It was in February that Sarah (name changed upon request) found out she had stage-four breast cancer. The Filipina receptionist felt a lump in her upper right breast that became itchy and turned red. She was advised to go for a mammogram and ultrasound, which led to three biopsies and a positive cancer result.
“I’m the first one in my family to have cancer,” she tells The National. “Maybe I got it from stress and lifestyle, although I don’t smoke and only drink occasionally.”
In seven months, she’s had 16 rounds of chemotherapy, she’s currently undergoing 28 days of radiation, plus she must take medication every day for five years.
She’s also had a mastectomy. For this, she’s turned to physiotherapy to help her manage the after-effects of surgery, which includes heavy scarring. Sarah now goes to Genesis Healthcare Centre, where she sees Laura Barrett, one of only two restore scar therapy practitioners in Dubai.
What is scar therapy?
Scar therapy is a method of non-invasive physical therapy and massage developed to treat scar tissue, fibrosis and adhesions, Barrett explains. “It uses a combination of specialist scar massage techniques, fascial release, therapy tools such as cupping, and self-care advice to promote healthy recovery.”
When your body is healing from an injury or surgery, scar tissue forms. This type of tissue is thick, less mobile and therefore less functional, Barrett explains. Adhesions may also form, sticking together under the layers of the skin. The therapy encourages fascia and muscle to improve restricted movement, tightness and pain, as well as reduces numbness, itching, burning and irritation. It also aims to minimise any longer-term complications.
Barrett, a women’s health physiotherapist who works closely with pre and postnatal clients, only completed her training in this type of therapy in the UK last month. While she’s treated C-section and perineal scars for most of her career, she developed a wider interest in the practice after her own bowel cancer diagnosis at 31.
“I experienced feelings of anger, anxiety and hatred towards my scars, felt restriction with movement and breathing, and felt embarrassed and ashamed,” she says. “Through scar therapy, I am now restriction-free, feel confident again in my body and have softer, flatter and lighter scars.
“I wanted to learn how to enable more people to feel this way.”
Helping breast cancer patients
Mastectomy scars, specifically, can affect the movement of someone’s arms and neck, and pain and tightness can change breathing patterns. “These scars can be red, thick, puckered and dipped,” says Barrett. “Releasing the underlying adhesions will improve these limitations in movement and allow the patient to breathe deeply pain-free,” she adds. It can also flatten and smooth them out.
Treatment can start six to eight weeks after a mastectomy, as long as the scar is dry, with no scabs or infection. Barrett cannot work on anyone while they’re having radiotherapy, however, as the skin is too sensitive, and patients must wait at least two weeks after the last session to resume therapy.
It’s never too late to start, says Barrett, although she adds sooner is always better. Sarah, for example, has only done three sessions since her surgery in August and she’s already seen a difference. “It's flattened my scar and loosened up the tightness,” she says.
There are several ways people can tell if their scar is affecting them, Barrett says. Firstly, appearance – if it’s red, raised, bumpy, thickened, puckering, dipping or twisting. They might feel pain, burning, numbness or itching, as well as pulling, tension, catching and pinching. You also might have reduced movement surrounding joints, your ability to breathe could be affected and there is aggravation with certain movements or activities.
It depends on the circumstances how long it can take to treat. “Someone with pain, restriction, thickening and puckering will generally require more sessions than someone who wants to improve the appearance of a well-functioning scar,” she says. “Some patients may notice a change in symptoms immediately or a few days following treatment. And some patients require a couple of treatments before any significant changes are observed.”
'It makes me feel at ease'
Each session begins with Barrett taking a full history from the patient. She discusses concerns, goals and any limitations to movement or activities. She’ll then do an assessment and look at the scar together with her client. “This is important as some patients are fearful of the scar or feel emotional when looking at and touching the area. It is important for recovery, both physically and emotionally, that they connect with the scar and acknowledge the linked emotions.”
She’ll then treat the scar using a variety of techniques and tools, depending on what she finds, and recommend creams or oils that might help. Patients might also do movements or self-massage in between sessions.
It shouldn't hurt, she adds. “It's gentle and light, especially in the early days,” she says. “I hope the patient will leave their first session feeling empowered, relaxed and with a feeling of lightness.”
Sarah says it makes her feel “at ease”.
Barrett’s main mission right now is to raise awareness of this type of treatment and how catching it early on can lead to better healing, function and appearance, plus fewer complications later in life.
“There aren’t many of us,” says Barrett. “I often think that after surgery for cancer, patients and their medical team are focused, rightly so, on recovery from the disease and are therefore less concerned about the symptoms related to their scar. The focus is on surviving.
“However, I believe these patients deserve a rounded approach to recovery.”
One of the most powerful things people can do after a mastectomy is to get familiar with their scar, adds Barrett. “Look at it in the mirror, lightly touch it and see it for the scar that it is – the scar that shows your bravery and strength, the scar that may have saved your life.”
That’s exactly how Sarah sees it. “I feel proud of my scars because it reminds me of what I lived through,” she says. “My scar tells a story, it can inspire others. It was when life tried to break me, but failed.”