Prostate Cancer

• Did you know that treatment for prostate cancer can affect your muscle strength?
• Did you know that urinary incontinence and erectile dysfunction are common after prostate surgery and that physiotherapy can assist your recovery?
• Did you know pelvic floor exercises before and after your surgery can help you recover?

What is Prostate Cancer?

Over their lifetime, 1 in 6 Australian men will be diagnosed with prostate cancer and it is the most common ‘non-skin’ cancer diagnosis in men. Diagnosis and treatment for prostate cancer can be emotionally and physically distressing for men and their families.

Your prostate is the main control mechanism for urinary continence. Removal of the prostate can impact on this control mechanism – leading to urinary leakage. In fact, loss of bladder control is generally expected after your surgery. Fortunately, this will usually improve over time, and improve more quickly with appropriate exercises and physiotherapy support.

Your pelvic floor also plays a large part in urinary continence, and will need to play a larger part in controlling leakage once your prostate has been removed.

After surgery, leaking urine may occur with activity, coughing or sneezing. How much, and for how long, differs between people. Pelvic floor exercises before and after your surgery will help improve your leakage and optimise your outcomes and recovery.

Physiotherapy can also assist in improving your overall general exercise tolerance after having treatment for cancer.

Common Symptoms After Prostate Surgery

Some common symptoms after your surgery may include:

• Discomfort or pain
• Nausea or vomiting
• Fatigue
• Urinary incontinence / leaking urine
• Constipation or faecal incontinence or soiling
• Erectile dysfunction
• Changes in mood and emotion
• Leaking urine on the way to the toilet, with activity or after urinating
• Going to the toilet more frequently

Our Men’s Health team work in close liaison with your medical specialists. Following your specialists’ instructions will ensure you get the best outcomes after your surgery. Your physiotherapist can help to monitor your symptoms and will escalate any important concerns to your surgeon in a timely manner.

How can we Help?

Physiotherapy and Surgery for Prostate Cancer

For over a decade, Active Rehabilitation’s Men’s Health Physiotherapists have been leading the way in the provision of physiotherapy for men with prostate cancer. We have collaborated with some of the best minds in urology and physiotherapy and have pioneered, researched and embedded a highly effective approach to the management of common problems after prostate surgery, such as incontinence and sexual dysfunction.

Our Men’s Health physiotherapists follow a structured ‘Prepare-Heal-Perform’ approach when working with men who are on a surgical pathway for their prostate cancer. We have researched and published evidence of the advantages of this approach over more traditional pathways. Our unique approach involves treatment both before and after surgery, with education forming a cornerstone of the model.

In the Prepare Phase, our specially-trained physiotherapists will take you through an individualised treatment plan to help you get ready for your surgery. This usually occurs over 3 face-to-face or telehealth sessions. You will be taught how to activate your pelvic floor, in preparation for surgery. At Active, we use transperineal ultrasound (non-invasive) to help you visualise your pelvic floor muscle contraction in real time. We know from our research that your ability to successfully contract your pelvic floor muscles is key to your recovery. We use the Prepare Phase sessions to help you understand how the surgery will impact on the functioning of your body and answer any questions you may have.

Our team will then work with you during the Heal Phase – usually 6-12 weeks after surgery. It can take some time to restore bladder control and urinary continence after surgery, but when pelvic floor muscle training has occurred before surgery, the severity and time for recovery is reduced. Your physiotherapist will monitor your recovery and work with you to reduce any urinary leakage, helping you to gradually reduce your reliance on pads. They will teach you exercises that are safe and appropriate for your stage of healing, and progress them according to your need. They will continue to provide you with information about your recovery, and liaise with your surgeon in the event this is required. Three to six physiotherapy sessions are usually recommended in this phase, depending on how long it takes for your continence to return. Your physiotherapist will also ask you about, and help you to manage, any difficulties you may experience with your sexual functioning.

Finally, in the Perform Phase, your physiotherapist will help you to achieve your exercise goals, supporting you to return to your pre-surgery activities. Many men report that they are stronger and fitter than they have ever been, after completing their physiotherapy sessions.

Physiotherapy and Prostate Cancer – a Non-surgical Approach

At Active, our Men’s Health and Cancer Care teams also treat men who do not progress down a surgical pathway for their prostate cancer. Men who are prescribed medications such as Eligard, describe reduced continence, muscle weakness and fatigue as common side effects. Carefully graded exercise programs and strategies to manage fatigue help men undergoing treatment to retain and improve their function, improve continence and alleviate the fear so commonly experienced by people impacted by cancer.

Our Connected Care Approach

With our unique ‘Connected Care’ approach, our team will expertly help you to prepare for your surgery, provide you with physiotherapy during your hospital stay and then after your surgery when you leave hospital, we’ll help you while you heal and return to performing your normal activity. You can connect with your physio in hospital, in our clinics and during our online video consultations.

What to Expect From my Appointment?

• Detailed Interview to fully understand your symptoms, medical and surgical history and your specific goals.
• Physical Assessment of your body, and pelvic floor using the latest technologies.
• Targeted Treatments which may include real time transperineal ultrasound to facilitate pelvic floor muscle activation, manual therapy and comprehensive advice and education.
• Progressive Exercise Program to assist you not only with your pelvic floor strength and endurance, but with your general fitness, health and well-being.
• Communication and Collaboration with your specialists and General Practitioner to keep them informed of your progress and to support your care.