There are many different types of cancer whose treatments may impact the ability of the pelvic floor muscles to function properly. These types of cancer include, but are not limited to, uterine, cervical, vulvar, ovarian, prostate, colon, rectal, and anal cancers. Most often, patients will undergo surgery, radiation therapy, chemotherapy, or a combination of these. The impacts from each of these treatments may impact the pelvic floor in different ways.
Surgery can disrupt muscle fibers or the nerves that supply sensation. This may impact a person’s ability to effectively contract the pelvic floor muscles which may contribute to incontinence. Surgery can result in scar tissue formation which may lead to muscle tension, pelvic pain, pain with intercourse, as well as muscle weakness. Alterations in hormones may also take place with removal of reproductive organs which can impact libido and a variety of other processes.
Chemotherapy has a high impact on mucosal membranes which may contribute to sores, decreased lubrication, and overall irritation of the tissues. This process may contribute to pain during intercourse and can potentially increase pelvic floor muscle tension.
If radiation is required, fibrosis of the tissues may occur. Tissue fibrosis is a hardening of the tissues which can impact the ability of the pelvic floor muscles to contract and prevent bowel/bladder leakage and can cause the muscles/tissues to have difficulty stretching which can contribute to pelvic pain, bowel/bladder urgency, and sexual dysfunction.
Although these treatments may contribute to pelvic floor dysfunction, there is good news! Research has shown that pelvic floor physical therapy can decrease the occurrence of pelvic floor dysfunction and improve quality of life in cancer survivors. A pelvic floor physical therapist may work on pelvic floor muscle strengthening to help with incontinence. Alternatively, they may begin working on scar tissue mobilty and techniques to decrease pelvic floor muscle tension which can help reduce pain and bowel/bladder urgency.