It seems self-evident that a cancer diagnosis changes one's relationship with one's own body. However, it is less clear when this change actually becomes distressing, particularly for adolescents and young adults, for whom appearance is closely linked to identity and belonging. Dr Céline Bolliger, postdoctoral researcher at the Faculty of Health Sciences and Medicine, therefore reviewed four decades of research alongside Dr Peter Francis Raguindin, who is a postdoctoral researcher at the Faculty, and an international team from the European "STRONG-AYA" project. This work began during Dr Bolliger's research stay with Prof. Dr Anne-Sophie Darlington at the University of Southampton in England, which was made possible by a mobility grant from the Graduate Academy of the University of Lucerne. Of the more than 700 titles and abstracts screened, 62 studies from twenty countries were included, published between 1986 and 2026. Four decades of research were thus distilled into a single question: how do young cancer patients and survivors experience changes to their bodies?

Multi-layered findings

Three reference points recur throughout the qualitative studies: one's own body prior to illness, healthy peers, and societal beauty ideals. Participants described feelings of shame and social withdrawal, as well as a sense of being left behind at important life stages. At the same time, treatments such as chemotherapy or amputation surgery were associated with a poorer body image.

Many studies reported several types of impact simultaneously. Negative impacts were described most frequently (in 57 studies), but positive impacts were also common (in 39 studies), such as developing a new relationship with one's own body or experiencing greater self-acceptance. Some participants found that their peers responded no differently to them than before, which helped to restore a sense of normality. Similarly, the quantitative studies produced mixed results: some found poorer body image compared to peers without cancer, some found no difference, and a few found a more positive perception. As Bolliger puts it: “Distress does not arise from objective differences alone, but also from how young people appraise and make sense of their bodies.”

A more differentiated view

As the review covers such a long period, it also reveals how the concept itself has evolved. Earlier work framed body image more narrowly as a matter of visible cosmetic change. In recent years, however, further dimensions have been added, such as body experience and functioning, as well as self-image and self-concept. This broadens the topics discussed between patients and health professionals as part of psychosocial care. This care complements medical treatment and also addresses the psychological and social consequences of a cancer diagnosis: it is about what the body is still capable of doing and who you are after the illness.

Drawing on these findings, the team concludes that, for this kind of care, support should be flexible and individually tailored, taking into account the respective developmental stage, interactions with peers and the role of social media. However, some questions remain. Almost all of the studies originate from North America and Europe, most capture only a single point in time, and it is unclear which aspects of changed body image are cancer-specific and which are part of normal development at this age. For the team, this review is therefore both a stocktaking and a starting point for further work.
 

Céline Bolliger, Nicole Collaço, Peter Francis Raguindin et al.
Body image issues among adolescents and young adult cancer patients and survivors – a literature review from the STRONG AYA Project
EJC Paediatric Oncology, Vol. 8, 2026
Open-Access

The STRONG-AYA project is funded by the European Union under Horizon Europe (HORIZON-HLTH-2021-CARE-05, grant no. 101057482). The UK project partners are supported by Innovate UK (UK Research and Innovation) under the UK government's Horizon Europe funding guarantee.