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Rehabilitating Pelvic Floor Muscles after Cancer Treatment

A recent systematic review by Bernard et al (2016) looked at the effects of radiation therapy on the structure and function of the pelvic floor muscles of patients with cancer in the pelvic area. Although surgery and chemotherapy are often used treatment approaches in the management of pelvic cancers, this paper specifically focused on radiation therapy: ‘… is often recommended in the treatment of pelvic cancers. Following radiation therapy, a high prevalence of pelvic floor dysfunctions (urinary incontinence, dyspareunia, and fecal incontinence) is reported. However, changes in pelvic floor muscles after radiation therapy remain unclear. The purpose of this review was to systematically document the effects of radiation therapy on the pelvic floor muscle structure and function in patients with cancer in the pelvic area.’

The paper concluded that ‘…There is some evidence that radiation therapy has detrimental impacts on both pelvic floor muscles' structure and function’ and that ‘A better understanding of muscle damage and dysfunction following radiation therapy treatment will improve pelvic floor rehabilitation and, potentially, prevention of its detrimental impacts.’

Pelvic floor therapists already working in the field of gynecologic oncology will be all too aware of the impacts clinically and functionally on pelvic cancer survivors’ quality of life. We are in a privileged position to provide an evidence based and solution focused approach to the pelvic health issues that are so often under-recognized, and frankly under-addressed for women undergoing treatment for pelvic cancers.

Whether it is advice on managing anal fissures (skin protection, down-training overactive pelvic floor muscles, achieving good stool consistency, teaching defecatory techniques) or dealing with dyspareunia (dilator or vibrator selection, choosing and using an appropriate lubricant, dealing with the ergonomic or orthopedic challenges that can be a barrier to returning to sexual function and enjoyment), pelvic rehab practitioners are probably the best clinicians for optimizing a return to both pelvic and global health during and after treatment for pelvic cancers.

"Pelvic Floor Rehab Physiotherapy is effective even in gynecologic cancer survivors who need it the most"

But one of the biggest barriers we face is lack of awareness – on the part of the patients but also, unfortunately the lack of awareness in the medical and oncology community about the benefits of pelvic rehab. Happily this situation is improving – not only is the evidence base expanding from the researchers, but oncologists are recognizing that pelvic rehab is a key component of regaining quality and not just quantity of life after treatment ends. As Yang reported in his 2012 paper – pelvic floor rehab programs improve pelvic floor function (particularly urinary continence and sexual function) and overall quality of life in gynecologic cancer patients. And perhaps, most heartening of all, was his statement that "Pelvic Floor Rehab Physiotherapy is effective even in gynecologic cancer survivors who need it the most"

You can learn more about pelvic floor muscle rehabilitation for cancer patients by attending "Oncology and the Female Pelvic Floor: Female Reproductive and Gynecologic Cancers" on April 29-30, 2017 in Maywood, IL.


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.’ J Cancer Surviv. 2016 Apr;10(2):351-62. doi: 10.1007/s11764-015-0481-8. Epub 2015 Aug 28. Bernard, S. et al
Effect of a pelvic floor muscle training program on gynecologic cancer survivors with pelvic floor dysfunction: a randomized controlled trial.’ Gynecol Oncol. 2012 Jun;125(3):705-11. doi: 10.1016/j.ygyno.2012.03.045. Epub 2012 Apr 1. Yang EJ, et al

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Upcoming Continuing Education Courses

Nutrition Perspectives for the Pelvic Rehab Therapist - Remote Course

Dec 3, 2021 - Dec 4, 2021
Location: Replacement Remote Course

Mobilization of the Myofascial Layer - Self-Hosted

Dec 3, 2021 - Dec 5, 2021
Location: Self-Hosted Course

Mobilization of the Myofascial Layer - Medford, OR Satellite Location

Dec 3, 2021 - Dec 5, 2021
Location: Asante Rogue Valley Medical Center

Mobilization of the Myofascial Layer - Derby, CT Satellite Location

Dec 3, 2021 - Dec 5, 2021
Location: Griffin Hospital

Mobilization of the Myofascial Layer - West Hills, CA Satellite Location

Dec 3, 2021 - Dec 5, 2021
Location: Touch of Life PT

CANCELED - Mobilization of the Myofascial Layer - Columbia, MO Satellite Location

Dec 3, 2021 - Dec 5, 2021
Location: Mizzou Therapy Services

CANCELED - Mobilization of the Myofascial Layer - Houston, TX Satellite Location

Dec 3, 2021 - Dec 5, 2021
Location: Memorial Hermann Health System

Mobilization of the Myofascial Layer - Madison Heights, MI Satellite Location

Dec 3, 2021 - Dec 5, 2021
Location: Team Rehabilitation Physical Therapy

Canceled - Mobilization of the Myofascial Layer - Jacksonville, FL Satellite Location

Dec 3, 2021 - Dec 5, 2021
Location: Summit Physical Therapy

Mobilization of the Myofascial Layer - Asheville, NC Satellite Location

Dec 3, 2021 - Dec 5, 2021
Location: Cornerstone Physical Therapy of North Carolina

Pelvic Floor Capstone - Wallingford, CT Satellite Location

Dec 4, 2021 - Dec 5, 2021
Location: Ivy Rehab Physical Therapy

Pelvic Floor Capstone - Self-Hosted

Dec 4, 2021 - Dec 5, 2021
Location: Self-Hosted Course

Pelvic Floor Capstone - Charlottesville, VA Satellite Location

Dec 4, 2021 - Dec 5, 2021
Location: Ivy Rehab Physical Therapy

Pelvic Floor Capstone - Charlotte, NC Satellite Location

Dec 4, 2021 - Dec 5, 2021
Location: Ivy Rehab Physical Therapy

Pelvic Floor Capstone - Virginia Beach, VA Satellite Location

Dec 4, 2021 - Dec 5, 2021
Location: Southeastern Physical Therapy

Pelvic Floor Capstone - Los Angeles, CA Satellite Location

Dec 4, 2021 - Dec 5, 2021
Location: Origin Physical Therapy

Pelvic Floor Capstone - Marietta, GA Satellite Location

Dec 4, 2021 - Dec 5, 2021
Location: Southern Pelvic Health

Pelvic Floor Capstone - Athens, GA Satellite Location

Dec 4, 2021 - Dec 5, 2021
Location: Thrive Integrated Medicine

Pelvic Floor Capstone - Richmond, VA Satellite Location (CANCELED)

Dec 4, 2021 - Dec 5, 2021
Location: Pivot Physical Therapy

Pelvic Floor Capstone Satellite Location - Livonia, MI

Dec 4, 2021 - Dec 5, 2021
Location: Mendelson Kornblum Physical Therapy

Pelvic Floor Capstone Satellite Location - Washington, DC

Dec 4, 2021 - Dec 5, 2021
Location: Georgetown University Hospital

Pelvic Floor Capstone Satellite Location - Wichita, KS

Dec 4, 2021 - Dec 5, 2021
Location: Summit Physical Therapy

Pelvic Floor Capstone - Greenville, SC Satellite Location

Dec 4, 2021 - Dec 5, 2021
Location: His Therapy

Biofeedback for Pelvic Muscle Dysfunction - Self-Hosted

Dec 4, 2021 - Dec 5, 2021
Location: Self-Hosted Course

Biofeedback for Pelvic Muscle Dysfunction - Tampa, FL Satellite Lab Course

Dec 4, 2021 - Dec 5, 2021
Location: Bloom Pelvic Floor Therapy & Wellness

Pelvic Floor Capstone - Garden City, NY Satellite Location

Dec 4, 2021 - Dec 5, 2021
Location: Metro Physical & Aquatic Therapy

Pelvic Floor Capstone - Houston, TX Satellite Location

Dec 4, 2021 - Dec 5, 2021
Location: Select Physical Therapy - Fannin

Doula Services and Pelvic Rehab Therapy - Remote Course

Dec 4, 2021
Location: Short Form Remote Course

Pelvic Floor Capstone - Lansdale, PA Satellite Location

Dec 4, 2021 - Dec 5, 2021
Location: Ivy Rehab Physical Therapy