Pelvic Therapy Interventions for Bladder and Gynecological Cancers

Cancer and oncology treatments have several common side effects like fatigue, changes in appetite, and pain. However, patients who have bladder or gynecological cancers can also experience side effects that affect the bladder, bowel, and sexual functioning. The pelvic floor muscles of these patients can be negatively impacted by many things including surgery, radiation, and in some cases, the tumor itself. Pelvic rehab programs can play a crucial role in improving pelvic floor function and overall quality of life for patients who have been diagnosed or treated for these cancers. Don't underestimate the impact of pelvic rehab on regaining both the quality and satisfaction of life after treatment.

Radiation for gynecological cancers, for instance, has been reported to cause vaginal stenosis resulting in generalized pelvic pain and dyspareunia.¹ Surgical options including tumor debulking, hysterectomy, and salpingo-oophorectomy can result in scar tissue that can cause tissues or muscles to shift. As pelvic rehab professionals, it is our privilege to offer an evidence-based and solution-focused approach for the often overlooked pelvic health issues faced by people undergoing treatment for pelvic cancers. Our role is crucial in providing much-needed support and care for these patients.

Pelvic rehab therapy can improve and sometimes even prevent the detrimental impacts on the pelvic and abdominal area that negatively impact the patient’s quality of life. Some of the most common therapy options to help improve your patient's pelvic functioning are:

• Soft tissue mobilization and stretching of tight muscles.
• Exercises to strengthen the core and pelvic floor muscles.
• Recommending dietary changes such as avoiding alcohol or caffeinated beverages and other dietary irritants.
• Relaxation and deep breathing to relax the muscles.
• Postural corrections.
• Biofeedback techniques.
• Vaginal dilators or anal dilators for pain during intercourse.

As Michelle Lyons shared in a past blog with the Pelvic Rehab Report, “Whether it is advice on managing anal fissures (skin protection, down-training overactive pelvic floor muscles, achieving good stool consistency, teaching defecatory techniques) or dealing with dyspareunia (dilator or vibrator selection, choosing and using an appropriate lubricant, dealing with the ergonomic or orthopedic challenges that can be a barrier to returning to sexual function and enjoyment), pelvic rehab practitioners are probably the best clinicians for optimizing a return to both pelvic and global health during and after treatment for pelvic cancers.”²

If you work with patients facing pelvic or abdominal issues from a cancer diagnosis or treatment regime, join Herman & Wallace in Oncology of the Pelvic Floor Level 2B scheduled for May 4-5, 2024. This course covers topics on bladder and gynecological cancers including diagnoses, medical treatments, and ways a pelvic rehab professional can help these patients recover. Learn how to help your patients, not just survive, but thrive after treatment. Pelvic therapy interventions from urinary continence to sexual function can offer valuable tools for your patient's long-term well-being.

Resources:

1. Damast S, Jeffery DD, Son CH, Hasan Y, Carter J, Lindau ST, Jhingran A. Literature Review of Vaginal Stenosis and Dilator Use in Radiation Oncology. Pract Radiat Oncol. 2019 Nov;9(6):479-491. doi: 10.1016/j.prro.2019.07.001. Epub 2019 Jul 11. PMID: 31302301; PMCID: PMC7944435. https://pubmed.ncbi.nlm.nih.gov/31302301/
2. Lyons, Michelle. “Rehabilitating Pelvic Floor Muscles after Cancer Treatment.” The Pelvic Rehab Report, Herman & Wallace. February 13, 2017. https://hermanwallace.com/blog/rehabilitating-pelvic-floor-muscles-after-cancer-treatment.

This article has been reviewed for accuracy by Allison Ariail.