Post Pelvic Cancer Rehab

Cancer in the Pelvis

Cancers in the pelvis account for a relatively large percentage of new diagnoses for both men and women: 45% of new diagnoses in men and 23% of new diagnoses in women. There are many different types of cancer in the pelvis, some common to both males and females, and some specific to both.

Types of Cancer in the Pelvis

Males

• Penile
• Testicular
• Prostate (most common)
  
  

Females

• Vulvar
• Vaginal
• Cervical
• Endometrial (most common)
• Ovarian

Males and Females

• Rectal Anal Colon Cancer
• Bladder

Side Effects of Cancer Treatment

Side effects can occur with any type of cancer treatment, whether that be surgical, radiation, or chemotherapy. The severity and type of side effects will depend on the specific area or organs effected, size of area treated, type and amount of surgery/radiation/chemotherapy, and overall health and co-morbidities. Commonly experienced symptoms for post pelvic cancer can be categorized into three main groups: urinary, bowel, and sexual.

Urinary Symptoms

• Urinary urgency
• Urinary frequency
• Urge urinary incontinence
• Stress urinary incontinence
• Nocturia
• Urinary tract infections
• Urinary retention
• Bladder pain

Bowel Symptoms

• Fecal or anal incontinence
• Constipation
• Pain before, during, or after bowel movements
• Bleeding with bowel movements

Sexual Function (Male Specific)

• Erectile dysfunction

Sexual Function (Female Specific)

• Vaginal stenosis (narrowing)
• Vaginal shortening
• Dyspareunia
• Vaginismus

Sexual Function (Male and Female)

• Difficulty reaching orgasm
• Decreased desire and arousal
• Intimacy challenges

Other

• Pelvic/abdominal pain
• Lymphedema
• Sleep disturbances
• Stress, anxiety, and depression
• Overall quality of life challenges

Treatment

Pelvic health physiotherapy is uniquely positioned to address all the above side effects listed, and is therefore a critical component in the recovery and rehabilitation phase of post pelvic cancer. Treatment options may include:

• Breathing techniques
• Education on movement
  • Transfers and transitional movements
  • Posture and positioning
  • Mobilityand walking
• I-L-U abdominal self-massage
  • Constipation
  • Abdominal pain and discomfort
  • Relaxation
• Scar treatment
  • Myofascial mobility
  • Decrease sensitivity
• Hemorrhoid and fissure care education
• Bowel and bladder education
• Using the bathroom and evacuation positioning techniques
• Diet modification
  • Adequate water and fiber intake
• Therapeutic exercise 
  • Whole body reconditioning
• External myofascial techniques
• Internal myofascial techniques
• Pelvic floor muscle training
  • Proprioceptive training
  • Strengthening muscles
    • Stress urinary incontinence
    • Fecal incontinence
    • Erectile dysfunction
  • Lengthening and relaxing muscles
    • Dyspareunia
    • Pelvic pain
    • Urge urinary incontinence
    • Constipation
    • Urinary retention
• Tips for intimacy
  • Positioning
  • Penile limiter for pain with deep penetration
  • Vacuum devices for erectile dysfunction
  • Education on vaginal dryness (moisturizers and lubricants)
  • Vaginal dilator guidance and treatment plan
• Mindfulness and meditation
  • Pain
  • Anxiety, stress, and depression
  • Relaxation
• Lymphedema treatment
• Visceral mobilization
• Prioritizing and goal setting
  • Especially important for cancer-related fatigue
• Pain education
• Treatment of the nervous system

Post pelvic cancer rehabilitation requires a holistic, whole-person approach, from the way one moves to how they breathe to how they think about pain. Treatment topics addressed in physiotherapy are vast and as unique as each person seeking treatment at a clinic. By addressing these treatment areas and putting them into practice, you are sure to regain confidence and improve your everyday quality of life.