Blog May 22, 2023

Recovering from cancer and pelvic floor dysfunction

Why pelvic health is important for oncology rehabilitation

While the pelvic floor is a mystery to many, it is important to your long-term health and quality of life.

But for those who have received a cancer diagnosis, the type of cancer and treatment regime can affect pelvic floor function.

But first, what is the pelvic floor?

The pelvic floor is a group of muscles, ligaments and tissue that form a sling to support the pelvic organs and spine. These muscles also help with control and coordination of bowel, bladder and sexual function.

Muscle control — the ability to squeeze and relax pelvic floor muscles — is key here.

Pelvic floor muscles contract to prevent bowel and bladder leakage. The muscles also relax to allow the bladder to empty completely when you void, empty the bowel without straining and have intimacy or pelvic exams without pain.

Therapist showing a patient a model of the pelvic bowl.

Pelvic floor muscles also support reproduction.

In women, pelvic floor muscles are the muscles that:

  • Contract with orgasm.
  • Support the uterus.
  • Promote circulation of blood and lymphatic fluids

With men, pelvic floor muscles help to:

  • Develop and maintain an erection.
  • Support the prostate.
  • Ejaculate during sex.
  • Promote circulation of blood and lymphatic fluids.
  • Prevent incontinence, or increased urgency.

Now, put it all together and pelvic floor dysfunction (PFD) describes bowel and bladder disorders, sexual disorders and chronic pelvic pain syndromes that affect the pelvic floor muscles’ inability to contract or relax appropriately.

What are common symptoms of PFD?

Unfortunately, pelvic health issues may go unrecognized and untreated. Indeed, people are often hesitant to share their concerns and, when they finally do, often wait several weeks or months to make an appointment with their doctor.

Common symptoms of PFD may include:

  • Urgent or frequent urination or bowel movements. You may feel like you have to go right away or all the time. You may also fear leaving your home so that you can stay close to the bathroom. 
  • Hesitancy or painful urination. You may also feel you need to ‘force it out’ to go or you might stop and start many times.
  • Constipation, or pain during your bowel movements. Up to half of people suffering from long-term constipation may have pelvic health dysfunction.
  • Straining or pushing really hard to pass a bowel movement. You may also find yourself changing positions on the toilet.
  • Leaking stool or urine (incontinence).
  • Feeling pain in your lower back or hips with no other cause.
  • Feeling ongoing pain in your pelvic region, genitals, or rectum.

If you’re experiencing any of these symptoms, it can feel as though your quality of life has diminished.

But, there’s no need to accept this as your new normal.

How cancer and the pelvic floor can go hand-in-hand.

Many people with cancer simply aren’t told that treatment side effects can impact their pelvic floor. They may believe that their symptoms are a normal part of aging or are so grateful to be cancer-free that they don’t put two and two together.

Women with gynecological cancers, including uterine (endometrial), ovarian, cervical, vulvar and vaginal cancer, men with prostate and testicular cancer and anyone with bladder, rectal or anal cancer are most at risk for experiencing problems with PFD.

For example, radiation for gynecological cancers, which are located in the pelvic region, may cause fibrosis, a hardening of tissue that may narrow or shorten the vaginal canal. This may cause generalized pelvic pain and pain with intercourse.

Men who have radiation therapy for prostate cancer treatment, or who undergo a prostatectomy (the surgical removal of the prostate), may develop incontinence and/or erectile dysfunction.

Several types of surgery may also affect the pelvic floor, including:

  • Tumor debulking to remove as much of a cancerous tumor as possible. 
  • Hysterectomy to remove the uterus.
  • Salpingo-oophorectomy to remove the ovaries and fallopian tubes.

Regardless of what caused your PFD, pelvic health therapy and cancer rehabilitation can help you feel your best.

How can pelvic health therapy help?

A pelvic floor specialist can help to develop a care plan to achieve the right mix of coordination, control and strength in the pelvic floor muscles.

Pelvic health therapy, whether it’s physical therapy or occupational therapy, aims to restore function and reduce pain. A pelvic health therapist will give you an assessment of your muscle function, posture, breathing patterns, strength and flexibility of your spine, hip and abdominals to determine contributing factors of any pelvic health issues.

Therapist helping a patient do pelvic floor exercises.

Every person is different, so pelvic health therapy will look different for everyone. Some interventions you might experience can include:

  • Therapeutic manual (or hands-on) therapy. 
    • Trigger point release: Trigger points are sensitive areas in the muscle or connective tissue that are painful when pressed. Trigger points may cause pain in the pelvic area. Trigger point release is a hands-on technique to relieve chronic pain.
    • Dry needling: This form of treatment uses a dry needle - a needle without medicine - to deactivate trigger points in the muscle, help reduce scar tissue and promote healing in the body. Dry needling is not acupuncture.
    • Connective or scar tissue mobilization: This form of manual therapy aims to break up fibrosis related to cancer treatment that may be causing stiffness, desensitization or pain. Besides gently breaking up the tissue, this type of hands-on therapy helps to stretch and relax surrounding muscles building essential flexibility.
    • Myofascial release: This treatment style helps to lengthen and reduce tension in the connective tissue.
  • Biofeedback, which is commonly used to retrain pelvic floor muscles. This pain-free procedure uses special sensors to monitor pelvic floor muscles as you try to contract and relax them. The sensors provide feedback to you and your therapist about which specific muscles you need to strengthen to gain sensitivity or improve coordination of pelvic floor muscles.
  • Pelvic floor exercises. Your therapist will prescribe exercises to enhance coordination, control and function of the pelvic floor and surrounding muscles like the back, abdominals and hips.

Talk to an oncology and pelvic health specialist today.

If you or someone you love has been impacted by cancer that has led to any sort of pelvic health issues, ReVital Cancer Rehabilitation can help.

Our compassionate clinicians are certified in oncology rehabilitation, and uniquely trained to treat pelvic health issues.

To request an appointment to work with one of our clinical team members or ask us questions about treatment, fill out our short online form. A member of our team will connect with you to confirm your visit.