A knight in armor and a cape walks out of a medical office.

Should I Go to Pelvic Floor Physical Therapy Before Treatment of Prostate Cancer?

Perhaps some of you are wondering what going to see a pelvic floor physical therapist would achieve prior to your prostatectomy or radiation to address prostate cancer. You may have already had your biopsy, which involved gathering a collection of cells from your prostate gland. You may then be forced to make a decision about how to treat your cancer.

This is a lot to take in. Sometimes the last thing a man wants to do in this moment is to pause and visit a physical therapist. And that is completely understandable.

Helping people at various stages

For many years now, I have been treating men before, during, and after their prostate procedures to eradicate cancer. It is a privilege that I don’t take lightly. Many people who haven’t gone to pelvic floor physical therapy wonder what we are doing and why it might be beneficial to seek it out before treating their prostate cancer.

I wish to tell you why the men with prostate cancer are my favorite people to treat, and what we can accomplish together when PT occurs before prostate surgery or radiation.

Urinary leakage and erectile dysfunction

Men commonly experience urinary leakage and erectile dysfunction as side effects of treatment for prostate cancer. That much we all know.

The pelvic floor muscles are responsible for stopping a urinary stream and for generating enough tension to allow for rigid erections. They often become weakened with interventions to treat prostate cancer. If a man can learn how to isolate his pelvic floor muscles (known as a Kegel exercise) before his treatment commences, he can stand a better chance of managing his symptoms of urinary leakage and erectile dysfunction once they begin.

Pelvic floor tension

But we don’t just instruct men in strengthening! The pelvic floor muscles must also be required to lengthen to allow for the bladder to empty naturally and to have complete bowel movements without straining. Now, if a man undergoes trauma to his pelvis in the form of surgery or radiation, these same muscles will likely tighten up.

This leads to the need to squeeze out urine instead of letting it flow naturally, and sometimes results in urinary retention. Furthermore, pelvic floor tension can also cause straining of stool, constipation, and hemorrhoids (which nobody wants, whether or not they have a prostate cancer diagnosis).

Being proactive

Going to see a pelvic floor physical therapist before the pelvis has been disrupted by prostate cancer treatments allows men to know the difference between what a Kegel feels like for strengthening and, conversely, how to lengthen the saddle muscles for ideal muscle balance.

And yes, these things can be learned after a prostatectomy and/or radiation, but I’ve found from personal experience that the guys who come for help before their treatment feel more confident facing their cancer diagnosis. They’ve also taught me so much about masculinity. That rare form of vulnerable masculinity unique to the arena of those living with prostate cancer.

Incredibly brave men

I have been with them, these incredibly brave men who are on the precipice of enormous loss. They are often afraid in ways we don’t commonly see men in this world. We sit together, sometimes in deep quiet, during those visits before the cancer treatment. It is a remarkable thing to watch these men remove their armor, piece by piece.

I sometimes catch a glimpse of them as they exit the doors of the office for that last time before their treatment. I am able to see the resignation in their shoulders. If I squint, I can visualize the cloak of a superhero upon them and hear the swoosh of the fabric.

Getting to know the hero

Of all the honors I have known in my lifetime, spending time with men before treatment for prostate cancer tops the list. As they face the greatest battle of their lives, I hope that their families and loved ones can see these warriors who live among us for who they are. Courageous. Stripped of armor. Yet undefeated in their vulnerability and strength.

So, yes. That is why I believe it is good to go to pelvic floor physical therapy once you have been diagnosed with prostate cancer and are awaiting treatment. To get to know the hero within you and let others meet him, too.

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