I’m unable to recall the title of a 1930s movie in which a terminally ill young bride, with perhaps only a few months to live, put on such a brave face that her husband was unaware of the seriousness of her condition. While on their honeymoon, he remarked that their happiness suspended their lives in time, to which she somberly replied, “Yes, it’s like living on the edge of eternity.” his exchange reminded me of the many conversations I’ve had with women facing life-threatening cancer diagnoses. They’ve often expressed the feeling that their lives were in a suspended state of existence while going through cancer therapies. The bodies they had before cancer had been replaced by bodies that were easily fatigued
and sometimes nauseous from chemotherapy and radiation. And if that
wasn’t difficult enough, therapy side effects such as total body
hair loss left them with an expressionless, zombie-like appearance.
At some point during treatment, these patients took control of
their healing by participating in support groups and seeking out
solutions to improve their appearance.
Certified Mastectomy Fitters
Mastectomy fitters should be trained and certified by the Board
for Orthotist/Prosthetist Certification (BOC) so that they can
provide patients with experienced and specialized care, including
patient education. Important information for the patient includes
an explanation of why the proper fitting and wearing of a breast
prosthesis is not only important for aesthetic reasons, but also as
a therapeutic measure that replaces the weight of the removed
breast. Patients also need to understand that lymphedema resulting
from underarm lymph node removal can be an issue. A fitter can help
by providing approved literature and appropriate referral options
for this condition.
|Bebe Tamberg helps breast cancer survivor Virginia Tweedy decide on headcoverings to wear during cancer therapy.|
As a certified mastectomy fitter and image consultant at a
leading California cancer center, I help women experiencing
personal appearance side effects resulting from cancer therapies
such as chemotherapy, radiation, and surgery. My background as an
image consultant and former fashion show producer and model agency
owner was very beneficial when I started helping cancer patients.
My first experience with cancer patients was as a hospice volunteer
caring for the terminally ill. I began helping these patients with
makeup and hair care and noticed their positive reactions. Very
soon their caregivers, physicians, and hospice nurses started
responding to them with approving and supportive comments.
Looking One’s Best Aids Healing
Studies have proven that looking one’s best plays an important
role in the recovery process, because an individual’s body image is
what projects a patient’s emotional health to the world. Presenting
a positive outer image to others produces positive reactions. This
positive feedback will often encourage a person undergoing therapy
to continue daily routines at home, school, the workplace, and
social engage-ments. Many women need to continue working during
treatment, and it’s important for them to look as normal and
healthy as possible for many reasons-not the least of which
is job security. Family members (especially children), caregivers,
and friends also benefit from seeing their loved ones dealing with
their treatment in such an optimistic and hopeful way. It’s a
win-win for all!
Personal appearance services are offered at some cancer centers
and hospitals as part of their continuum of care. Because it is
often difficult to locate these specialized services and products
in the general retail world, I created the program at my cancer
center to fill this need. Once physicians and nurses became aware
of my onsite service, appearance consultation became a regular part
of the pre-treatment education for their patients. All
consultations are private and are offered free of charge.
In addition to post-mastectomy fittings, several other services
are available, such as hair loss alternatives that include wigs,
bangs, turbans and hats. Hair lost as a side effect of treatment
does not usually start to grow back until therapy is completed,
which may take three to six months. Skin care and makeup techniques
include showing the patient how to correct unwelcome changes in
skin appearance and how to camouflage eyebrow and eyelash hair loss
to avoid the zombie-like appearance mentioned earlier.
I created and continue to coordinate a breast health
presentation for service clubs and organizations interested in
educating members about the importance of early breast cancer
detection. Joining me in these presentations are an oncologist, a
nurse practitioner, and a breast cancer survivor. Our presentations
have often resulted in saved lives because of our emphasis on the
importance of proper breast self-examinations.
Health Insurance Coverage
It is very important to help patients with insurance coverage
issues before fitting appointments. In doing so, a fitter avoids
frustrating situations for the patient who cannot be fitted due to
lack of proper insurance documentation or because the fitter is not
an HMO-designated provider. It has been my experience that all
private health insurance providers, Medicare, Medicaid, and HMOs
are mandated by federal law to cover post-mastectomy breast
prostheses and bras. For private insurance, Medicare, and Medicaid,
an insurance card and prescription from a physician are necessary.
In the case of HMO insurance, a prescription authorization needs to
be requested by the primary physician.
Cranial Hair Prosthesis Insurance Coverage
Medicare, Medicaid and most HMO’s do not cover hairpieces,
turbans or hats. Private insurance policies often don’t specify
exclusion from coverage, so we recommend that patients read their
policies carefully. For hair prostheses, we suggest obtaining a
prescription from a physician stating: “Cranial hair prosthesis for
medical purposes. Alopecia secondary to chemotherapy or radiation
therapy.” It might be helpful to include a letter from the
physician with a photograph of the patient without hair to show
that the wig prosthesis is for medical, not cosmetic, needs. And
even if insurance coverage is denied, these items can probably be a
tax-deductible medical expense.
As healthcare professionals, we are in a unique position to
improve our patients’ quality of life and help in their recovery by
addressing the additional side effects resulting from cancer
therapies. Consider offering your patients another bridge back to
their healthy world.
Manufactures of Breast Forms and Prostheses
Surgical Appliance Industries, Inc./Airway
Bosom Buddy/B&B Company, Inc.
Carper City, FL
Little Rock, AR
Jodee Bra, Inc.
Ladies First, Inc./Softee Comfort Form
Otto Bock Health Care
Spenco Medical Corporation
“TLC” Tender Loving Care/American Cancer
Thaemert USA, Inc.
West Berlin, NJ 800.753.5883
This information is provided for the benefit of our readers. It
is not all-inclusive. If your manufacturing company has been
omitted, please contact us, and we will be happy to list your
company on our website.