Keesha Carter was diagnosed with cervical cancer in 2009. Following her surgery at Novant Health Presbyterian Medical Center, the single mother of one underwent chemotherapy and radiation when the surgery revealed that the cancer had spread to her lymph nodes.
Eight years later, Carter said she’s feeling good. There is no evidence of the disease. But the cervical cancer and its treatment did have side effects.
“I weighed 110 pounds when I had cancer, but now I am up to 165 and I think it’s because of menopause,” said the 36-year-old. Shortly after treatment, Carter said she had both diarrhea and constipation and bleeding in the uretha and rectum. The radiation caused constant back pain and she had problems with urination and defecation. When she had an urgency, she had to go.
Additionally, two years after her treatment was completed, the radiation caused her vaginal walls to close. Dr. Matt McDonald, her gynecological oncologist recommended that Carter get pelvic floor therapy.
The pelvic floor muscles form a "hammock" across the opening of a woman's pelvis, holding the uterus, bladder and rectum in place. When these muscles are weak, damaged or not functioning properly, women may experience problems such as pelvic organ prolapse, urinary incontinence, interstitial cystitis, chronic pelvic pain and sexual dysfunction.
Carter said her therapist helped return her quality of life. “She taught me stretches and got me to eat the right foods to help with my issues. She showed me massages for my belly and thighs that helped my tight muscles and showed me how to stretch the walls of the vagina,” she said.
“When looking at pelvic health, physical therapists will focus on the muscles, tissues and joints of the pelvic area,” explained Erin Ball, Novant Health’s rehabilitation regional manager. “Sometimes it’s a multimodal approach that uses exercise and medications to retrain the joints of that area. Primarily, we look at controlling pain and eliminating incontinence.”
Pelvic therapy can benefit a wide variety of people not only those recovering from cancer. “We help peri-partum women or women before and after giving birth who may have back pain or incontinence issues,” Ball said.
“Sometimes, menopausal women will have incontinence issues as a result of hormonal changes. We also help women dealing with uro-gynecological cancers, such as ovarian, uterine, cervical and colon cancers.”
The therapy is also useful for men living with certain conditions. “We primarily help men who’ve had prostate cancer, but also men recovering from rectal or colon cancer.”
When it comes to pelvic floor health, it’s important to seek treatment early on before the issue becomes more engrained. Novant Health offers inpatient and outpatient physical therapy programs throughout its footprint.
Both Ball and Carter admit there is a stigma associated with discussing some of the problems associated with pelvic floor health.
“People don’t talk about pelvic issues. It’s not polite conversation so you are not going to learn that there is a treatment for this from your friend, for instance,” Ball said. “Even patients who benefitted from the physical therapy are reluctant to discuss it.”
“Whether women have had cancer or not, they are living with problems that can be addressed with therapy and they can improve on their quality of life,” Carter said.
Carter has become an advocate on pelvic floor health and talks about its benefits at support groups. “There is so much women don’t know about their body below the belt. It’s important that we educate ourselves so that we can feel better.”