Self-image among adolescent and young adult cancer survivors: a qualitative study

Objective This study describes adolescent and young adult (AYA) cancer survivors’ self-image, including the role of social media, in the context of social interaction. More specifically, this study describes how survivors view their physical appearance, personality, and capabilities throughout their cancer experience. Methods Data were derived from semi-structured interviews of 21 AYA oncology survivors, ages 16–22 years, who were treated for cancer 1–4 years prior to participation. A five-phase approach for data analysis that incorporated both deductive and inductive qualitative strategies was used to identify themes of self-image. Results The analysis revealed two themes for each of the self-image components (personality, appearance, and capabilities). Specifically, AYA reflect on how a cancer diagnosis affects their identity, self-esteem, physical features, and social normalcy. In terms of the role of social media, AYA cancer survivors identified that social media promotes an unrealistic expectation and is used for external validation. Conclusions Survivors report ways in which their cancer experience and social perceptions contribute to their sense of self. The multifaceted aspects of self-image described are key concepts that psychosocial providers should assess throughout the AYA cancer trajectory. From AYAs’ perspective, social media contributes to their self-image by creating a pressure to conform to societal expectations on appearance; additional research and support to mitigate this impact are warranted. Increasing AYAs’ media literacy and enhancing psychosocial assessments and support to navigate online and offline social worlds may help shape AYA’s self-image.