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The Pelvic Floor and Prostate Cancer

Hello friends! It’s September which means it is National Prostate Cancer Awareness Month.

Prostate cancer is one of the most common cancers in men. (Roscow, 2016; Milios, 2019; Sayilan, 2018) One in every nine men will be diagnosed with prostate cancer—those who are over 65 and/or African-American have a greater chance of being diagnosed with prostate cancer. (American Cancer Society, 2020) But there’s good news! Most men that are diagnosed with prostate cancer do not die from it. (American Cancer Society, 2020)

So, what is the prostate? The prostate is a gland that sits right under the bladder and wraps around the urethra or "urine exit canal," The prostate helps with semen production and semen movement during ejaculation.

The treatments for prostate cancer can often affect the functioning of the pelvic floor muscles and the pelvic organs. The pelvic floor muscles are responsible for controlling peeing, pooping, and sexual function. Incontinence, erectile dysfunction, Peyronie’s disease, and bowel (poop) dysfunction are all common side effects of prostate cancer treatments.

The most common treatment for prostate cancer is a surgery to remove the prostate, part of the urethra, and the seminal vesicles (often called a radical prostatectomy). (Roscow, 2016) After a radical prostatectomy, up to 98% of men report urinary incontinence, or involuntary leakage of urine. (Roscow, 2016; Milios, 2019)

About half of the cases of incontinence resulting from a radical prostatectomy are stress incontinence. This occurs when the pelvic floor muscles are either too weak, too tight, and/or unable to do the right thing at the right time which lets urine leak out. (Roscow, 2016) With stress incontinence, things like laughing, sneezing, or jumping put more pressure on the pelvic floor than it can handle resulting in leakage. When the pelvic floor muscles aren’t working, they can be strengthened and trained to function properly. A pelvic floor physical therapist is an expert in these muscles and can help you to get them working again.

Having pelvic floor physical therapy before a radical prostatectomy has been shown to help promote less leakage, quicker return to continence, and improved quality of life in patients after surgery. (Milios, 2019; Sayilan, 2018)

Along with incontinence, another side effect of prostate cancer treatment is Peyronie’s disease. Peyronie’s disease can cause a curve in the penis, shortening/narrowing of the penis, penile pain, and erectile dysfunction. It is caused by scar tissue formation. Scar tissue can form in many other areas of the body and is common after many orthopedic injuries (like joint replacements or sports injuries). With the help of a skilled provider, the negative effects of scar tissue can be addressed.

Peyronie’s disease occurs in 1 in 6 men after a radical prostatectomy. (Tal, 2010) and 1 in 8 men after radiation therapy for prostate cancer. (Frey, 2017)

Pelvic floor physical therapy has shown improvements in about 70% of cases with Peyronie’s disease; and the best part? There are little to no negative side effects of physical therapy!

Radiation therapy is another medical treatment for prostate cancer. Radiation therapy can cause bowel (poop) problem. But more good news, seeing a pelvic physical therapist can help with this, too!

The diagnosis of cancer by itself can be scary to navigate, and issues like incontinence and sexual dysfunction can seem overwhelming. Remember there is help out there, and you can live a happy, fulfilling life!

If you, or someone you love, is dealing with prostate cancer here are some steps you can take:

For Healthcare providers, check out our courses to help you treat males with pelvic floor dysfunction. Join our Ambassador Program and most of our courses are included with your membership!

What experiences or tips do you have with prostate cancer that can help others? We’d love to hear them. Please join the conversation in the comments section below.  

By Emily Reul, PT, DPT

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