Pelvic Health Oncology: How Pelvic Floor Physical Therapy Can Support Cancer Recovery

A cancer diagnosis can affect many aspects of a person's life, including areas that are often difficult to discuss. Treatments such as surgery, radiation therapy, chemotherapy, and hormone therapy can impact bladder function, bowel function, sexual health, pelvic pain, and overall quality of life. Fortunately, specialized pelvic floor physical therapy can help patients manage many of these challenges and regain confidence in their bodies.

What Is Pelvic Health Oncology?

Pelvic health oncology focuses on the unique physical and functional challenges experienced by individuals who have been diagnosed with cancers that affect the pelvic region. These may include:

• Gynecologic cancers (cervical, uterine, ovarian, vulvar, and vaginal cancers)

• Prostate cancer

• Colorectal and anal cancers

• Bladder cancer

• Other cancers requiring pelvic surgery, radiation, or chemotherapy

Cancer treatments can be lifesaving, but they may also create lasting changes in the muscles, nerves, connective tissues, and organs of the pelvis. These changes can affect everyday activities and significantly impact quality of life.

Common Symptoms After Cancer Treatment

Many patients are surprised to learn that symptoms they experience after treatment are common and highly treatable. These may include:

Bladder Dysfunction

• Urinary leakage or incontinence

• Urinary urgency or frequency

• Difficulty fully emptying the bladder

Bowel Dysfunction

• Constipation

• Fecal urgency

• Bowel leakage

• Difficulty with bowel movements

Pelvic Pain

• Pain in the pelvis, hips, tailbone, or lower abdomen

• Pain related to scar tissue

• Persistent discomfort after surgery or radiation

Sexual Health Concerns

• Pain with intercourse

• Vaginal dryness or tightness

• Erectile dysfunction

Musculoskeletal Changes

• Muscle weakness

• Reduced flexibility

• Scar tissue

• Fatigue and decreased endurance

Lymphedema

• Swelling in the legs, pelvis, or genital region due to lymph node removal or radiation treatment

How Pelvic Floor Physical Therapy Can Help:

• Improve Bladder Control: Following cancer treatment, some patients experience urinary leakage or urgency. Pelvic floor physical therapy can help strengthen and retrain the muscles responsible for bladder control to improve continence.

• Address Pelvic Pain: Surgery, radiation, and scar tissue can contribute to pain and restricted movement. Physical therapists use techniques such as soft tissue mobilization, stretching and relaxation strategies to help reduce discomfort and improve overall function.

• Support Sexual Health: Cancer treatments may affect sexual function in both men and women. Pelvic floor physical therapy can help address muscle tension, pain, tissue restrictions, and pelvic floor dysfunction that contribute to sexual health concerns.

• Restore Strength and Mobility: Many patients experience weakness and deconditioning during or after treatment. A physical therapist can develop a personalized exercise program to improve strength, endurance, and overall physical function.

• Manage Scar Tissue and Radiation Effects: Radiation therapy and surgery can lead to tissue tightness and reduced flexibility. Treatment may include gentle stretching, scar tissue mobilization, and vaginal or anal dilator training.

•  Assist with Lymphedema Management: For patients experiencing cancer-related lymphedema, specially trained therapists may provide manual lymphatic drainage, compression recommendations, and exercise guidance to help manage swelling.

When Should You Seek Pelvic Floor Physical Therapy?

You do not need to wait until symptoms become severe. Pelvic floor physical therapy can be beneficial:

• Before cancer treatment to establish a baseline and prepare for recovery

• During treatment to address emerging symptoms

• After treatment to restore function

• Years after treatment if symptoms develop or persist

The Bottom Line

Cancer treatment can have lasting effects on pelvic health, but many of these challenges are manageable with the right support. Pelvic floor physical therapy offers a safe, evidence-based approach to addressing bladder and bowel dysfunction, pelvic pain, sexual health concerns, weakness, and other treatment-related side effects.

If you or a loved one has undergone cancer treatment and is experiencing pelvic health concerns, know that help is available. Pelvic floor physical therapy can be an important part of recovery, helping individuals return to the activities they enjoy and improve their overall quality of life. If you're experiencing pelvic health symptoms during or after cancer treatment, speak with your healthcare provider about whether pelvic floor physical therapy may be right for you.