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physical therapy for pelvic cancer
Photo by Ashwin Vaswani on Unsplash

Specialized Physical Therapy after Pelvic and Breast 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. Physical Therapy after breast cancer can help manage lymphedema (several of our DPTs are also Certified Lymphedema Therapists) and restore upper extremity strength and mobility.

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. Both men and women are at risk for breast cancer, however it it much more common in women. Physical therapy for pelvic and breast cancer can help reverse the negative symptoms and side effects from the medical treatments performed.

Treatment of Gynecologic and Breast Cancers

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

Types of Treatment

Gynecologic and Breast 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 both gynecologic and breast cancer treatment that oncologists don’t often talk about, But there are treatments to help, including the type of physical therapy for pelvic and breast 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 sexual function.

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 the initial cancer treatment has ended. If you are currently experiencing these effects you are not alone, and we do offer customized treatments to help support your return to exercise, return to sex and return to thriving.

How Pelvic Floor Physical Therapy Can Help

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

  • Our comprehensive cancer survivor and thriver rehabilitation program, including Lymphedema therapy with Complete Decongestive Therapy.
  • Dilator therapy to help with pain with penetrative intercourse and to prevent or reverse scarring if your vaginal tissues are affected
  • Scar tissue remediation over surgical sites.
  • Exercises for your whole body, including pelvic muscles, to help improve bladder issues, 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 irritation and dryness—including vaginal lubricants and moisturizer recommendations
  • Manual lymphatic drainage for tight, aching, or provoked pain in extremities, vulva, breast, armpits, and chest wall or lymphedema
  • Therapeutic yoga and/or pilates 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—and 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 physical therapist.
    Get a comprehensive evaluation with one of our pelvic floor physical therapists 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 breast and pelvic cancer. Your sexual health 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 Ann V.

I wish i could give this place 10 stars!! 
I have been suffering from vaginismus for 5 years and never found the cure to it. I had seen an ob/gyn and he diagnosed me with vaginismus and told me i needed a surgery to cure my condition, which i refused to do. He also referred me to a PT that he works with, i had given them multiple calls and they never responded back to me, so i started searching yelp for another PT. I am SO HAPPY I found Heather's office! I was working with Laureen, and with her guidance and techniques i was able to be cured from vaginismus in only 2 1/2 short months!!! I couldn't believe how quickly their program worked for me! I am forever grateful and thankful from Heather, and Laureen! They are the absolute best at what they do!

Read more: Testimonial by Ann V.

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

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 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 M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

Read more: Testimonial by P.M.

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