Pelvic Floor Therapy: A Critical Partner In Cancer Care

When someone is diagnosed with cancer, a team comes together from differing areas of medicine to create a care plan. Professionals, including oncologists, surgeons, chemotherapy nurses, nutritionists or counselors, may be with you at various times and durations during treatment and recovery. For those battling bladder, cervical, colorectal, ovarian, prostate or uterine cancers, physical therapists specializing in pelvic floor health help patients navigate issues related to post-cancer care and aid in healing and recovery.

What Is The Pelvic Floor?

The pelvic floor is a crucial part of controlling bladder and bowel function for both men and women. It comprises the nerves, muscles, tendons and ligaments that extend from the center of the pubic bone along the groin to the tailbone. There are three hammock-shaped layers of muscles inside the pelvis that support the bladder and rectum. For men, their pelvic floor also supports the prostate. In women, the uterus, cervix and vagina.

A disruption to the pelvic floor function can lead to bladder or bowel leakage, incontinence, constipation, difficulty emptying your bladder, frequent bathroom trips, lower back or hip pain, difficulty sitting or moving or intimacy issues. Pelvic floor therapists are well versed in improving function and providing cancer patients with relief.

How Does Cancer Treatment Affect The Pelvic Floor?

Changes in the muscles and tissues surrounding the pelvic floor—whether through surgery, chemotherapy or radiation—can lead to pain, dysfunction and weakness. Although these are potentially necessary procedures, the aftereffects of treatment can negatively impact the area, organ function, posture and stability. Vulnerability in the hips, bottom, belly and pelvis affects daily activity. Some cancer treatments leave behind soft tissue tightness in the abdominal core and pelvic floor, painful scarring and shifts in sensation or feeling. Without intervention, overall mental health and wellness may decline, making it challenging to overcome how the body has changed.

How Does Pelvic Floor Therapy Aid In Healing?

Treatment is multifaceted and specifically tailored for each patient.

Sandra Scherschel, DPT, is part of Franciscan Health’s Specialty Therapy department and manages the pelvic health therapy team. This rehabilitation area is dedicated to helping clients gain back mobility, flexibility and function by utilizing several techniques, including patient education, pelvic floor exercises, biofeedback and manual therapy.

“When it comes to cancer, surgical and radiation treatments leave scarring. That means control issues arise because the pelvic floor tissues have been disrupted. Cancerous tumors can be removed but procedures can leave behind nerve damage. That’s what we work to repair,” she shares.

The therapist’s role depends on where the patient is recovery-wise. One of the most critical factors in recovery, Scherschel states, is working with someone well versed in this type of therapy as soon as possible.

“The earlier we are involved in the care team, the less intensive therapy may be required down the road. Early intervention can also prevent years of scar tissue buildup and aids the healing process. We recommend patients see us as soon as their doctor allows so we can help them relearn to control, relax and contract their muscles just as they did before.”

What Can I Expect During My Appointment?

When attending an appointment for the first time, patients get to know their therapist just like they would a physician. While meeting privately, they’ll gather as much information as possible and formulate a treatment plan. Topics for discussion include medical history, current health, sleep patterns, exercise habits, nutrition, hydration and life stressors.

Therapists will also listen, answer questions and relieve any concerns about the process. Next, measurements will be taken to gather a baseline of function and mobility. Externally, information is collected concerning posture and alignment, joint mobility, muscle strength and flexibility.

Depending on the diagnosis, an internal examination may be necessary to assess the muscles within the pelvic floor for sources of pain, tightness and weakness.

Last, a unique treatment plan comes together outlining goals and how progress is measured. Clients also find out what to expect during therapy appointments and have an opportunity to ask questions. Most importantly, therapists are there to listen to patients’ concerns about the process.

Is Pelvic Floor Therapy Just For Cancer Patients?

Pelvic floor therapists see a wide range of patients beyond those battling cancer. People seek therapy for incontinence, pelvic floor prolapse, overactive bladder, constipation, painful intimate relations, tailbone pain, general pelvic pain, pediatric incontinence, postpartum issues, post-pelvic surgery and those who have suffered sexual trauma. While some conditions may require surgery to correct, physical therapy can be the perfect solution for others from the very beginning. Patients who are surgical candidates may not feel ready to take that step. The conservative approach of working with a therapist may provide relief to those who are not quite ready for something more invasive.

What Are Signs Someone May Need Pelvic Floor Therapy?

Girlfriend to girlfriend, Scherschel wants women to know there is nothing to be embarrassed about or anything too personal to mention that she and her team have not heard from those seeking therapy before. That’s why she speaks plainly about signs women experience that make them perfect candidates for treatment.

“If you experience urine leaks when you sneeze or cough, wear a pad ‘just in case,’ you know where every bathroom is at the mall or experience pelvic pain, please know you do not have to live with those struggles. The old wives’ tales that dictate these issues are just a part of aging are not true: it does not have to be that way, and we can help.”

What Should Potential Patients Know?

Recovery from anything in life is always a process, including pelvic floor therapy. No two people heal or bounce back at the same speed or with identical outcomes. Yet even the slightest improvement can help people return to doing what they love most and alleviate the pain or issues that kept them on the sidelines.

Scherschel wants her therapy team’s potential patients to know that their compassion and understanding run deep. Some can feel timid when asking questions or contacting their department about therapy. Yet she encourages: "We know this is a very intimate relationship that at first can feel embarrassing, yet please do not let fear hold you back from allowing us to help you find relief and live your best life possible."