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Cancer Rehabilitation Treatments for Pelvic Area Cancers and More
How can physical therapy support cancer rehab?
Physical therapy offers a wide range of treatments to support people recovering from injuries, surgeries, diseases, and other significant changes to someone’s physical function. Cancer rehabilitation is no different. Whether the treatments are surgical, from radiation therapy, or effects of chemotherapy; treatments for cancer often bring the need for rehabilitation. Side effects from cancer treatments can greatly impact quality of life in ways that physical therapists can help manage.
Physical therapists can work with a survivor with their specific needs and with any other health conditions they have to offer evidence based care.
Here are some ways PT can help:
- Flexibility and mobility training
- Pain reduction
- Specific exercise plans for strength and conditioning
- improving sexual health, function, and reducing pain
- Improving urinary function
- decreasing constipation
- Improving function in arms or legs
- Managing edema/lymphedema
- Improving mobility of scar tissue
- Improving balance to reduce risk of falls
Pelvic Floor Dysfunction
The abdomen and pelvis are central to so many of our bodily functions and our pelvic floor plays a significant role. Treatments for pelvic cancers such as prostate, anal, or gynecological cancers ( cervical, vulvar, uterine) can impact the strength, movement, and coordination of the pelvic floor. The pelvic floor helps support our pelvic organs and acts as a gateway for important bodily functions. Changes in sexual function, urinary or bowel function can have a significant impact on quality of life. Medical treatments to manage hormone sensitive cancers like prostate cancer or breast cancer can induce atrophy in the genitals and cause pain or erectile dysfunction. Pelvic floor physical therapy can help by improving muscle function, skin/tissue mobility, and even sexual function. When radiation is used as part of cancer treatment, pelvic PTs can help the patient improve bowel or sexual function with dilator training. Erectile dysfunction and urinary incontinence are common following a prostatectomy, but these side effects are treatable. Pelvic PTs can help train the muscles to decrease urinary incontinence and depending on the surgery pelvic PTs can also help improve or restore erectile function. For more information about pelvic floor dysfunction beyond cancer - click here.
Lymphedema
Lymphedema is a common consequence of cancer therapies. Surgical treatments and radiation therapy often involve the removal or irradiation of lymph nodes to prevent the spread of cancer. Once the lymphatic system has been impaired, it increases the risk of developing lymphedema - a protein rich edema that can occur in the affected region of the body. Lymphedema can form in the head and neck, breast, torso, arms, legs, and genitals. Breast cancer treatments are the leading cause of secondary lymphedema in the US. Physical therapists and certified lymphedema therapists can help manage lymphedema and improve quality of life. The standard of care for treating lymphedema is complete decongestive therapy which includes manual lymphatic drainage, compression therapy, exercise, and skin care. For more information on treatments for lymphedema, and a related condition - lipedema, read more on our sister website here.
Radiation Fibrosis
Oncologists often use radiation therapy to help stop cancer. For the areas treated, the body responds with inflammation, sclerosis, and fibrosis in what is known as radiation fibrosis. This is a progressive condition that can result in decreased range of motion in the limbs, feelings of tightness, and pain. Licensed physical therapists can help manage radiation fibrosis with flexibility training, education, and once healed - gentle manual therapy.
Cancer related fatigue
People undergoing cancer treatments often experience fatigue. Resistance and aerobic exercise can help manage fatigue and are associated with improved quality of life and also improve anxiety, depression, and physical functioning. Physical therapists can help develop a safe evidence based exercise plan to address these changes.
Axillary web syndrome
Another common side effect of breast cancer treatments is Axillary web syndrome also known as axillary cording. Cording can be very painful and limit the use of the affected arm. The exact causes and nature of cording are not fully understood. Common risk factors for AWS are lower body mass index, radiation therapy, lymph node biopsies, and being younger. Physical therapists can help by restoring range of motion and strength to the arm.
Cardiotoxicity
Many cancer survivors need additional support due to changes in their heart function caused by radiation, chemotherapy, and immunotherapy. Evidence supports the benefits of exercise for cancer survivors and individuals with heart disease. Physical therapists can coordinate with oncologists and cardiologists to offer safe exercise that will improve overall health and quality of life.
Links:
- CDC Physical Activity for Cancer Survivors
- American Cancer Society - Physical Activity and the Person with Cancer
- American Cancer Society - What is Cancer Rehab?
- ChoosePT - Physical Therapy Guide to Cancer
- National Lymphedema Network
Fusion Wellness is proud to offer a comprehensive cancer survivor rehabilitation program for men and women, including Lymphaedema therapy (complete manual decongestive therapy / manual lymphatic drainage), post radiation dilator use for pelvic area cancers, post-prostatectomy biofeedback for incontinence, garment recommendations, and more. On staff we have three Certified Lymphedema Therapists that work in our cancer rehabilitation program.
If you are ready to take the next step in recovery, please contact us for more information, we're here to help!
Additional references:
Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. 2019 Nov;51(11):2375-2390. doi: 10.1249/MSS.0000000000002116. PMID: 31626055; PMCID: PMC8576825.
Rizzo A. The Role of Exercise and Rehabilitation in the Cancer Care Plan. J Adv Pract Oncol. 2016 Apr;7(3):339-342. doi: 10.6004/jadpro.2016.7.3.20. Epub 2016 Apr 1. PMID: 29152403; PMCID: PMC5679055.
Sewell, S., & Cantu, E. (2024). Oncology Rehab A Pocket Guide (1st ed.). PDX CancerRehab LLC.
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