Hello! And thank you for inviting me to be a contributor to this blog! My name is Dr. Allison Romero, DPT and I am a pelvic floor physical therapist dedicated to revolutionizing health care for people with pelvic floors (that’s pretty much all of us). I have been a specialist in this field for nearly a decade and, along the way, I have taken a particular interest in those thriving following anal cancer diagnosis and treatment.
Some readers may remember a series of articles that I wrote a few years back highlighting neuromusculoskeletal treatment options to help with returning to a new normal following treatment for anal cancer. I’m back now to reiterate and shine new light on some great ideas for healing our systems after taking down anal cancer.
After processing the complex emotions and trauma that can come with a cancer diagnosis, many of us dive headfirst into doing everything we can to squash the disease. This can range vastly from person to person, but often we are dealing with surgical trauma, chemotherapy, radiation, not to mention the mental and emotional traumas that can be associated with these experiences. So after we get through everything that we need to get through in order to be in remission, we are left thinking “Now, what?” What will bowel movements, urinary function, sex, overall continence look like? It can feel uncertain and scary. Our body can feel like a totally new place to be. So here are my thoughts and recommendations for where to go from there in the physical therapy space:
Once your MD gives you the greenlight to start physical therapy, find a specialist in your area that is knowledgeable about your situation. Look to the International Pelvic Pain Society, the American Physical Therapy Association-Section on Pelvic Health, and Pelvic Rehab for lists by state
Therapy sessions should include:
- Fascial mobilization to the abdomen, buttock, perineum and internal tissue (this can be done via the vagina and/or rectum and needs to be in line with each individual’s comfort level). This mobilization helps to flush toxins through the tissues, increase blood flow, and overall give the pelvic tissues a springy suppleness that we associate with healthy tissue.
- Biofeedback training: this can be a great tool for identifying chronically tight or less than optimal muscle function. It helps us identify times when we should be relaxed and are not AND/OR when and where we need to increase the muscle strength.
- Neuromuscular re-education: following treatment for anal cancer we can come out on the other side feeling scathed, so it is no surprise that the body, brain, and muscles are often living in a constant state of protection and stress. We need to work with the neuromuscular systems to unlearn some habits that we may have unintentionally acquired so that we can allow the brain/body complex to live in a low stress and more relaxed state overall.
- Exercises to do on a daily basis that both allow the muscles and fascia to lengthen and relax (think deep squatting, child’s pose, knees to chest positions) and also strengthening the pelvic floor and pelvic girdle muscles to allow for full use of the tissues’ range to be a dynamic supporter of the bowel, bladder, and sexual systems.
- Lymph drainage: is an important modality following radiation and chemo to flush the lymph system and stimulates the lymph nodes that have been taxed and injured with the nearby radiation.
There is SO MUCH that can be done to bring you back to feeling healthy and energetic and full of life after you have made it through the cancer treatments. Pelvic physical therapy will get you on the right track and get you ready to continue thriving. I feel optimistic for every client that comes through my door that we can make great strides together to keep living their best lives. If at any time you feel like you have hit a roadblock or can’t find a therapist in your area, feel free to send me an email at firstname.lastname@example.org
I will get back to you!