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Pelvic Health Physical Therapy · Talking FACS

• 0:01
  Welcome to Talking Facts and thank you for tuning in to cancer Conversations On Talking Facts,
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  a podcast collaboration between the University of Kentucky,
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  Mary Cancer Center and the UK College of Agriculture,
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  Food and Environments Cooper Extension Service.
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  We will share with you the latest developments in cancer prevention diagnosis,
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  treatment and research from the experts at Mary Cancer Center.
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  Kentucky's only National Cancer Institute designated Cancer Center.
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  Talking Facts is hosted by the UK Family and Consumer Sciences Extension program.
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  Our educators share research knowledge with individuals,
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  families and communities to improve quality of life.
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  Hello and welcome to Cancer Conversations on Talking Facts.
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  I am your host,
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  Mindy mckelley Family and Consumer Sciences Extension Specialist for instructional support at the University of Kentucky.
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  One of the great benefits of our partnership with Market Cancer Center for Cancer Conversations is that we get to talk to so many professionals that members of the general public might not ever consider when seeking cancer care.
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  Today,
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  I'm going to visit with one such professional and I'm pleased to welcome Lauren Carney,
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  a physical therapist with UK healthcare specializing in pelvic floor physical therapy.
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  Welcome,
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  Lauren.
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  Hi.
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  Thank you.
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  Well,
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  we are so glad you're here.
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  And I doubt that many people have thought about their pelvic floors unless they have encountered issues with incontinence or constipation.
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  So,
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  before we speak specifically about how it relates to cancer care,
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  can you share a little bit about pelvic health,
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  physical therapy and exactly what that is?
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  Sure.
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  So I tell my patients that I'm a physical therapist,
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  just like any other physical therapist.
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  I just happen to specialize in the pelvis,
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  you know,
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  versus your knee or your shoulder.
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  And so I use the terms pelvic health therapy and pelvic floor therapy.
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  Interchangeably,
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  I like pelvic health therapy because I feel like that's a little broader and that encompasses a little more because I don't just treat the pelvic floor,
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  which is,
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  is just a small group of muscles in the pelvis.
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  Ok.
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  So I treat any diagnosis almost that that you can think of as it relates to the pelvis.
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  So,
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  incontinence,
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  constipation,
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  pelvic pain,
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  you know,
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  pregnancy problems during pregnancy problems,
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  you know,
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  postpartum or during menopause,
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  you know,
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  again,
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  really,
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  really any diagnosis um that relates to the pelvis that has something to do with the muscles uh that attach to the pelvis,
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  right?
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  And those are probably not muscles that if we're doing typical exercise that we are really strengthening.
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  Yeah.
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  So um you know,
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  I,
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  I tell people it might be something that you might be a,
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  you know,
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  part of your body that you haven't thought about very much that you're not really addressing,
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  you know,
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  with another exercise program.
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  Um,
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  and it,
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  it might be,
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  you know,
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  a lot of times we're treating problems that people haven't even talked about very much with other people or with,
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  even with their,
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  their health care providers.
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  Sometimes I get patients who have put off talking to providers,
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  um,
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  until it's really,
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  they're really feeling pretty bad.
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  And so I'm there to kind of help them through a problem that maybe they haven't thought about very much or haven't talked about very much with anyone else.
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  And I'm guessing that people who have issues,
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  they might just say,
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  well,
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  this is just part of it and I'm just gonna have to live with it or,
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  you know?
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  Absolutely.
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  And it's not right,
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  we can fix.
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  Correct.
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  Correct.
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  Yeah.
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  Absolutely.
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  So,
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  I get a lot of new moms who say,
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  um,
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  I thought urinary incontinence was just normal as a part of being a mom and it's not something that we want you to have to live with.
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  You know,
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  some women think that some degree of pelvic pain is,
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  uh,
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  normal or ok.
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  And that's also not something we want people to have to live with,
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  or sometimes people think that something might be a normal part of aging and it's actually something that we can treat.
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  And so if it's,
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  it's something that we can improve upon,
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  then we want to be able to do that and the nice thing about therapy is that it's low risk,
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  it's conservative.
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  A lot of it's exercise based and so you don't have a lot to lose often by trying therapy.
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  Right.
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  So,
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  it's not gonna hurt you no matter what you do.
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  Right in general.
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  Yeah.
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  Yeah.
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  How might pelvic cancers in their treatment affect pelvic health?
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  So,
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  cancer treatments in general are sometimes pretty harsh.
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  Now,
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  I tell people that have had cancer.
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  I'm,
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  I'm so glad you're still with us.
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  Um,
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  you know,
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  you're a cancer survivor and that's always great news that you're on the other side of it.
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  Um,
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  usually by the time I see people they're already through with their treatment,
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  but the,
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  the treatments for cancer can cause some symptoms as well.
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  And so chemotherapy has a pretty well documented effect on muscle string.
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  So you can have muscle weakness anywhere.
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  But that includes the pelvic floor.
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  You can,
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  uh,
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  um,
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  you know,
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  have post op scarring.
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  So sometimes if you've had,
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  you know,
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  maybe a,
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  uh,
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  if you have a pelvic cancer,
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  maybe you've had a total hysterectomy and you have new scarring,
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  you can have,
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  you know,
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  from that surgery,
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  you can have,
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  uh,
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  early menopause if you've had your ovaries removed at an early age,
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  radiation changes tissue.
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  So after radiation,
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  a lot of people notice that they have new pain because they've had some skin changes or tissue changes.
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  And so sometimes that can have an effect and then just general maybe being less active during cancer treatment.
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  I mean,
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  sometimes that leaves you,
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  uh,
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  with some weakness or mobility issues.
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  I think those are maybe most of the way.
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  So it's again,
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  surgery,
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  chemotherapy radiation,
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  those treatments,
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  those might be issues for any type of cancer treatment.
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  Not,
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  not specifically the pelvic areas.
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  Yes.
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  Um,
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  so if you have a pelvic cancer,
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  you might have more pelvic floor symptoms,
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  but you can have pelvic floor symptoms after any cancer.
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  You know,
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  breast cancer,
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  for example,
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  is not a pelvic cancer,
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  but often you're uh with that,
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  you might be taking hormone suppressant.
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  So if your estrogen suppressed,
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  you're maybe gonna have pelvic floor symptoms cause you,
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  you lose muscle mass.
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  Uh,
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  it's a little bit like an exaggerated menopause in that way.
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  So you might have urinary symptoms.
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  Um,
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  you might have bowel symptoms,
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  all that stuff's pretty common with cancer and especially cancers of,
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  of the pelvis.
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  So what treatments do you have that are available for patients who have,
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  I guess cross made it to the other side.
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  Um,
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  they're ready to,
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  to start life again.
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  Yeah.
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  So it depends on what the problems are.
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  So,
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  if you have uh one of the things I see is just weakness um or,
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  or decreases in strength after cancer treatment.
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  So,
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  if you need strengthening,
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  we can do strengthening at the pelvic floor.
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  If you,
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  you know,
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  are having uh pain or um maybe muscle tension,
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  we can do relaxation exercises.
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  Sometimes some hands on treatment.
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  I have a lot of tools here that I can use.
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  Sometimes we'll do biofeedback,
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  which is a way to measure muscle activity at the pelvic floor.
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  So there's a lot of different available treatments depending on what's wrong.
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  Um,
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  but if you're experiencing urinary symptoms,
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  bowel symptoms,
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  new pain,
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  pain with sexual activity,
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  all of that,
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  all of those would be reasons to seek care and then we,
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  you know,
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  do whatever exercises or,
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  you know,
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  hands on treatments are necessary to help with your symptoms.
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  Well,
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  and some of the cancers that we've talked about are specifically,
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  um,
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  cancers that females experience that do make and also benefit from pelvic health treatment.
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  They do.
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  So,
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  the most common,
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  uh,
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  cancer diagnosis I see with that would be,
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  uh,
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  prostate cancer.
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  Sure.
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  So if you have a,
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  if you have a,
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  your prostate removed in,
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  in men,
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  the prostate ax is kind of a plug for the bladder and so many men will experience urinary incontinence after that,
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  sometimes that goes away on its own.
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  Um,
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  and that would be the hope is that,
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  that just resolves,
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  but if it's not resolving or if it's not resolving quick enough,
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  we can help that along.
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  And then I would see men,
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  you know,
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  after maybe,
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  uh,
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  a colon or rectal cancer,
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  if they're having weakness or symptoms.
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  And so,
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  yes,
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  I do.
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  I treat men and women,
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  you know,
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  my male patients are probably a good,
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  you know,
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  five or 10% of my patient population.
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  All right.
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  That,
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  that's great information to know because when you think about it,
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  it's like this is gonna be primarily females,
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  but definitely,
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  but yeah,
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  we do treat men as well.
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  So what are some related conditions that we might not often consider when we think about pelvic floor?
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  Yeah,
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  or pelvic.
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  Well,
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  I mentioned,
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  you know,
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  other cancers.
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  Um so breast cancer is one that has sometimes a pretty significant effect on the pelvic floor.
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  Also,
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  you know,
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  in cancer patients,
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  early menopause is common.
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  And so you might not think about menopause as having a relationship with pelvic symptoms,
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  but it does,
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  you know,
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  those are a couple of the things that I can think of,
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  you know,
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  was there anything you were thinking of specifically?
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  Maybe that,
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  you know,
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  you had questions about?
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  Uh well,
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  I'm just thinking that as we see some like changes in other physical abilities,
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  maybe knees or,
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  or hips or things.
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  Do you see some related challenges in the pelvic floor?
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  Oh,
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  yeah.
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  Yeah.
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  So I would say there's some issues that can compound the problems at the pelvic floor.
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  So maybe you've had some abdominal surgeries.
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  Um and you have,
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  you know,
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  new abdominal weakness that can affect the pelvic floor.
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  If you have decreased mobility in general,
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  sometimes that can affect the pelvic floor.
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  So maybe,
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  you know,
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  uh and knee or hip arthritis or something you're maybe not up and moving as much.
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  Um So that could definitely have an effect on the pelvic floor.
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  Um So I,
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  I try to look at the,
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  the whole person and so when people come in for an evaluation,
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  I'm often,
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  you know,
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  I mentioned that I'm not just looking at the pelvic floor.
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  So,
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  you know,
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  we look at hip strength,
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  we look at the abdomen,
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  we look at any other problems you might have.
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  Um,
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  because that all links together and like I said,
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  it's,
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  it's,
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  you know,
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  you're looking at a pool person and,
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  and not just that specific group of muscles.
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  I think this has been a fascinating conversation and I,
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  if I'm not mistaken,
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  I think you might be our first physical therapist guest.
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  So I'm glad that you brave today.
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  Um Is there anything else that you wanna add before we wrap up?
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  What I would say to patients is,
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  uh,
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  if you're having problems,
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  don't hesitate to bring these problems up with your doctor.
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  So,
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  you know,
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  I'll mention again any new urinary symptom,
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  any new bowel symptom,
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  any new pain would be reason to talk to your doctor.
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  We have good evidence that would suggest that people are often not bringing these things up because they think they feel like they're complaining or,
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  you know,
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  they should just be happy to be alive after cancer and,
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  and they shouldn't bring up quality of life problems and that's not really true.
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  We,
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  we want,
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  uh,
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  you to seek care for things that don't feel normal or,
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  or,
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  you know,
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  don't feel like they did before your cancer.
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  And so I would encourage people to bring these problems up with your doctor.
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  I promise they've heard it before.
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  So,
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  yeah,
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  you would not be the first person that,
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  and that is a great note to end on because we have,
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  you know,
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  people have been having cancer for decades and,
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  and so there probably is nothing new uh to the to our health care providers.
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  Yeah,
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  Lauren,
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  thank you so much for your time today.
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  Thank you for having me.
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  Yeah,
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  like I said,
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  I think this has been a fascinating conversation.
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  Well,
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  good.
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  All right,
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  to our listeners.
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  If you are just joining us,
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  you can find Cancer Conversations Monthly on the Talking Facts podcast,
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