Unraveling the Links: Understanding Cancer's impact on the Pelvic Floor
Unraveling the Links: Understanding Cancer's impact on the Pelvic Floor
In the journey of cancer treatment and recovery, rehabilitation plays a crucial role in restoring physical function and enhancing overall well-being. While much emphasis is rightly placed on addressing the primary effects of cancer and its treatments, secondary issues like pelvic floor dysfunction often go unnoticed. Pelvic floor muscle training, a therapeutic approach often associated with conditions like urinary incontinence or pelvic organ prolapse, holds significant importance in cancer rehabilitation.
Understanding Pelvic Floor Dysfunction in Cancer Patients: Cancer and its treatments, including surgery and radiation therapy, can have profound effects on pelvic floor health. Some evidence shows that Radiation therapy has detrimental effects on both the pelvic floor muscle structure and function.(1) Radiation therapy in pelvic cancer treatments can cause inflammation and scarring, further compromising muscle function. This can manifest as urinary or faecal incontinence, sexual dysfunction, pelvic pain, or discomfort.
Pelvic floor muscle training involves the contraction and relaxation of the muscles supporting the pelvic organs. While traditionally associated with addressing urinary incontinence, its benefits extend far beyond. In cancer rehabilitation, pelvic floor muscle training can:
Improve Continence: By strengthening the muscles responsible for bladder and bowel control, pelvic floor exercises can help cancer survivors regain continence and manage incontinence issues effectively.(2)
Improve Sexual Function: Cancer treatments often disrupt sexual function, leading to issues like erectile dysfunction or vaginal dryness. Pelvic floor exercises can improve blood flow to the pelvic region and enhance muscular control, thereby aiding in the restoration of sexual function and intimacy.
Alleviate Pelvic Pain: Pelvic floor dysfunction can contribute to chronic pelvic pain, a prevalent issue among cancer survivors. Targeted exercises help alleviate muscle tension and promote relaxation, offering relief from discomfort.
Enhance Quality of Life: By addressing urinary, bowel, and sexual dysfunction, pelvic floor muscle training contributes to an improved quality of life for cancer survivors. Restoring confidence and independence in activities of daily living.
Bone health can be an issue in cancer survivors due to prolonged use of hormonal therapies.(3) This can lead to increased fracture risk. Research has demonstrated that participation in various types of exercise including aerobic and resistance training is associated with improved bone mineral density.(4) Your pelvic physiotherapist can advise you on the best exercise to complete during and after your treatment.
Integrating pelvic floor muscle training into cancer rehabilitation requires a comprehensive approach tailored to individual needs. Oncology rehabilitation specialists, including pelvic physiotherapists, play a pivotal role in guiding patients through appropriate exercises. Key considerations include:
Patient Education: Providing our patients with information about the pelvic floor, its anatomy and function, and the importance of exercises promotes engagement and compliance. Understanding the rationale behind pelvic floor muscle training empowers our patients to take an active role in their rehabilitation journey. (5)
Personalized Exercise Programs: Every cancer survivor has unique needs and challenges. Your pelvic physiotherapist can tailor exercise programs to address specific concerns to ensure optimal outcomes. This may involve a combination of strength training, endurance exercises, and relaxation techniques, gradually progressing as tolerated. Individualization of physiotherapy programs can have a good impact on patient cooperation. (6)
Pelvic floor muscle training represents a valuable yet underutilized tool in cancer rehabilitation. By addressing pelvic floor dysfunction and associated issues, it empowers cancer survivors to reclaim control over their bodies and lives. Through targeted exercises, education, and multidisciplinary collaboration, we can optimize the rehabilitation journey, enhancing the quality of life for those affected by cancer.
References:
1. Bernard, S. et al. (2015) ‘Effects of radiation therapy on the structure and function of the pelvic floor muscles of patients with cancer in the pelvic area: A systematic review’, Journal of Cancer Survivorship, 10(2), pp. 351–362. doi:10.1007/s11764-015-0481-8.
2. Lin, K.-Y. et al. (2014) ‘Pelvic floor muscle training for bowel dysfunction following colorectal cancer surgery: A systematic review’, Neurourology and Urodynamics, 34(8), pp. 703–712. doi:10.1002/nau.22654.
3. Handforth, C. et al. (2018) Cancer treatment and bone health, Calcified tissue international. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805796/
4. Singh, B. and Toohey, K. (2022) ‘The effect of exercise for improving bone health in cancer survivors — a systematic review and meta-analysis’, Journal of Science and Medicine in Sport, 25(1), pp. 31–40. doi:10.1016/j.jsams.2021.08.008.
5. Okeahialam, N.A. et al. (2022) ‘Prevention and non-surgical management of pelvic floor dysfunction: Summary of nice guidance’, BMJ [Preprint]. doi:10.1136/bmj.n3049.
6. Zyzniewska-Banaszak, E., Kucharska-Mazur, J. and Mazur, A. (2021) ‘Physiotherapy and physical activity as factors improving the psychological state of patients with cancer’, Frontiers in Psychiatry, 12. doi:10.3389/fpsyt.2021.772694.
