The Full Treatment


After 31 years as a licensed cosmetologist, Joanna Pupos has grown accustomed to people fretting about their looks, about frizzy hair, crow's feet--the usual cosmetic gripes.

These days, the 58-year-old Costa Mesa resident talks to cancer patients about what to do if their hair falls out, not if it turns gray. She shows them how to enhance their eyes when they have no eyelashes or eyebrows. In essence, she teaches them how to camouflage the devastating side effects of their illness.

The idea: Raise their spirits by helping them deal with the physical changes caused by chemotherapy and radiation.

"Some of them come in feeling weary from treatment. Then they start playing with makeup, and they stop focusing on being sick. They walk out of here feeling better; they're happier," said Pupos, a volunteer with a program called Look Good . . . Feel Better, which is offered through the American Cancer Society/Orange County Region.

Pupos understands how upsetting the changes caused by chemotherapy can be. She has battled breast cancer twice and knows what it's like to lose all of her hair. She, too, has looked in a mirror and hardly recognized the reflection.

"They know I've been there. I've had to cover my head. I've had blotchy skin," Pupos said. "I'm not just a cosmetologist saying, 'This sounds like a good idea.' I've done it."

Her experience helps her establish a comfortable rapport with patients, as was evident at the recent workshop she conducted with Mary La Fornara at the Hoag Cancer Center in Newport Beach. Pupos and La Fornara, who offers one-on-one cosmetic consultations at the center's Brighter Image boutique, lead the sessions on the first Wednesday of each month.

At this month's session, eight women sat at a long table in one of the center's conference rooms. Most wore wigs and head wraps, having already lost their hair.

When Pupos asked Diane Sweet of Corona del Mar to sit for a make-over, Sweet apologized, saying, "I just got back from Hawaii, so my skin's kind of dark."

"You went to Hawaii? Well, good," Pupos responded and rubbed Sweet's skin with a moisturizer and a foundation.

"You may have spots where you didn't before," she explained about the skin's reaction to cancer treatment. "That's where you'd use concealer."

Eyelashes and eyebrows often are lost to chemotherapy. Using Sweet as an example, Pupos outlined her eyes with powder and created eyebrows with a tiny brush instead of a pencil for a more natural look.

"When I lost my eyebrows, I tried drawing them on with an eyebrow pencil and I ended up looking like my mother," Pupos told them. "She just drew hers on with what looked like crayon."

The women laughed.

In her flowing dress and sandals, Pupos becomes a kind of den mother, confidant and cheerleader for program participants. It's the camaraderie they share with her and with one another that is more important than any makeup tip, she said.

The women complimented one another's cheekbones, and some even laughed about their missing hair.

"I think this is screaming for a tattoo," said one, doffing off her baseball cap to reveal a bald head.

Look Good . . . Feel Better is a national program supported by the American Cancer Society, the National Cosmetology Assn. and the Cosmetic, Toiletry and Fragrance Assn. Foundation. The local society offers about 65 sessions a year at hospitals throughout Orange County, and the classes are free to male and female cancer patients undergoing chemotherapy or radiation treatments. Each cancer patient is given a box filled with complimentary cosmetics donated by cosmetics companies.

"You learn these [makeup] techniques so that when you pass by a mirror, there's not this sick person looking back at you," Pupos said.

Cosmetic side effects caused by cancer therapy are almost always temporary, but they're still devastating and demoralizing to many patients. Skin can change color and texture, becoming drier and less elastic, which means that patients must be diligent about using moisturizers and sunscreens.

For women, it almost always requires re-education.

"You may know how to put makeup on, but suddenly you find yourself with a condition you've never faced," Pupos said. "When your eyebrows go, your face looks sort of blank."

For patients, losing their hair is especially traumatic, she said. Her own hair fell out 17 days after she started chemotherapy but has since grown back.

"That was the hardest part. I was like, 'Oh my God, I'm going to be bald.' My own grandson was afraid of me. I did not look like Grandma," Pupos said.

To help patients disguise their hair loss, the program includes tips on using wigs and head coverings.

"Chemo does damage to other fast-growing cells like hair and nails, not just cancer," Pupos said.

Her concern for cancer patients is more than just skin deep.

She tries to provide the emotional support they need to get through their ordeal. So she volunteers as the unit coordinator of the local cancer society's Reach-to-Recovery program. She's always on call, matching women who have had breast cancer and have been out of treatment for at least a year with newly diagnosed patients. Volunteers visit patients one-on-one in their homes to answer any questions about cancer or treatments.

"The women can ask questions like, 'Where can I get a prosthesis?' or 'Am I going to be OK?' " Pupos said. "Some are terrified, and some just seem to rise to the occasion. Some are really weepy. But then, we all have periods when we weep."

She does it because she has been there herself. When her breast cancer was first diagnosed, in April 1989, the cancer society sent a Reach-to-Recovery volunteer to her home.

"I knew how much it meant to talk to someone who had been through what I was going through," Pupos said.

She was in remission for six years when the breast cancer returned. She had to stop her volunteer work for more than two years to undergo high-dose chemotherapy. Five months ago, after beating cancer once again, she was back helping other cancer patients.

"She's a great inspiration to people going through diagnosis or treatment," said Jane Tackett, a cancer control specialist at the American Cancer Society in Santa Ana. "She's always upbeat and reaching out to others. She devotes endless hours."

It's a mission of sorts. She serves on the society's advisory board for HelpLine, which gives patients information and resources. She also attends the New Image Breast Cancer Support Group at the Hoag center.

"I've seen her in the support groups," said Christine Smith, a 49-year-old breast cancer patient from Newport Beach who attended Pupos' makeup session. "She goes to them all. She knows a whole lot about cancer, and it's very reassuring."

Pupos retired from working as a stylist in hair salons in 1981. She's a single mother of four boys, ages 12 to 39, and has three grandchildren.

Her volunteer work, she said, "is one way I can make sense of having cancer.

"I can use my experience to help someone else."

For information about upcoming Look Good . . . Feel Better programs or to reach the American Cancer Society's HelpLine, call (949) 261-9446.

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