A Whole Look

In the realm of specialty shops, perhaps no stores are as little known, yet as necessary, as those selling clothing and accessories to cancer patients.

Here, people dealing with the disease can find fashions, cosmetics and prostheses to help them cope with hair loss from chemotherapy, soothe skin irritation caused by radiation or compensate for body changes after mastectomy or other surgeries.

These shops--the newest and most sophisticated of which, Reflections, opens this month at UCLA--are places you aren’t likely to hear about until you need them. This year alone, the American Cancer Society estimates, 33,950 people in Los Angeles County will find out they have cancer; many will want to look and feel whole again after appearance-altering treatment.

In interviews, patients--who asked for anonymity--spoke of addressing their appearance as a life-affirming step.

“First you have to freak out about the cancer,” says one woman about to undergo a mastectomy. “Then you have to freak out about the way you look and how people look at you. You need to rally your positive feelings. You need to feel and look as good as possible because it empowers you. Otherwise, you’d have to hide. This is the solution part. It shows that people live on after diagnosis.”

“I couldn’t face the world without some of these things,” says another patient, who found comfort in makeup and wigs. “I would have given up. . . . You need to make yourself look good so you don’t look in the mirror and see sick. You see yourself.”

“There’s no question that, if appearance is important to you and you are able to improve your appearance, your quality of life is better,” says Dr. Fawzy I. Fawzy, a professor of psychiatry at UCLA who, together with his wife, Nancy Fawzy, director of psychosocial programs at Joyce Eisenberg Keefer Breast Center at St. John’s Health Center, Santa Monica, has done research on the positive role support groups play in helping cancer patients.

Cancer or no cancer, everyone wants to look good, says Elaine Harrison, coordinator of the Positive Appearance Center at St. John’s. “After you’ve combed your hair, put on your makeup, you feel better. So what if a woman combed her hair on a mannequin’s head first? If a cancer patient sees a positive image in the mirror, it helps her heal.”

Reflections has its grand opening Sept. 25, but the shop is already in business. Part of UCLA’s Rhonda Fleming Mann Resource Center for Women With Cancer, it offers counseling and psychosocial services to cancer patients from UCLA and other hospitals.

Reflections was stocked and organized by Linda Secher, the consultant who helped set up appearance centers at St. John’s and at Baylor Medical Center in Dallas, and is run by cancer survivor Fran McFall, who can speak the patient’s language because she’s been there--she knows firsthand, for example, the psychological plus from having a chemotherapy patient shave her head before her hair falls out.

“They get their appearance needs met, but it’s not just putting a hat on your head or a prosthesis in your bra,” says Dr. Anne Coscarelli, a psychologist and director of the Resource Center. “The body, the mind and the soul have all been injured in this process. One of the important things for us to do is to say, ‘You’re not alone.’ ”

The shop was inspired by loss, as was the resource center itself. “I was angry with what we didn’t have,” says Rhonda Fleming Mann, the actress-philanthropist whose sister, Beverly, died after a long battle with ovarian cancer in the 1980s--before there were any psychosocial and appearance centers. “That drove me. Others do not have to experience what my sister went through.”

With its soft green carpet, mirrors and warm woods, the on-campus shop looks much like any light and airy clothing boutique. While most of the products are for women--men’s baldness is more acceptable, even fashionable--there are hats and canes for men and books for children and adults. The inventory includes wigs, scarves, hats, state-of-the-art breast prostheses, camisoles, lingerie and specialty items such as nonmetallic deodorant for radiation patients.

There are the $10 berets and other moderately priced head coverings found at other shops, but also contemporary scarves in fashionable colors. And there’s a $100 straw hat by Kaminski. (Hillary Rodham Clinton was recently seen wearing a Kaminski on a family sail at Hyannisport). Also in stock are Mambosok skateboarder hats, popular both for their high fashion and high comfort.

In patient shops, scarves must be rayon or cotton, not silk--because pure silk slips off the head too easily--and they must be long enough to wrap and tie. Hats must be soft enough not to rub sensitive skin and must have deep crowns and wide brims that cover the scalp. There are mother-daughter matching hats--to “normalize the experience,” says Coscarelli, when either mother or child is undergoing treatment.

“A lot of our products are made by women who have had experiences with cancer,” says Secher, who buys from seasonal fashion markets and specialty lines. She makes sure patients are given cotton caps to protect their scalps beneath wigs and either instructs them on clever ways to tie scarves or has them watch a video that walks them step-by-step through artful scarf tying.

Merchandise aside, there are noticeable differences between patient shops and an average clothing boutique. There’s an emphasis on privacy, with large, comfortable dressing rooms. Staffs are highly trained--they know medical jargon and they have nurturing and comforting skills.

“Most doctors don’t tell [patients] about the cosmetic effects,” says St. John’s Harrison. She says each week she might see five to 10 patients who have recently been found to have the disease, many of them in tears. “We prepare them. We show them they can do this with dignity.” The center carries sun-protective clothing for melanoma patients, lymphedema compression garments, hats and wigs, skin care products and breast forms.

Range of services also separates these shops from the greater world of retail. Sales staffs are schooled in custom-fitting techniques for mastectomy patients. Wig stylists trim and shape hairpieces right on the wearers and teach patients about home maintenance.

City of Hope Positive Image Center Manager Janine McDonough has met considerable challenges with creative thinking. For young patients, she introduced “chemo dolls,” bald baby dolls of both sexes and all colors. She once designed a custom beard for a man whose melanoma surgery claimed a good portion of his jaw.

In some cases, cosmetics can help hide the effects of chemo or radiation, and many centers will bring in consultants to teach women how to cope with changes in skin texture and color, as well as loss of brows and lashes.

“You do need a little advice with makeup and clothing colors,” says an ovarian cancer survivor. “There’s a chemo pallor. Your skin gets a little green or beige. Or you can get jaundiced. You need to stay away from certain colors like yellow and beige. They teach you to go with stronger colors.”

If chemotherapy temporarily claims patches of hair, many patients learn from the staff that shaving off the rest is empowering: They’re taking control rather than watching helplessly as clumps fall out in the shower and on the pillow. And, regrowth comes in more evenly and attractively. Staffs encourage patients to go for it and will do it for them on the spot--if the patient’s ready.

“ ‘G.I. Jane’ is very timely,” says one patient just starting chemotherapy. “I went to the movie because of that head-shaving scene. And it was great to see it. Here’s a woman [Demi Moore in the military] shaving her hair to fit in. She could do whatever she wanted to do, no matter what she looked like.”