Restoring Pelvic & Sexual Health After Cancer Treatments

I Survived Cancer, Now What? 

When it comes to cancer, pelvic floor therapy is often the last thing on someone’s mind. This often holds true until a cancer survivor is perhaps trying to reestablish intimacy or a sex life with their partner after invasive medical treatments, tremendous stress, role changes from partner to caregiver and back to partner, bladder and bowel fluctuations, and immense bodily changes through treatment and healing. This is often when we get the call from clients that are going through this experience, wondering if this is where they should turn next for support and if it is too late to do so. 

TLDR (Too Long Didn’t Read): It is never too late. 

To give some context, pelvic cancers may include the larger categories of gastrointestinal, gynecological, and urogenital cancers. Within these categories, pelvic cancer may be more specific to a certain region, such as the bladder or cervix for instance. The range of treatments for cancer vary based on the type and severity of cancer. Some side effects from treatment, such as external beam or internal radiation, may be immediately noticeable during the time of treatments. However, other side effects are more long-term and can even be nonexistent before presenting months to years later. Pelvic floor therapy can help restore function and wellness as people experience these side effects, whether in the immediate days or weeks after treatments or even years later. 

How Can Pelvic Floor Therapy Help Me?

There are many changes to the pelvic structures and tissues following cancer treatments, which may include radiation cystitis, proctitis, pain with sex, radiation fibrosis, and stenosis. The often traumatic experience of cancer and its related treatments has a huge impact on mental health, bladder and bowel health, and sexual health. At Bloom Pelvic Therapy, we hope to bridge the gap in care to support clients throughout their cancer experience and survivorship while decreasing the time between cancer treatments and our clients receiving essential support.

When working with cancer survivors, we may hear that information on strategies such as dilators was provided when they were not in the right state of mind to absorb this information, let alone try this out at home. On the other side of the coin, we also hear that they feared to start pelvic floor therapy several years after their cancer treatments because they were worried it was “too late.” Again, it is never too late to get started with pelvic therapy. While early intervention is supportive in improving health and wellness, it is not a “lost cause” – we hear that one too – to begin pelvic floor therapy years after treatment. 

Home exercise programs (HEP) instructions, such as dilators, are often given directly after treatment, if at all, but then may leave the person without adequate resources for support as they are experiencing either long-term effects of treatment or have finally reached the state of readiness to implement. With using vaginal or rectal dilators as an example, it may be recommended to begin using them around 4 weeks or so after radiation. However, when to start and how to do so is dependent on that specific person’s needs, pain levels, goals, etc. Dilator training may continue for years or even a lifetime for continued, as-needed maintenance. Alterations to this plan are dependent on the specific person’s progress and needs, which is one of the reasons why it is important to collaborate with a pelvic floor therapist on which dilator(s) to use, for how long, when, and using which strategy/technique.

Aside from supporting clients with a home program, pelvic floor therapy in-office interventions may include manual therapies, which can be external and internal techniques to reduce scar tissue and myofascial restriction, which is often seen with stenosis and fibrosis. Restoring movement, mobility, and improving strength around the abdomen, pelvis, hips, and legs is essential to recovery after pelvic cancer treatments. 

Some of our favorites movements begin with may include diaphragmatic breathing, book openers, child’s pose, frog rock backs, figure-4 and may progress all the way up to core and full-body strengthening. You may be thinking, well that seems simple enough. However, it can be extremely confusing for people to navigate what is safe to implement after cancer treatments and when. Our pelvic floor therapists are skilled in helping guide clients through the just-right exercises in the just-right time for them.

What About Sex?

Returning to sex after cancer treatments can be challenging for clients and their partners to navigate. Between healing, tissue changes, hormone changes, libido fluctuations, and the overall mental load of cancer, seeing oneself as a sexual being can also be negatively impacted. Working with clients to restore their sexual health while helping them to reconnect with themselves and/or their partners is a huge part of pelvic rehabilitation that should not be overlooked. We recognize that it is not as simple as – “Just use these dilators and carry on.” Quality of life and satisfaction with participation in all of your daily life activities, including sex, is of utmost importance to us as we help our clients throughout their treatment plan. 

If you are curious if pelvic floor therapy can help you at your stage in your cancer journey, give us a call. One of our team members would be honored to share more information on how we can help.

References

Hill, A. (2024, September 27). Beyond the beam: Post-pelvic radiation therapy considerations [Conference presentation]. Pelvicon 2024, Atlanta, GA, United States.

Misher, C. (2024, August 14). Vaginal dilators for radiation therapy. OncoLink. Retrieved  October 2, 2024 from https://www.oncolink.org/support/sexuality-fertility/sexuality/vaginal-dilators-for-radiation-therapy