From information gap to bullying: what does a cancer patient look like?

Evre Başak Clarke shared her cancer journey she had been fighting for two years.

After marrying in 2023 and, in the same year, giving birth to her son Oscar, Evre was diagnosed with metastatic bowel cancer. To secure Oscar’s future, she launched a fundraising campaign on GoFundMe. Tens of thousands of people supported her; thousands donated.

Sadly, a short time ago Evre announced that her body was no longer responding to treatment and that doctors had given her only 3–4 weeks to live.

But then something happened. A group of people on social media didn’t believe Evre and accused her of fraud. They claimed she wasn’t actually ill and that the donations were collected unfairly. The online pile-on grew. At the heart of the fraud allegations was Evre’s “healthy” appearance: according to the claims, her hair wasn’t falling out, she wasn’t losing weight, and therefore “didn’t look like a cancer patient at all.”

On August 24, her family announced that Evre had passed away.

I was one of Evre’s followers. I watched the pile-ons and accusations with astonishment and wondered: can cancer be reduced to just a few physical symptoms? Aren’t there cancer patients whose hair doesn’t fall out and who “look well”? And does that suffice to accuse someone of fraud?

Cancer does not have a single, uniform look

Cancer does not have one single physical appearance. According to the Institute of Cancer Research, there are more than two hundred types of cancer. Naturally, different cancers are treated in different ways. That means the side effects patients may experience can vary according to the type of cancer, the type of treatment, and the individual’s own biology. In other words, each patient’s physical appearance may be affected by the illness in different ways.

So which treatments can lead to which side effects and physical changes?

• Chemotherapy aims to destroy rapidly dividing cancer cells with medications. It’s important to note there are over a hundred chemotherapy drugs and different drugs cause different side effects, but possible physical changes include hair and beard loss, dry skin, discoloration of the nails, and weight changes.
• Immunotherapy, that is, treatment that harnesses the immune system to fight cancer, generally does not cause hair loss; however, itching and rashes on the skin and fatigue can occur.
• In radiotherapy, cancer cells in a specific area are destroyed with radiation. Most commonly, redness and dryness appear in the irradiated area, along with localized hair loss and a sense of fatigue.
• Targeted therapies (so-called “smart” drugs) typically do not cause hair loss because they act more specifically on cancer cells, but dry skin is among the most commonly seen physical side effects.
• Hormone therapy aims to halt cancer growth by lowering hormone levels; because it alters the body’s natural hormonal balance, it can lead to side effects such as weight changes or pronounced fatigue.

Every person’s experience of cancer is unique. Not everyone will have all of these side effects, and their severity can vary from person to person. Moreover, thanks to advances in medicine, doctors also offer various supportive treatments to help manage these effects.

At the same time, in some cancers the illness experience may not be visible from the outside. Unrelenting fatigue, bone and muscle pain, reduced immunity, anxiety and depression… None of these may be noticeable in photos. Because they aren’t visible, people may think, “They look great, so they must not be sick.” But their invisibility doesn’t mean they aren’t real. What is really needed here is not to pass judgment based on someone’s appearance, but to practice empathy.

Not every cancer patient loses their hair

One of the most widespread assumptions is that every cancer patient will lose their hair because of treatment. This may stem from dramatic hair-loss scenes we see in films or sensational stories we hear around us. While such assumptions are often harmless, they can, without our noticing, lead to faulty judgments and, in the next step, feed a culture of online shaming. For example, some people pointed to the fact that Evre’s hair hadn’t fallen out and she hadn’t lost weight as if it were “proof” that she was a fraud.

Yet hair loss is a side effect seen only with certain types of chemotherapy. And every body can respond differently to treatment. Research shows that among people receiving the same chemotherapy, some lose all body hair, some experience only mild thinning, and some do not lose hair at all. So the fact that someone hasn’t lost their hair does not mean they are not a “real patient.”

“But you don’t look sick:” from incomplete information to hate speech

What happened to Evre Başak Clarke actually reminds us of something very basic: the lack of public knowledge about cancer does not remain limited to individual misunderstandings; it can easily turn into hate speech, prejudice, and discrimination. When people don’t know how cancer is “supposed to look,” they treat the picture in their own minds as a universal truth. Yet cancer cannot be defined by a single look or a single experience; the stage of the disease, the treatment used, the person’s own biology, and even their preferences can all shape that experience differently.

Failing to know and understand this diversity leads not only to false judgments; it also opens the door to people being targeted and publicly shamed at their most vulnerable moments.

All the judgments based on “not looking like a patient” place yet another burden on patients and their loved ones. They end up having to struggle not only with the disease, but also with the pressure to be a “convincing patient” in the eyes of society. This stigma can sap morale during treatment, lead to loneliness, and even force people to hide their experiences.

Another example comes from Julia Tugwell, who was diagnosed with cervical cancer. Tugwell explains how “not looking sick” turned into a pressure for her:

“After I was diagnosed with cervical cancer, one of the first things my nurse told me was: ‘It’s going to be hard because you won’t look sick. You won’t match the image of a cancer patient people have in their heads—bald, thin, with a sick bowl in hand.’ At first, I didn’t really understand why not being bald or thin or ill would make it difficult.”

Because she didn’t lose her hair, Julia Tugwell heard “you look absolutely fine” from those around her, and even faced the idea that she was “not sick enough.” Yet the losses and side effects she experienced—loss of fertility, sexual dysfunction, urinary problems, and a constant fear of recurrence—though invisible from the outside, permanently affected her life. Looking healthy on the surface made daily life easier in one sense, but the public’s misperception placed a heavy emotional burden on her.

Like misinformation, incomplete information is a serious public-health problem. The responsibility should not be placed solely on patients or their families. Through collaboration among healthcare institutions, civil-society organizations, and media partners, more inclusive cancer-awareness efforts can reduce social prejudice; people can approach both the illness and those living with it more empathetically and more fairly.