Men’s health physiotherapy for prostate cancer

Prostate cancer is the most common cancer in Irish men and the second most common overall, above breast cancer. According to the National Cancer Registry, 3,474 men are diagnosed with prostate cancer each year in the country. This means that 1 in 8 men will be affected by the disease during their lifetime. Positively, prostate cancer has one of the best survival rates of all cancers and with early detection, the right support and rehabilitation; full physical, psychological, social and sexual recovery is possible.

Treatment of prostate cancer will have some side effects depending on the type and size of cancer, treatment choice (surgery, radiotherapy or hormonal treatment) and your general health. After prostate removal surgery the bladder shape changes, the urethra is shorter and muscles are weaker. These can lead to symptoms such as incontinence, frequency, urgency or erectile dysfunction. These urinary and sexual symptoms can be reduced by specialist physiotherapy including bladder training, pelvic floor rehabilitation, individualised advice and support alongside pharmacological and medical intervention.

Research shows that commencing high intensity pelvic floor exercises 5 weeks pre-surgery improves recovery time and outcomes. You should do 10 fast and 10 long pelvic floor muscles contractions 6 times a day in a standing position.

To contract your pelvic floor you should feel something tense inside your pelvis but not your bum, legs or tummy. Make sure you relax fully afterwards and avoid holding your breath.

• Imagine you are stopping the flow of urine
• Lift your testicles up inside
• Lift your penis upward
• Imagine you are walking into cold water

After surgery once the catheter is removed you can being the pelvic floor exercises again: very gently initially and build up as able. At 6 weeks post-op an assessment with a pelvic health physiotherapist is recommended to make sure you are on track, assist you with progression, answer any questions that you might have and guide you with returning to more energetic exercise.

Tips to aid your recovery

• Physical activity : Before surgery, try to be as fit as possible. If you are in a good shape before, it will be easier to recover after. During the first month after surgery, stay active without doing too much to encourage optimum healing. Avoid heavy lifting for approx 6 weeks
• Hydration: Drink enough water. 30ml/kg of body weight as a guide. Spread throughout the day to avoid drinking a lot at night. Restrict your caffeine (tea and coffee), fizzy drinks and alcohol.
• Avoid constipation: Eat a balanced diet with plenty of fibre. When opening your bowels sit with your knees higher than your hips and avoid straining or holding your breath.
• Don’t smoke: This helps with healing and limits coughing pressure.
• Sexuality: it’s important to maintain the elasticity of the penis by having erections regularly. This will be difficult initially after surgery but several methods exist to help you. Ask your urologist or physio.
• The Knack: Before a cough, sneeze or laugh lift your pelvic floor muscles quickly and strongly to maintain support and hopefully keep you dry. With practice this action will become automatic again.

About 6 in 10 cases of prostate cancer are diagnosed after 65. It’s very important to have a screening after 50 even if you are symptom free. And even if you had your surgery years ago but still leak you should contact your local men’s health physiotherapist to see if your symptoms can be improved any further.