January 16, 2020
Many people know that cancer treatments like surgery, radiation and chemotherapy can cause general weakness, fatigue and effects on daily functioning. However, there are often other potentially sensitive side effects that are not as well known.
For patients with pelvic or abdominal cancers—including endometrial, prostate, bladder, and ovarian cancers—treatment can impact bladder, bowel and sexual functioning. Physical therapy to strengthen the pelvic floor can help.
Physical therapists strive to help people return to life after cancer. This may mean having the energy to golf again, go back to work without fear of having accidents, or return to intimacy with your partner. Treatment may involve one screening session before, during or after your cancer treatment, or ongoing therapy to help you reach your goals.
What is the Pelvic Floor?
Many people think only women have pelvic floor or “Kegel muscles,” but men have them too. I explain to my patients that if they think of their core as a canister, the diaphragm is on top, abdominals are on the sides, and the pelvic floor is on the bottom. The pelvic floor is a group of muscles surrounding the anus and urethra (where urine is released). If you are lacking strength or coordination in any area, this can affect your core stability and lead to dysfunctions ranging from back pain to urinary or stool leakage and pelvic pain.
Kegel exercises make your pelvic floor muscles stronger and can be done anywhere without anyone knowing.
- Find the muscles you use to stop urinating.
- Squeeze these muscles for 3 seconds. Then relax for 3 seconds. Your stomach and thigh muscles should not tighten when you do this.
- Add 1 second each week until you are able to squeeze for 10 seconds each time.
- Repeat this exercise 10 to 15 times per session. Try to do this at least 3 times a day.
- Don't do Kegels while you urinate. Doing them during urination can hurt your bladder.
What is Pelvic Physical Therapy?
Your doctor may recommend pelvic physical therapy. Different from traditional physical therapy, pelvic physical therapy takes place in a private treatment room. The therapist screens for bowel, bladder and sexual issues you may have experienced since receiving cancer treatment. Like traditional physical therapy, pelvic health physical therapists also assess upper extremity, lower extremity and core strength, range of motion, gait and functional stability, and posture.
Biofeedback and Pelvic Floor Therapy
Your therapist may use biofeedback in conjunction with traditional exercise, breathing and massage. Biofeedback shows electrical activity of your muscles on a computer screen. This better helps you see your muscles work, strengthens them, and improves your overall control of your pelvic muscles.
Working together with your entire cancer team, you can start to live life to its fullest following cancer treatment.