Les changements dans l’apparence
Authors:
Dr. Christine Maheu, RN, PhD ,
Ms. Rosemary Cashman ,
Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital ,
Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C, BC CancerDr. Christine Maheu, RN, PhD
Dr. Christine Maheu is an Associate Professor in the Ingram School of Nursing, Faculty of Medicine, McGill University. Dr. Maheu is also an Affiliate Scientist at the University Health Network and the University of Toronto. At McGill University, she teaches research methods, supervises graduate students (masters, doctoral, post-doctoral), mentors practicing nurses and students in research, and conducts research in English and French. She has held research awards with the Canadian Institutes of Health Research, the Canadian Cancer Society, and the Canadian Partnership Against Cancer. These awards funded her research in psychosocial oncology, which focuses on developing and testing psychosocial interventions or measurements tools for various cancer populations. Additionally, in partnership with Ipsos Canada and funded by the Canadian Partnership Against Cancer, she is co-leading a nationwide survey of the needs of cancer patients for transition care from the end of their treatment to three years after their diagnosis. Dr. Maheu received awards for excellence in nursing research (2013, 2015, 2016) from Ovarian Cancer Canada, the Canadian Association of Nurses in Oncology, and the Quebec Association of Nurses in Oncology.
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Ms. Rosemary Cashman
Ms. Rosemary Cashman is a nurse practitioner at the BC Cancer Agency and an Adjunct Professor in the Faculty of Nursing at the University of British Columbia. Her professional experience includes the care of lymphoma, lung cancer and brain cancer patients. She co-chairs the Patient and Family Advisory Council, which guides the brain tumour care program at the BC Cancer Agency. She has authored book chapters and articles related to the care of brain tumour patients and their families. Ms. Cashman was involved in developing and implementing a rapid-access radiotherapy clinic for the palliative treatment of lung cancer and she continues to work in this clinic.
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Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital
Ms. Kyla Johnson, M.Sc.A., originally from Edmonton, Alberta, Kyla Johnson works as an Occupational Therapist at the Segal Cancer Center of the Jewish General Hospital. She holds a Master of Science in Occupational Therapy from McGill University. Her goal as a rehabilitation professional in Oncology is to enable people with cancer to be able to do what they want and need to do, in all stages of their cancer experience. Kyla helps develop strategies and accommodations to facilitate a return to meaningful life roles, including work. She is specialized in cancer-related cognitive dysfunction and runs a weekly group teaching strategies to improve daily cognitive functioning. Kyla also leads a volunteer yoga class for young adults with cancer. She lives in Montreal, Quebec.
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Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C, BC Cancer
Ms. Maureen Parkinson is the province-wide vocational rehabilitation counsellor at the BC Cancer Agency. She has also been vocational rehabilitation counsellor at a public rehabilitation hospital and vocational rehabilitation consultant to insurance companies and the court system. She has instructed and facilitated Service-Canada-funded programs on job searching and career exploration. Ms. Parkinson has a Masters in Counselling Psychology, is a Canadian Certified Rehabilitation Counsellor, and completed the Certified Return to Work Coordinator Program through the National Institute for Disability Management and Research. She has developed return-to-work and job-search seminars for cancer patients and created the guidebook “Cancer and Returning to Work: A Practical Guide for Cancer Patients” as well as on-line articles about returning to work and school. She also co-authored a paper commissioned by the Canadian Association of Psychosocial Oncology, “Cancer and Work: A Canadian Perspective”.
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Il arrive que le cancer et les traitements associés provoquent des changements dans l’apparence, pouvant entraîner une détresse psychologique variant selon la personne affectée et l’âge, la personnalité, le sexe et la culture. Certains patients s’inquièteront davantage de leur apparence, tandis que d’autres seront également perturbés par les modifications de leurs fonctions corporelles.
L’un des changements concerne la chute de cheveux à la suite de la chimiothérapie ou de la radiothérapie. Le risque dans ce domaine dépend du type de chimiothérapie, de la dose et de la région visée par le rayonnement. En général, la chute est temporaire. Mais il arrive toutefois qu’elle soit permanente, comme en cas de rayonnement direct sur la tête.
Les personnes qui n’aimaient déjà pas leur image corporelle avant le diagnostic auront encore plus de mal à accepter les changements dans leur apparence. La réaction du conjoint ou des autres peut également modifier la manière dont la personne s’adapte à ces modifications. Pour certains, les changements physiques ne font qu’aggraver leur détresse psychologique en leur rappelant sans cesse qu’ils souffrent d’un cancer. Certains changements ne durent que peu de temps, tandis que d’autres sont permanents.
Voici les changements d’apparence possibles :
- Des cicatrices après la chirurgie
- La chute de cheveux à la suite de la chimiothérapie ou de la radiothérapie
- La modification de parties du corps suite à une chirurgie
- La prise ou la perte de poids
- Les signes cutanés comme les rougeurs, les démangeaisons, l’augmentation de la sensibilité ou des douleurs au site du traitement
- La perte de masse musculaire ou la faiblesse musculaire
- L’augmentation du volume des seins chez les hommes (gynécomastie)
- Le lymphœdème
- Des modifications dans le fonctionnement sexuel
Conséquences sur le travail
La vision qu’a l’employé des modifications qui touchent son apparence peut déterminer sa relation aux autres. Elles seront plus visibles avec certains types de cancer, comme ceux de la tête et du cou. Le traitement contre le cancer du sein peut nécessiter une ablation. Quelles soient visibles ou non, les modifications du corps sont susceptibles de toucher les employés tant physiquement que psychologiquement. Par conséquent, ils en ressentiront les effets sur leur confiance en eux en présence de collègues ou de membres du public.
Étape suivante :
L’adaptation du lieu de travail en fonction des changements dans l’apparence