Cancer and changes in facial appearance: A meta‐ethnography of qualitative studies

Abstract

Introduction. Living with an altered facial appearance as a result of treatment for cancer requires considerable psychological adjustment. As such it is essential that health care professionals understand the lived experience of people affected. This systematic review provides a meta-ethnography of studies that have explored the experience of changed facial appearance as a result of cancer. Methods.A search of four databases (Web of Science, CINAHL, PsycInfo, and Scopus) took place using terms relating to qualitative research, cancer, and changed facial appearance. Thirteen studies were identified, appraised, and included in the synthesis. The findings and interpretations within the studies were subject to meta-ethnography procedures so as to elicit novel cross-cutting themes.Findings. The experience of changed facial appearance after cancer was clustered into three contexts. In the context of the disease, subthemes were the primacy of survival, the changing relationship with the disease, and the impact of the care team on the experience of changed appearance. In the context of the social world, subthemes were positive reactions, negative reactions, and coping strategies. In the context of the self, subthemes were the self under attack, self-to-self relating, the self in the world, and rebuilding the self.Conclusions. The findings indicate that health care professionals must conduct holistic assessments, so as to fully recognize and where necessary address the impact upon self. The meta-ethnography shows that the experience of facial appearance change following cancer is complex and requires awareness of a number of theoretical areas including identity construction, social support, stigmatization, and the specific literature on visible difference. Statement of contributionWhat is already known on this subject?Changed facial appearance after cancer can cause significant social difficulties and impact on the sense of self.

Management of nasal vestibule carcinomas: recommendations by the Oncological Committee of the Italian Society of Otorhinolaryngology – Head and Neck Surgery

“…Significant nasal deformities can greatly affect first impressions and social interactions 19,20 . Research has demonstrated the influence of nasal appearance on selfidentity and mental health, underlining the critical need to ensure acceptable cosmetic outcomes 19,[20][21][22] . Radiation and surgery currently represent the two primary treatment options for NV carcinomas 8,9,11,13,[23][24][25] .…”

Towards a better understanding of the social stigma of facial difference

“…Link and colleagues (Link et al, 1989; see also Link & Phelan, 2013) identified three main coping orientations to face public stigma: secrecy, withdrawal, and education. Although FD is undoubtedly visible, many people with FD engage in measures to conceal their FD (e.g., cosmetic cream, prosthesis, surgery), often to ease outings in public places (Keys et al, 2021;Thompson et al, 2020) and in social interactions (Bemmels et al, 2013;Myhre et al, 2021). Their stigma is thus partially concealed, because it may not be readily apparent to others.…”

“…In addition to concealment, people with FD may also adopt avoidant behaviors and social withdrawal, in order to prevent stigma. However, this reduces opportunities to socialize and access social support (Griffiths et al, 2012;Halioua et al, 2017;Lanigan & Cotterill, 1989;Magin et al, 2008;Thompson et al, 2020).…”

Manufacture of Silicone Nasal Prostheses With Digital Tools and 3d-Printed Molds

“…In addition to the aggravating factor of skin cancer, these data also include the 6th position in the world ranking occupied by head and neck cancer, a modality also strongly associated with facial mutilations, resulting from the low socioeconomic conditions of the patients. These anomalies can be embarrassing for the bearer and often make these individuals traumatized, embarrassed and psychologically debilitated [2][3][4][5][6][7][8][9][10].…”