Wednesday, October 17, 2012

Breast Cancer and the Pelvic Floor

In honor of Breast Cancer Awareness Month, this post is dedicated to those women who have been or are being treated for breast cancer. I want these brave women to know that there is help available for some of the secondary issues they may be dealing with due to breast cancer treatment.

So why would someone being treated for breast cancer need to see a pelvic floor physical therapist?

Well, you see, there is a common link between some causes of pelvic pain and breast cancer, and the culprit is hormones. Hormones occur naturally in the body and control the growth and activity of our cells. Unfortunately, two hormones - estrogen and progesterone- can help some types of breast cancer grow. Some breast cancer treatments reduce or block the amount of estrogen or progesterone in the body. The side effects of this treatment can include vaginal tissue thinning, dryness and irritation as well as weakness. All of these side effects can affect your pelvic floor and lead to a couple of difficult issues...pain with intercourse and incontinence.

Pain, dryness and irritation of the vagina, along with the stress that comes along with undergoing cancer treatment, can lead to dyspareunia (AKA - painful intercourse) and vaginismus (involuntary tightening of pelvic floor muscles). Weakness of the pelvic floor muscles due to treatment can lead to urinary or fecal leakage. These are some pretty major issues to have to deal with while undergoing treatment for breast cancer. The good news is that seeing a pelvic floor physical therapist can help.

A physical therapist that specializes in pelvic floor dysfunction can customize a treatment to address whatever issues you may be having due to cancer treatment. If you are having problems with urinary or fecal incontinence, a PT can instruct you in a rehabilitation program to strengthen your pelvic floor muscles and improve your bowel / bladder control and continence.

If your problem is pelvic pain, a PT can perform manual treatment to release tense pelvic muscles and release trigger points, which are hypersensitive areas in muscle that can contribute to pain. A PT will also instruct you in relaxation techniques and help you to improve your conscious control over your pelvic floor muscles. Therapy may also include education on care for vaginal tissue, appropriate types of lubrication and sexual positioning to decrease discomfort with intercourse.

Another side effect of breast cancer treatment, including chemo and radiation, can be decreased libido. This can be a result of fatigue due to treatment, changes in body image, pain with intercourse, and hormonal changes. A PT can instruct you in an appropriate and gentle exercise program as well as energy conservation techniques to decrease fatigue. They can use other alternative methods to increase your libido as well. A PT may also be able to refer you to a sex therapist that can be helpful in assisting with regaining intimacy during and after treatment.

If you are being treated for breast cancer and experiencing any of these issues, the first step to regaining control of your body is talking to your doctor and finding out if pelvic floor physical therapy may benefit you. Even though you are going through a lot during this time, there is no reason that you should have to suffer with these secondary issues. These problems can negatively affect your self esteem and have serious effects on your quality of life, so please don't suffer in silence!

A special thanks to Angela Wicker-Ramos, MPT, CLT, LANA, my co-worker and friend, for her expertise in this area!