Breast Cancer and the Pelvic Floor
As we enter into November, we leave October and Breast Cancer Awareness Month behind, meaning you’ve likely been seeing PINK splashed across your social media feed, the stores you go into, and the commercials you see on TV.
About 1 in 8 women will experience a breast cancer diagnosis at some time in their life and diagnoses have been on the rise in women under 40 over the last decade (Side note: Hi! Peyton, clinic admin here–I was diagnosed at just 29-years-old so I’m here to say that no one is too young for breast cancer!). When we think breast cancer, we think chest (of course!) but did you know that a breast cancer diagnosis also has the potential to impact the pelvic floor? It’s all connected!
Considering the prevalence of breast cancer and the impact a diagnosis can have on the physical and emotional well-being of a woman, it’s time we talk about how breast cancer can affect the pelvic floor and explore ways to help survivors find deeper comfort and connection with their bodies.
What is Breast Cancer?
Breast cancer is the growth of abnormal cells within the breast. The signs and symptoms of breast cancer can often mimic other benign breast conditions and may include:
Swelling of all or part of the breast
Skin irritation or dimpling
Breast pain
Nipple pain or the nipple turning inward
Redness, scaliness, or thickening of the nipple or breast skin
Nipple discharge other than breast milk
A lump in the underarm area
Important Note! The most current guidelines recommend that women of average risk for developing breast cancer start getting screening mammograms every other year from ages 40 to 74. If you have not yet reached the age of 40 or you are in between mammograms, you might consider performing monthly self-exams to better know your normal and be aware of any changes that might be occurring. Here is a great resource to learn how to do a breast self-exam!
Types of Breast Cancer and Treatment
There are a number of different types of breast cancer but the most common ones include:
Ductal carcinoma in situ (cancer that is contained to the milk ducts)
Lobular Carcinoma in situ (cancer that is contained to the lobules)
Invasive ductal carcinoma (cancer that has started to invade into the tissues outside of the ducts)
Invasive Lobular Carcinoma (cancer that has started to invade into the tissues outside of the lobules)
Inflammatory Breast Cancer (cancer that infiltrates the skin and lymph vessels of the breast)
Metastatic Breast Cancer (also classified as Stage 4 Breast Cancer in which the cancer has spread to other parts of the body)
There are five treatment options and most treatment plans include one or more of the following: surgery, radiation, hormone therapy, chemotherapy, and targeted/immunotherapies.
Breast Cancer and the Pelvic Floor
Women who have gone through breast cancer often find themselves entering into survivorship but continuing to experience long-term impacts of their treatment. Chemotherapy and hormone therapies in particular cause changes and disruptions in a woman’s hormonal balance, which can affect pelvic floor health and function.
Because many (most, actually!) breast cancers are either estrogen positive and/or progesterone positive, meaning the cancer is driven by the presence of one or both of these hormones, many treatment plans include the addition of hormone blockers. Anti-hormone medications such as Tamoxifen can trigger menopausal symptoms such as vaginal dryness, night sweats, joint pain, and hot flashes and because estrogen is so important to the health and functioning of the vagina and pelvic tissues, many women find that they experience pelvic dysfunction following the use of anti-cancer hormone therapies.
Additionally, one of the side effects of some chemotherapies can also be the onset of temporary menopause. The decreased estrogen levels associated with the induction of menopause can cause symptoms such as vaginal dryness and disrupted vaginal pH levels, leading to more vaginal, urinary tract, and bladder infections; painful sex; and a weakened pelvic floor. Chemotherapy can also cause changes in bowel and bladder habits leading to constipation, urinary incontinence, and an associated decreased quality of life long after treatment has ended.
How Can Pelvic Floor Therapy Help?
Pelvic floor therapists are trained to use a holistic approach to assess and treat pelvic pain associated with breast cancer treatment. A pelvic floor therapist may use relaxation strategies, pelvic floor strengthening, hands-on therapies such as myofascial release, and education to help resolve these pelvic floor issues. Along with the guidance of pelvic floor therapy, we encourage our patients to inform their doctor about their pelvic floor related concerns, as there may be pharmaceutical options that can help in conjunction with pelvic floor physical therapy. We’re here to help you reconnect with your body and find a way to thrive, not just survive, after cancer treatment. You deserve to live life doing the things you love, feeling confident and empowered!
