
    Ganz, P.A., Desmond, K.A., Leedham, B., Rowland, J.H., Meyerwitz, B.E., & Beli, T.R. (2002). Quality of life in long-term, disease-free survivors of breast cancer: A follow-up study. Journal of the National Cancer Institute, 94, 39-49.
    Ganz, P.A., Rowland, J.H., Desmond, K.A., Meyerowitz, B.E., & Wyatt, G.E. (1998). Life after breast cancer: Understanding women's health-related quality of life and sexual functioning. Journal of Clinical Oncology, 16, 501-514.
    Ganz, P.A., Schag, A.C., Lee, J.J., Polinsky, M.L., & Tan, S.J. (1992). Breast conservation versus mastectomy. Is there a difference in psychological adjustment or quality of life in the year after surgery? Cancer, 69, 1729-1738.
    Hartl, K., Janni, W., Kastner, R., Sommer, H., Strobl, B., Rack, B., et al. (2003). Impact of medical and demographic factor on long-term quality of life and body image of breast cancer patients. Annals of Oncology, 14, 1064-1071.
    Nolte, S., Donnelly, J., Kelly, S., Conley, P., & Cobb, R. (2006). A randomized clinical trial of a videotape intervention for women with chemotherapy-induced alopecia: A Gynecologic Oncology Group study. Oncology Nursing Forum, 33, 305-311.
    Pelusi, J. (2006). Sexuality and body image. Research on breast cancer survivors documents altered body image and sexuality. American Journal of Nursing, 106(3, Suppl.), 32-38.
    Penson, D.F., Feng, Z., Kuniyuki, A., McClerran, D., Albertson, P.C., Deapen, D., et al. (2003). General quality of life 2 years following treatment for prostate cancer: What influences outcomes? Results from the prostate cancer outcomes study. Journal of Clinical Oncology, 21, 1147-1154.
    Polivy, J. (1977). Psychological effects of mastectomy on a woman's feminine self-concept. Journal of Nervous and Mental Disease, 164, 77-87.
    Rosner, B. (1995). Fundamentals of biostatistics (4th ed.). Belmont, CA: Harvard University, Duxbery Press.
    Rowland, J.H., Desmond, K.A., Meyerowitz, B.E., Belin, T., Wyatt, G.E., & Ganz, P.A. (2000). Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. Journal of the National Cancer Institute, 92, 1422-1429.
    Schag, C.A.C., Ganz, P.A., Wing, D.S., Sim, M.S., & Lee, J.J. (1994). Quality of life in adult survivors or lung, colon and prostate cancer. Quality of Life Research, 3, 127-141.
    Soothill, K., Morris, S.M., Harman, J., Francis, B., Thomas, C., & McIllmurray, M.B. (2001). The significant unmet needs of cancer patients: Probing psychosocial concerns. Supportive Care in Cancer, 9, 597-605.
    Stein, K., Smith, T., Kim, Y., Mehta, C.C., Stafford, J., & Spillers, R.L. (2006). The American Cancer Society's studies of cancer survivors: The largest, most diverse investigation of long-term cancer survivors so far. American Journal of Nursing, 106, 83-85.
    Stewart, A.L., & Ware, J.E. (1992). Measuring functioning and well-being: The Medical Outcomes Study approach. Durham, NC: Duke University Press.
    Thors, C.L., Broeckel, J.A., & Jacobsen, P.B. (2001). Sexual functioning in breast cancer survivors. Cancer Control, 8, 442-448.
    van Tulder, M.W., Aaronson, N.K., & Bruning, P.F. (1994). The quality of life of long-term survivors of Hodgkin's disease. Annals of Oncology, 5, 153-158.
    Ware, J.E., Jr., Snow, K.K., Kosinski, M., & Gandek, B. (1993). SF-36 health survey manual and interpretation guide. Boston, MA: Health Institute Medical Center.
    Wellisch, D.K., DiMatteo, M.R., Silverstein, M., Landsverk, J.A., Hoffman, R., Waisman, J., et al. (1989). Psychosocial outcomes of breast cancer therapies: Lumpectomy versus mastectomy. Psychosomatics, 30, 365-373.
    Wilmoth, M.C. (2001). The aftermath of breast cancer: An altered sexual self. Cancer Nursing, 24, 278-286.