The Vital Role of Pelvic Floor Therapy in Cancer Survivorship

Surviving cancer is an incredible achievement - but for many, the end of treatment marks the beginning of a new chapter that includes ongoing physical and emotional recovery. As a pelvic floor therapist, I have the privilege of helping cancer survivors navigate some of the most personal and often unspoken challenges that linger after treatment. One area that is frequently overlooked in the recovery journey is pelvic health.

The pelvic floor is a group of muscles and connective tissues that form a supportive hammock across the base of the pelvis. These muscles control vital functions such as urination, bowel movements, sexual function, and core stability. Cancer treatments - particularly those targeting the pelvic and abdominal regions - can cause significant disruptions to these functions. The good news is that pelvic floor therapy offers an evidence-based, empowering pathway to reclaiming function, confidence, and quality of life.

Pelvic Therapy: Restoring Bladder and Bowel Control

Pelvic therapy: Improving Sexual Function and Intimacy

Pelvic Therapy: Reducing Pelvic Pain and Tissue Restriction

Pelvic Therapy: Addressing Postural and Core Stability Changes

1. Restoring Bladder and Bowel Control

One of the most common complaints among cancer survivors - especially those treated for prostate, bladder, colorectal, or gynecologic cancers - is incontinence. Treatments like prostatectomy, colon resection, radiation, and pelvic surgery affect the muscles and nerves that control the bladder and bowels, leading to leakage, urgency, or incomplete emptying.

Through pelvic floor muscle training, we teach patients how to properly contract and relax these muscles as well as optimize the mobility of surrounding soft tissues. This improves both strength and coordination, reducing incontinence episodes and helping survivors regain control over their bladder and bowel functions. This isn't just about physical relief - restoring continence profoundly improves daily confidence, social engagement, and emotional wellbeing.

2. Reducing Pelvic Pain and Tissue Restriction

Many survivors, especially women treated for gynecologic or colorectal cancers, suffer from chronic pelvic pain, often caused by scar tissue, radiation fibrosis, or nerve irritation. Pain may affect the vagina, rectum, tailbone, lower back, or hips - and it often interferes with sitting, walking, intimacy, and daily tasks.

We use manual therapy techniques like myofascial release, trigger point therapy, and internal soft tissue mobilization to reduce muscle tightness and improve tissue mobility. By addressing the source of the pain - not just masking it - we help patients move with greater comfort and freedom.

3. Improving Sexual Function and Intimacy

After cancer, many survivors experience dyspareunia (painful intercourse), vaginal dryness, loss of libido, erectile dysfunction, or altered body image. These issues are common after treatments such as chemotherapy (which can induce menopause), radiation (which can cause vaginal stenosis), or surgery.

Pelvic floor therapy supports sexual recovery through a combination of gentle muscle retraining, dilator therapy, scar tissue mobilization, and education. We also provide guidance on positioning, communication, and the use of lubricants or moisturizers. Addressing sexual health restores not only physical function but also emotional intimacy and self-esteem - core components of human connection and identity.

4. Addressing Postural and Core Stability Changes

The pelvic floor is a key part of the core muscle system, working with the diaphragm, abdominal muscles, and back muscles. Surgeries and inactivity during cancer treatment can weaken these systems, leading to poor posture, back pain, and balance issues.

Through a whole-body approach, pelvic floor therapy helps survivors rebuild strength, improve postural alignment, and increase confidence in movement. This makes a huge difference in energy levels and participation in daily activities.

5. Empowering Survivors Through Education and Support

Perhaps one of the most important aspects of pelvic floor therapy is the emotional transformation that takes place. Survivors often feel isolated or embarrassed by symptoms they were never warned about. We provide a safe, supportive, and nonjudgmental environment where people can talk openly about their experiences and learn how to advocate for their bodies.

Education is a critical piece - we teach patients about anatomy, normal function, healing timelines, and self-care tools. This knowledge gives people back a sense of agency in their recovery, which is profoundly empowering after the loss of control many experience during cancer treatment.

Pelvic Floor Therapy is Essential, Not Optional

Despite the clear benefits, pelvic floor therapy is still underutilized in cancer care. Many patients are never referred. But this is changing. As awareness grows and survivorship care evolves, more oncology teams are beginning to recognize that pelvic rehabilitation is not just helpful - it’s essential.

Cancer changes lives, but with the right support, survivors can heal more completely. Pelvic floor therapy offers a powerful combination of physical rehabilitation, emotional support, and restoration of dignity - allowing people to move forward with strength, confidence, and hope.

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References:

• Chang, J. I., Lam, V., & Patel, M. I. (2016). Preoperative pelvic floor muscle exercise and postprostatectomy incontinence: A systematic review and meta-analysis. European Urology, 69(3), 460–467.

• Hazewinkel, M. H., et al. (2010). Pelvic floor muscle training for the treatment of dyspareunia: A systematic review. International Urogynecology Journal, 21(12), 1497–1504.

• American Cancer Society. (2023). Cancer Treatment & Survivorship Facts & Figures.

• Cheville, A. L., et al. (2011). The integration of rehabilitation and supportive care into cancer care. PM&R, 3(5), 427–434.