Side Effects of Cancer Treatment Affects Pelvic and Sexual Health

Treatments for Gynecologic Cancers Can Affect Sexual Function and Responses to Intimacy

Side effects of gynecologic cancer and its treatment can affect sexual identity and sexual health

While many of the side effects of cancer and its treatment cannot be seen, they can still have a detrimental effect on cancer patients' sense of well-being and quality of life. One of these is the side effects that cancer treatments such as radiation and chemotherapy have on pelvic and sexual health.

According to the University Health Network, the changes experienced from treatments for gynecologic cancers can affect patients' sexuality in different ways, both directly and indirectly. It often involves a lot of creativity, communication and patience to copy with them while dealing with cancer and still maintain a sexual identity and sexual health.

Vaginal Stenosis, Pelvic Floor Muscle Weakness and Urinary Incontinence Can Result from Gynecologic Cancer and Its Treatment

Some of the ways that cancer and its treatments can impact healthy pelvic and sexual function are:

• Radiation to the pelvis can cause vaginal dryness and stenosis (narrowing and shortening of the vagina) that can lead to pain with penetration or intercourse ("dyspareunia") or even pelvic exams that are so important for cancer reoccurence monitoring
• Pelvic radiation and chemotherapy can lead to pelvic floor muscle wasting and weakness which can lead to urinary/fecal incontinence and even pelvic organ prolapse

Pelvic Floor Rehabilitation Can Help Restore Sexual Function and Pelvic Health After Cancer

At Cancer Rehab Canada, a trained pelvic health physiotherapist can be an invaluable resource to help cancer patients overcome the side effects that cancer treatment may have on their sexual and pelvic health. According to Liane McCabe, Physiotherapist at the LifeMark Bathurst Clinic, pelvic floor rehabilitation includes:

• Teaching patients how to locate and strengthen pelvic floor muscles to improve bowel/bladder control or pelvic organ prolapse
• Teaching patients how to relax and stretch tight pelvic floor muscles to make sexual intercourse and pelvic examinations less painful
• Educating patients on techniques to improve the health of their vaginal tissues

For more resources on cancer and sexual and pelvic health please visit:
Canadian Cancer Society – Sexuality and Cancer
University Health Network Gynecologic Cancers
Ovarian Cancer Canada
Foundation for Women’s Cancer

Please contact one of our 62 Cancer Rehab locations across Canada. Links will direct to a Cancer Rehab provider in your area.

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Cancer Rehabilitation: An Update and Discussion on Future Care

Workshop by Dr. Julie Silver at American Congress of Rehabilitation Medicine

Nicole Stout and Dr. Julie Silver at the American Congress of Rehabilitation Medicine in Toronto Oct 8, 2014

Today at the American Congress of Rehabilitation Medicine, I was fortunate to have attended a workshop with Dr. Julie Silver, co-founder of Oncology Rehab Partners, an associate professor at Harvard and a breast cancer survivor. I have been reading her cancer rehab research over the past couple years and it was a thrill to hear her speak.

Her message to the medical professionals (oncologists, physiotherapists, physiatrists, nurses) in the room was simple. Cancer cases are expected to surge by 57% worldwide in the next 20 years. People are surviving cancer like never before, but many are living with impairments. Cancer rehabilitation should be provided to address these impairments and yet their needs are consistently not being met leading to disability that could have been prevented.

Nicole Stout Spoke on the Value of Cancer Rehabilitation to Policy Makers and Clinicians

The second speaker of the day, was Nicole Stout, a physical therapist and clinical researcher for the National Institute of Health. She is best known for the Prospective Surveillance Model for Breast Cancer patients. Once again I was awed to be in her presence as she has done so much to elevate the profession of physical therapy with her cancer rehab research and her involvement with policy development on many levels. She feels that the value of Cancer Rehabilitation is finally being appreciated by policy makers and clinicians across the USA, but we are still having difficulty operationalizing its delivery.

Highlights of the 2013 Institute of Medicine Report "Delivering High Quality Cancer Care" 

The 2013 Institute of Medicine report on “Delivering High Quality Cancer Care” concluded that we need to re-examine how we can work together to improve the quality of life and outcomes for people facing a cancer diagnosis. In Canada, it seems that Cancer Rehabilitation is often considered optional and it is time that we include it as part of our standard of care for all cancer patients. This would involve a shared model of care, where the every patient is screened for impairments along their continuum of care and the appropriate rehab intervention is provided in an effort to avoid chronic disability and instead return them to happy and productive lives.


Please contact one of our 62 Cancer Rehab locations across Canada. Links will direct to a Cancer Rehab provider in your area.

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Pelvic Health Physiotherapy Can Assist with Prostate Cancer & Treatment Side Effects

By Laura Ritchie, MPT, MCISc (Manip), FCAMPT Registered Physiotherapist,  Centric Health Physiotherapy and Wellness, London, Ontario

Prostate Cancer and its Treatment Discussed in Webinar by Dr. Bobby Shayegan

On October 3, 2014 I listened to an interesting webinar on prostate cancer and its treatment, presented by Dr. Bobby Shayegan and hosted by the Canadian Cancer Survivor Network.

Dr. Shayegan is currently an associate professor in the department of surgery at McMaster University.  He received his MD and completed his urology residency from the University of Toronto.  He subsequently pursued a fellowship in urologic oncology at Memorial Sloan-Kettering Cancer Center.

After the webinar I asked Dr. Shayegan a question about the potential side effects of treatment for this type of cancer. He reported that stress incontinence is a common short-term concern following surgery, while urgency incontinence and bleeding are more likely following radiation therapy.

Dr. Shayegan added that sexual dysfunction can occur with both types of treatment and that with radiation in particular, at least half of patients develop erectile dysfunction over time (but not necessarily right away).

How Physiotherapists with Specialized Training in Cancer Rehabilitation Can Help with Prostate Cancer Side Effects

Pelvic Health Physiotherapy can assist with both urological and sexual dysfunction.

Dr. Shayegan also reported bones can become thinner and weaker as a result of treatment and that weight-bearing is recommended to counter this. Physiotherapists with specialized training in Cancer Rehabilitation can prescribe a safe and effective exercise program for this purpose.

The webinar is still available for viewing on the CCSN website.

Please contact one of our 62 Cancer Rehab locations across Canada. Links will direct to a Cancer Rehab provider in your area.

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LifeMark-Centric Health Proud Sponsor of Calgary Run For The Cure

Calgary Team Assembles for CIBC Run For the Cure

LifeMark-Centric Health has entered a team for the CIBC Run/Walk For the Cure for the past several years

For the past several years, LifeMark-Centric Health has entered a team for the CIBC Run/Walk For the Cure, and this year is no exception! Headed by Barb Morrison, the goal is to have 50 walkers and runners participating on the LifeMark-Centric Health team. Anyone wishing to help build the team or donate can do so at the registration page.

LifeMark-Centric Health Massage Therapists and Physiotherapists Donate Their Time at the Run

Several LifeMark massage therapists and physiotherapists in Calgary will be volunteering their time at the Calgary Run For the Cure. They are offering free massage and physio treatments to participants and attendees who need to get the kinks out and sore muscles soothed.

LifeMark massage therapists and physiotherapists in Calgary volunteer their time at the event

New T-Shirts Accentuate Cancer Rehab's Focus on Your Care

The new t-shirts for Team LifeMark-Centric Health were designed by Barb Morrison, LifeMark Clinic Director

Barb has designed special Cancer Rehab t-shirts for the event which will be worn proudly by the LifeMark-Centric staff.

LifeMark-Centric Health Booth Informs Calgary Run For the Cure Participants of the Benefits of Physiotherapy

Calgary LifeMark staff put the finishing touches on the Calgary Run For the Cure booth

The LifeMark-Centric Health booth has a wealth of information describing how physiotherapy can help you. Along with cancer rehabilitation, other techniques address pain management, dizziness, orthotics and bracing, post-surgical rehabilitation and sports injuries.

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How to Get Cancer Rehabilitation

Please contact one of our 62 Cancer Rehab locations across Canada. Links will direct to a Cancer Rehab provider in your area.

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Managing Side Effects of Ovarian Cancer Treatment with Cancer Rehab

Cancer rehabilitation can help manage the side effects of ovarian cancer treatment

September is Ovarian Cancer Awareness Month

For ovarian cancer patients, cancer rehabilitation can help manage the pelvic pain, urinary incontinence and vaginal stenosis often experienced after cancer treatment. Specially trained pelvic health physiotherapists who have received additional training typically perform an internal examination of the musculature of the pelvic floor. This examination will determine whether there are areas of scar adherence or weak musculature that can be addressed through rehab techniques. Internal treatment techniques for the pelvic floor muscles as well as connective tissues and nerves can address these pelvic floor disorders. A good resource to find out more about pelvic floor rehabilitation is Pelvic Health Solutions.

Follow-up after treatment of ovarian cancer often involves physical exams and blood tests for tumor markers that help identify whether the cancer will come back. But when discussion with your doctor includes what you can do about other side effects of ovarian cancer treatment, that's where cancer rehabilitation can also help.

Exercise prescriptions provided by cancer rehab professionals can go a long way in reducing the pain and fatigue often experienced by ovarian cancer patients. Pain and parathesia are also managed by acupuncture and TENS - both good ways to manage symptoms with reduced medication.

Cognitive Behavioural Techniques Help Overcome Hormonal Changes, Anxiety and Depression

Hormonal changes, anxiety and depression are other effects sometimes experienced by ovarian cancer patients after surgery, chemotherapy and radiation therapy. Cognitive behavioural techniques used by occupational therapists are often helpful in overcoming these issues and can provide you with the emotional strength to return to living a full life again. In addition, acupuncture, exercise, and massage therapy all help to reduce anxiety and promote relaxation.

Knowledge of Ovarian Cancer Signs and Symptoms Needed

Ovarian Canada states that when it comes to ovarian cancer, knowledge is power. Ovarian cancer is diagnosed annually in nearly a quarter of a million women globally, and in Canada there are 17,000 women living with this disease. Since it is very difficult to detect ovarian cancer and there is no early detection test for it, the national organization has a goal of spreading awareness of the signs and symptoms to help detect it.

Please contact one of our 62 Cancer Rehab locations across Canada. Links will direct to a Cancer Rehab provider in your area.

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Recommendations for Men's Cancer Awareness Signal Need for Cancer Rehab Services

Cancer rehabilitation and pelvic health physiotherapy can help overcome the side effects of cancer treatment

Recommendations for Men's Cancer Health Awareness

Prostate Cancer Canada's recommendations urge men to have baseline PSA testing in their 40s rather than waiting until they are in their 50s. Risk factors include diet, age, race, lifestyle and family history. There are a number of nationwide events being held to raise awareness of prostate cancer.

The Role of Cancer Rehab in Prostate Cancer Treatment

Cancer rehab and physiotherapy can help prostate cancer patients manage the side effects of prostate cancer treatment. With approximately 25% of all new cancer cases diagnosed in Canada being for prostate cancer and an estimated 23,600 Canadian men diagnosed with the disease in 2013, there is a growing need for rehabilitation services for prostate cancer patients.

Exercise prescriptions are also an integral part of cancer rehabilitation. A study lead by the Jonsson Comprehensive Cancer Center, University of California reported that exercise and diet can actually reduce prostate cancer risk, in addition to helping prostate cancer patients with pain and fatigue.

Physiotherapy Treatment for Pelvic Floor Rehabilitation Helps Prostate Cancer Patients

Prostate cancer can be treated by radiation, chemotherapy, hormone suppression therapy, and surgery to remove the prostate, among other therapies.  There are a number of issues following treatment that can be alleviated through cancer rehabilitation. Pelvic Health therapists have received additional training in pelvic floor rehabilitation to treat pelvic floor dysfunction such as:

• Post-prostatectomy urinary incontinence
• Bowel dysfunction including chronic constipation
• Sexual dysfunction including erectile dysfunction
• Pre and post-operative prostate surgery
• Chronic pelvic pain

Cancer rehabilitation and pelvic health physiotherapy  are relatively new and emerging areas of specialty for physiotherapists in Canada. They have a great deal to offer in terms of drug free alternatives to overcoming the side effects of cancer treatment. Many people, including physicians, are not yet aware of the many rehabilitation options that have been recently developed based on the latest scientific research. A specially trained physiotherapist may be able to help alleviate or improve your problems, allowing you to resume your previous lifestyle.

How to Get Cancer Rehabilitation

Please contact one of our 62 Cancer Rehab locations across Canada. Links will direct to a Cancer Rehab provider in your area.

Ontario
British Columbia

Alberta

Saskatchewan & Manitoba

Nova Scotia

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Increased Physical Activity Improves Cancer Survival Rates

Are You a Cancer Survivor With N.E.D.?

Cancer survivors can improve their chances of remaining NED through regular exercise

We live in a world of acronyms that are only meaningful to people "in the know". I have worked my whole life with PTs, OTs and RMTs who do things like measure ROM, use the IFC and put people through FCEs. What may seem strange to those outside my physiotherapy world is all very clear to me.

The Importance of the Acronym N.E.D.

One acronym that really sticks in my mind these days though, is N.E.D.! This has a special meaning to me, along with thousands of other cancer survivors. It means No Evidence of Disease. These are the best three letters you can hope to see written at the bottom of your doctor's chart. Nothing makes me happier than hearing that the follow-up test results have shown N.E.D.!

Increased Physical Activity Improves Survival Rates

But the question remains how cancer survivors can improve their chances of remaining N.E.D. One of the best ways is engaging in regular exercise.

A systemic review completed in 2010 by Barbaric et al, looked at the Effects of Physical Activity on Cancer Survival. They concluded after reviewing hundreds of scientific research articles that there is growing evidence demonstrating that increased physical activity improves survival rates in patients with breast or colorectal cancers. The recommended amount required to make a difference is a mere 3 hours of moderately paced walking per week. More recently, there is evidence supporting exercise with other types of cancers including lung and prostate. Surely regular daily exercise is possible for most cancer survivors and should be strongly encouraged by the medical community.

I believe it is time to challenge the meaning of N.E.D.! From now on... let us all remember that it really should mean NEED EXERCISE DAILY!

How to Get Cancer Rehabilitation

Please contact one of our 62 Cancer Rehab locations across Canada. Links will direct to a Cancer Rehab provider in your area.

Ontario
British Columbia

Alberta

Saskatchewan & Manitoba

Nova Scotia