The Benefits of Being Oncology Aesthetics Trained
The following is from a spa owner after some negative side effects resulting from a face/eyebrow waxing after cancer treatment. “I hope you can help me. One of my aestheticians recently did a facial/brow waxing for a client who had previously completed cancer treatment. The client was fully aware that there may be possible side effects, but wanted to proceed with the waxing anyway. During our follow-up call with her, she mentioned she stayed extremely red for the entire evening. Two days later, there were three little sores that had begun to dry up and scab.”
Unfortunately, these things happen when skin care professionals and the actual survivor are not well versed on the possible, negative side effects resulting from treatments after cancer treatment and even during the recovery process.
Once a person has undergone cancer treatment, their skin is usually never the same as it was prior to the treatment. Keep in mind that each person responds differently and many treatment protocols are different, depending on the type of cancer, the aggressiveness of the cancer, and other factors. This change is considered a 'new normal.' The skin has to be treated with extreme care and many spa treatments need to be handled very slowly. For example, at this point, waxing would be considered an aggressive spa treatment due to many unknowns.
When handling treatments for clients with a history of cancer, a general protocol and standard cannot be provided. However, there are some key questions to consider:

• What type of cancer has this client had?
• What treatment did this client have?
• When did they complete their cancer treatment?
• What medications are they taking, if any?
• What are the known side effects to the medications, if any?
• How was their skin affected from the treatment? (treatment specific)
• Have they had any waxing since completing their cancer treatment?
• If the client had not been waxed since completing the cancer treatment, was any consideration given to perform a patch test first?
• Has this client had an issue with facial hair prior to cancer treatment?
• Is it possible that the client is now on hormone therapy, which exacerbates excessive hair growth, even if just vellus hair?

My question to the skin care professional and spa owner:
What are the possible negative outcomes to having facial/eyebrow waxing with compromised skin, especially when there are no details on how to approach the situation? More importantly, the removal of hair from this client’s face and eyebrows are clearly important to her. There can be a negative psychological impact if a spa or professional refuses to provide the facial/eyebrow waxing. The client may simply go down the road and refuse to impart any information to professionals at another location, leaving them vulnerable to causing harm.

As a result, education for both the professional and survivor is absolutely necessary. This situation is a good example of why completed intake forms are necessary and, in this case, why a client needs to sign off on a treatment even if cautioned about possible repercussions.

Training in oncology aesthetics is available to spa therapists, globally, where they can learn about this disease, treatments, and side effects. The training ensures that safe adaptations, in regard to people undergoing cancer treatment and those recovering from cancer treatment, are taught. Consider sending at least one skin care professional to this form of training so that the spa can appeal to all cancer survivors and ensure safe treatments as best as possible.

Every professional in today’s world will encounter a client who has, who is, and who will be diagnosed with cancer in their lifetime. Every professional with oncology aesthetics knowledge can safely modify any spa treatment to ensure the client’s safety and improved quality of life, even if they do not feel comfortable working with a client undergoing treatment for their disease.

This industry is compelling and sometimes overwhelming, but at the end of the day it is about touching, nurturing, and perhaps finding meaning. Providing safe modifications can win professionals a client for life. This aspect of skin care is empowering and rewarding.

The Psychological Impact of Breast Cancer
A diagnosis of breast cancer has a very strong social and psychological impact on younger women versus mature women. Younger women are devastated, terrified, and lost. When compared to mature women, young women with breast cancer have numerous unique needs, given their stage in life, such as concerns with preserving fertility or having young children and families for which to care. Many younger women are establishing early relationships and working on emerging careers. Moreover, when friends and peers are healthy and active, the experience of diagnosis and treatment may feel particularly isolating.

In general, a person diagnosed with breast cancer will feel as if they are on an emotional roller coaster. Their feelings may fluctuate and they may feel scared, shocked, sad, angry, guilty, anxious, confused, overwhelmed, out of control, vulnerable, or in denial. They may find that their feelings will change each day and at different times. For many, a cancer diagnosis can shake their entire world, including their sense of self and belief system. They may find themselves reassessing their values and priorities in life. What seemed important before may not seem so important to them now. Do not be surprised if clients change their services with you – they will either place an emphasis on taking care of themselves, exercising, or something else instead of a spa treatment. Try not to be judgemental – communicate empathy and understanding without being sympathetic.

As a skin care professional, remind yourself that everybody has a different way of coping with cancer. There is no right or wrong way for a person to feel. While a client may be optimistic that their cancer will be effectively treated, there may be times when their outlook darkens. If you feel that the client needs some recommendations on how to handle the emotions they are experiencing, suggest journaling, walking, yoga, meditation, joining a support group, or making an appointment with an oncology psychologist.

Psychological distress among those with breast cancer is common and is linked to worse clinical outcomes. Symptoms of depression and anxiety affect up to 40 percent of breast cancer patients.1 Depression is associated with a higher relative risk of mortality in individuals with breast cancer.2 The risk of developing a depressive disorder is highest in the first year after receiving the breast cancer diagnosis.3

Health in The Mirror, an initiative at the San Raffaele Hospital in Milan, Italy, has a monthly gathering of cancer specialists, psychologists, aestheticians, makeup artists, fashion experts, and volunteers. The focus of this initiative is to make the patients feel more comfortable with themselves by helping them believe that they are still beautiful, even when going through cancer treatment. The goal is to make beauty therapy and aesthetics an intervention that is a part of the therapy for the patient.

This initiative is still in its early days and the initial results look very promising. To date, patients who have participated have shared their own feelings and sensations on how they view a hospital, how they feel pampered during the monthly visit, why they go out after the visit, the outfits they now wear, and why they thought they would never again wear those outfits as a cancer patient. Husbands also share that after these gatherings, their wives gush with joy and laughter, just as they would have prior to the diagnosis.

Levels of anxiety, depression, and quality of life are evaluated at the beginning of each session, at the end of each session, and three months later. The outcome to date shows a significant decrease in depression, an increase in quality of life, and a small decrease in levels of anxiety. This stable improvement confirms the importance of including psychosocial support interventions with conventional medical treatments. It represents an example of “humanization of medical care in the oncology field.”

Making a Difference
Be educated and well informed on this disease, know what safe adaptations can be made to any spa treatment, and be aware of the psychological impact on the client and the skin care professional. Be mindful, learning to be aware in the present moment with a non-judgemental attitude, and take a good look at the business, seeing how to ethically contribute to improving the quality of life of people in the local community, including those who are not currently clients.

References:
1. Von Ah D, Kang DH. Correlates of mood disturbance in women with breast cancer: patterns over time. J Adv Nurs. 2008;61(6):676-689.
2. Hjerl K, Andersen EW, Keiding N, et al. Depression as a prognostic factor for breast cancer mortality. Psychosomatics. 2003;44:24-30.
3. Fann JR, Thomas-Rich AM, Katon WJ, et al. Major depression after breast cancer: a review of epidemiology and treatment. Gen Hosp Psychiatry. 2008;30:112-126.