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Pelvic floor problems can affect anyone, including people with cancer. In fact, certain types of cancer, like cervical cancer or prostate cancer, can damage the pelvic floor. So can some cancer treatments, like surgery or radiation therapy. The good news? With the help of pelvic floor therapy, you can rebuild your pelvic floor strength to get the support you need.

The pelvic floor muscles play a big role in controlling your bladder and bowels and supporting sexual health. Damage to these muscles can cause problems like incontinence or pelvic pain. Whether you¡¯re dealing with prostate, bladder, ovarian, endometrial, or other cancers that affect the lower abdomen, your pelvic floor may need extra support.

¡°Pelvic floor therapy is really important for quality of life. While these issues are sometimes difficult or embarrassing to talk about, limiting pain, having regular bowel and bladder function, and being able to have a healthy sex life is hugely important,¡± said Lan Coffman, MD, PhD, an expert and Associate Professor of Hematology-Oncology at the University of Pittsburgh School of Medicine.

Benefits of pelvic floor therapy during cancer

The pelvic floor is a group of muscles, ligaments, and tissues that are like a sling or hammock at the bottom of your pelvis. The pelvic floor muscles hold up important organs like the bladder, vagina, uterus, and rectum. That¡¯s why keeping them strong matters. The main benefit of pelvic floor therapy during cancer is restoring pelvic function.

¡°Pelvic floor therapy is like physical therapy to strengthen all the muscles and tissues in your pelvis that can become weak after treatment for cancer, particularly for gynecologic or urologic cancers,¡± said Dr. Coffman.

Pelvic floor therapy can help with problems like:

• Bladder problems and incontinence, such as leaking urine
• Bowel problems, including constipation or trouble controlling bowel movements
• Sexual problems, such as erectile dysfunction or pain during sex
• Bladder, bowel, or pelvic pain
• Pelvic organ prolapse, when a pelvic organ drops from its usual position

Issues like these can happen during cancer for different reasons. Sometimes the location of a tumor causes pelvic problems. Or, if you have surgery to remove cancer in a pelvic organ, you might experience side effects that can affect the pelvic floor. These problems can have an impact on your overall quality of life. Pelvic floor therapy can help you regain the functions you need to live more comfortably with cancer.

What happens during pelvic floor therapy?

First, ask your doctor for a referral to a pelvic floor therapist. Cancer treatment centers often have pelvic floor therapists who specialize in helping patients. ¡°If a patient doesn¡¯t seek help from a pelvic floor therapist, the symptoms are unlikely to improve and can get worse,¡± said Dr. Coffman. ¡°The sooner someone receives help, the sooner their function will improve.¡±

After you get a referral, you¡¯ll meet with a pelvic floor therapist. They¡¯ll ask about your cancer diagnosis and the treatments you¡¯ve received. They¡¯ll also ask about any problems you¡¯re having. Then the therapist might perform an internal pelvic exam. The exam helps them evaluate the strength and mobility of your pelvic floor muscles. Once they understand the impact of cancer on your pelvic floor, they¡¯ll recommend a treatment plan.

The options your therapist might recommend include:

• Pelvic floor muscle strengthening exercises, such as Kegels
• Stretching exercises to relax your pelvic floor muscles
• Education on bladder and bowel habits, such as the best posture to use on the toilet
• Biofeedback therapy, which involves retraining the muscles
• Electrostimulation, which uses a low electrical current to encourage your muscles to contract
• Vaginal dilators, which stretch the vaginal tissue to help relieve pain

Be open with your therapist about what you are or aren¡¯t comfortable with. They¡¯ll work with you to tailor treatment based on your needs and comfort level.

Many pelvic floor exercises can be done at home. But remember to get guidance from a trained pelvic floor therapist first. ¡°A therapist who specializes in pelvic floor rehabilitation can offer individualized and effective treatment in a comfortable, private space. Although there are many online resources, one-on-one attention is best,¡± said Lisa Mager, PT, MPT, CLT-LANA, WCS, a physical therapist specializing in pelvic health and oncology at the University of Pittsburgh Medical Center.

How can you tell if you need pelvic floor therapy during cancer?

If you¡¯re in or about to begin cancer treatment, ask your doctor if the treatment might lead to pelvic issues. If so, ask if they recommend pelvic floor therapy. ¡°Be sure to raise any concerns you have regarding symptoms in the pelvic region,¡± said Dr. Coffman.

You should also talk to your doctor if you start having a hard time with any pelvic functions as treatment continues. They can advise you on whether pelvic floor therapy might help. ¡°I encourage patients to speak honestly with their health care team about any symptoms they have,¡± said Mager. ¡°No one should have to struggle with pelvic problems during cancer.¡±

Learn more from the American Cancer Society:

• Anatomy of the female genitourinary system
• Anatomy of the male genitourinary system

Dr. Coffman is a member of .