Whether it’s cancer within one of the pelvic organs or cancer that affects one’s hormones or abdominal organs, individuals may face impairments that can be helped by pelvic floor rehabilitation.
What Happens to the Pelvic Floor During Cancer
With cancer treatments, whether it be surgery, chemotherapy or radiation, the pelvic floor and core can be weakened. It could be directly, as with gynecological or urogenital cancers, or indirectly, as with breast or colon cancers.
With breast cancer, many women are placed on hormone reducing medications, specifically aromatase inhibitors, which can cause vaginal dryness and pain with sexual intercourse or pelvic exams as well as reduced tissue mobility.
Some women may also have flap surgeries due to mastectomies. This can cause scar tissue at the site, often times abdominally, that will in turn impact the mobility of myofascial tissue. This loss of mobility increases tension, which can refer to the pelvic floor as well as back and cause low back pain, potential for abdominal hernias.
Pelvic floor therapy for these women addresses vaginal health, pelvic floor lengthening, scar & tissue massage & biofeedback strategies.
With gynecological or urogenital cancers, individuals may face removal of organs or radiation treatments that impact the overall tissue integrity. Males who require prostatectomies due to prostate cancer may suffer from urinary incontinence that lingers past their acute healing stage, pelvic pain, sexual dysfunction and potentially bowel disruptions.
One case study reported a patient who was post prostatectomy 10 years and underwent pelvic floor therapy due to his urinary incontinence (Kilgore, 2017). During the course of therapy, with the provision of behavioral strategies to manage his urges as well as pelvic floor strengthening, this patient was able to achieve an overall reduction in incontinence episodes & improved quality of life.
Ovarian, Uterine, or Cervical Cancers
Women who have ovarian, uterine or cervical cancer may suffer from pain due to treatments, increased incontinence, reduced ability to fully void their bladder and bowel disturbances. Women who undergo radiation due to gynecological cancers also exhibit changes in vaginal health, including the vagina becoming narrower, shorter, drier and less elastic. This would lead to pain with pelvic exams and sexual intercourse as well as potential impact on wearing clothing & sitting on various surfaces.
Pelvic floor therapy would work to address vaginal health, including proper lubrication, potential use of moisturizers or prescription creams, use of dilators and pelvic floor lengthening exercises.
With colorectal or anal cancers, individuals may require removal of a length of their colon, surgical intervention for cancerous tissue as well as radiation treatment. This can result in loss of the ability to control bowel movements or flatulence, pain with defecation or irregular bowel movements.
Pelvic floor therapy for these individuals would address colon health, pelvic floor strengthening/lengthening, scar/tissue mobility & biofeedback for improved sensation and control. Pelvic floor therapy would also work on addressing strategies to reduce the incidence of anal fissure and/or hemorrhoid formation via nutrition, defecation mechanics and pelvic floor relaxation strategies.
Pelvic Floor Therapies Can Help
When working with individuals with or post cancer, pelvic floor therapists apply a comprehensive & holistic approach to identify and treat what is impacting their ability to participate fully in the work, home & social life (Filocamo, M.T., et al., 2005; Rutledge, T., Rogers, R., Lee, S-J. & Muller, C., 2014). Pelvic floor therapy may include the use of relaxation strategies, pain management strategies, bowel/bladder/pelvic health strategies, pelvic floor strengthening & biofeedback training. Any patient who has received radiation to their pelvic and/or abdominal regions or has been placed on hormone blocking medications would benefit from seeing a pelvic floor therapist to ensure optimal bowel, bladder and sexual functioning.
Reach out to your provider or to our pelvic health team for more information.
Filocamo MT, Li Marzi V, Del Popolo G, Cecconi F, Marzocco M, Tosto A, Nicita G. Effectiveness of early pelvic floor rehabilitation treatment for post-prostatectomy incontinence. Eur Urol. 2005 Nov;48(5):734-8. doi: 10.1016/j.eururo.2005.06.004. Epub 2005 Jun 22. PMID: 16002204.
Rutledge, T. L., Rogers, R., Lee, S. J., & Muller, C. Y. (2014). A pilot randomized control trial to evaluate pelvic floor muscle training for urinary incontinence among gynecologic cancer survivors. Gynecologic oncology, 132(1), 154-158.