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physical therapy for pelvic cancer
Photo by Ashwin Vaswani on Unsplash

Specialized Physical Therapy for Pelvic Cancer Treatment

Physical therapy for pelvic cancer can relieve pain with sex and general pelvic pain that results from gynecological cancer of the female reproductive organs.

Types of Gynecologic Cancer

  • Cervical cancer begins in the cervix, which is the lower, narrow end of the uterus. (The uterus is also called the womb.)
  • Ovarian cancer begins in the ovaries, which are located on each side of the uterus.
  • Uterine cancer begins in the uterus, the pear-shaped organ in a woman’s pelvis where the baby grows when she is pregnant.
  • Vaginal cancer begins in the vagina, which is the hollow, tube-like channel between the bottom of the uterus and the outside of the body.
  • Vulvar cancer begins in the vulva, the outer part of the female genital organs.
    CDC, 2020

Each of these types of cancers has different signs and symptoms, varying risk factors, and different prevention strategies. All women are at risk for gynecologic cancers, and risk increases with age. Physical therapy for pelvic cancer can help reverse the negative symptoms of many forms of pelvic cancer.

Treatment of Gynecologic Cancer

According to the CDC, when gynecologic cancers are found early, treatment is more effective.

Types of Treatment

Gynecologic cancers are treated in different manners, depending on the type of cancer and its spread (stage). Women with a gynecologic cancer often get more than one kind of treatment.

  • Surgery: Doctors remove cancer tissue in an operation.
  • Chemotherapy: Using special medicines to shrink or kill the cancer. The drugs can be pills you take or medicines given in your veins, or sometimes both.
  • Radiation: Using high-energy rays (similar to X-rays) to kill the cancer.

Sexual Problems and Cancer Treatment

Sexual problems are a side effect of cancer treatment that oncologists don’t often talk about, but there are treatments to help, including the physical therapy for pelvic cancer that we do at Femina. Surgery, chemotherapy, radiation, hormonal therapy, stem cell transplantations, and other procedures can negatively affect quality of life, including sexual health and happiness. These side effects are not limited to cancers of the sexual organs either. Cancer treatment anywhere in the body (cervix, breast, throat, GI tract) can lead to changes in sexuality.

Up to 64% of women affected by cancer experience “altered sexuality”—their sex lives just feel different than they did before. There are physical side effects like fatigue, nausea, dry, painful, itchy, and burning vaginal tissues, and hormonal changes which make sex unappealing and painful. Altered self-image, depression, and anxiety can make it hard to connect with others and feel intimacy. These effects can last years after cancer treatment. If you are currently experiencing these effects you are not alone, and there are treatments using physical therapy for pelvic cancer that can help.

How Pelvic Floor Therapy Can Help

The therapists at Femina can help with some of the sexual problems that you may be feeling. Therapy may include:

  • We offer a comprehensive cancer survivor rehabilitation program, including Lymphaedema therapy.
  • Dilator therapy to help with pain with penetration and to prevent or reverse scarring if your vaginal tissues are affected
  • Exercises for pelvic muscles to lower pain, improve bladder retention, improve bowel function, and increase the flow of blood to the area, which can improve your sexual health
  • Skincare and hygiene regimens to reduce vulvar tissue thinning, irritation, and dryness—including vaginal lubricants and moisturizers
  • Manual lymphatic drainage for tight, aching, or provoked pain in extremities, vulva, breast, armpits, and chest wall
  • Therapeutic yoga to improve lymphatic drainage and reduce chronic pain
  • Neuromuscular re-education and autogenic relaxation to reduce chronic muscle over-activity, reduce pain, and improve sleep

Consult with your Doctor

Unfortunately, not all doctors and nurses are equipped or comfortable with asking about sexual health. Most women can be sexually active during treatment, but you’ll want to confirm this with your doctor. You have every right to bring it up—be empowered to do so.

Sage Bolte, PhD, LCSW, OSW-C, CST, offers the following suggestions in her article, Your Sexual Health and Cancer: What to Know, What to Do” for the American Society of Clinical Oncology:

Write Down Questions and Requests Before Your Appointment

It's easier to remember things you want to bring up with your doctor before your visit. If you are feeling shy, you might even be able to show it to them.

Example: I am experiencing pain with penetration and vaginal dryness. I would like a referral to a pelvic floor therapist to address these issues.”

Write down your questions and requests and hand them to your health care provider or email/fax them before your next appointment. You can also bring someone with you to your appointment to help you address your concerns.

If you are having sexual pain right now: What you can do

  • Schedule an appointment with your doctor.
    Ask a health care professional to explore potential causes and treatments for changes in your sexual health and function.
  • Schedule an appointment with a pelvic floor therapist.
    Get a comprehensive evaluation with a pelvic floor therapist to establish a treatment plan and goals for your road to sexual health and recovery.
  • Explore other avenues for intimacy.
    Sex isn’t the only form of intimacy. Skin is the largest sex organ and the brain is the most important sex organ. Don’t be afraid to explore. If you need more support, consider finding a therapist who specializes in sexuality.
  • Plan for sex and intimacy.
    Engage in sex and intimacy during the times of day you have the least fatigue or feel at your best. Time sex and intimacy with your medication schedule so that you don’t feel nauseous or tired. Adjust the temperature of the room so you are comfortable and have any supplies (lubes, condoms) nearby.
  • Communicate your needs.
    Ask for what you want and need from your partner(s) and health care team. You possess the best knowledge of what you are feeling and what you need.
  • Take it easy.
    Rest during sex if you need to; it’s not a marathon.

Whatever your path is, you have many options to explore, including physical therapy for pelvic cancer. Your sexuality is important, and you should feel empowered to bring it up with your team of providers.


 

 

Resources:

Coady D, Kennedy V. (2016). Sexual Health in Women Affected by Cancer: Focus on Sexual Pain. Obstet Gynecol. 128(4):775-91
https://www.ncbi.nlm.nih.gov/pubmed/27607852

National Cancer Institute. (ND). Sexual Health Issues in Women.
https://www.cancer.gov/about-cancer/treatment/side-effects/sexuality-women

CDC. What is Gynecologic Cancer.
https://www.cdc.gov/cancer/gynecologic/basic_info/what-is-gynecologic-cancer.htm

CDC. How are Gynecologic Cancers Treated?
https://www.cdc.gov/cancer/gynecologic/basic_info/treatment.htm

CDC. What are the Symptoms of Gynecologic Cancer?
https://www.cdc.gov/cancer/gynecologic/basic_info/symptoms.htm

CDC. What Can I Do to Reduce My Risk?
https://www.cdc.gov/cancer/gynecologic/basic_info/prevention.htm

Bolte, S. (2017). Your Sexual Health and Cancer: What to Know, What to Do.
https://www.cancer.net/blog/2017-03/your-sexual-health-and-cancer-what-know-what-do

What Our Patients Have to Say

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Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

Testimonial by Lauren B.

Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

Read more: Testimonial by Lauren B.

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

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