Physiotherapy should be part of standard care for prostate cancer, which affects one in seven Australian men, according to APA physiotherapist Jason Crow.

Mr Crow says while men are often reluctant to seek physio input, once they understand how important strong pelvic floor muscles are to full recovery, they’re more than happy to participate.

“Physiotherapists can help men undergoing prostate cancer treatment in several ways,” says Mr Crow.

“Firstly, physiotherapy is important for men diagnosed with prostate cancer who then proceed to radiation therapy or surgical management with a prostatectomy, as specially trained physiotherapists can develop a pelvic floor training program which can reduce the incidence and severity of urinary leakage after treatment for prostate cancer.

“Physiotherapists also provide in-hospital physiotherapy to assist with immediate recovery after surgery to help develop strategies for managing the first few weeks at home and returning to work or sport.

“Finally, physiotherapists work with men across the treatment journey by providing general exercise programs to build up physical fitness after surgery and maintain fitness during any other treatments such as chemotherapy or radiation.”

Ideally, men should be seen by a physiotherapist prior to surgery to learn their general and pelvic floor exercises before symptoms develop. They are then reviewed by a physiotherapist in-hospital, and for ongoing physiotherapy after surgery.

“Treatment from a physiotherapist aims to decrease incontinence in men post-surgery, with targeted pelvic floor exercises and training.

“Physiotherapy management, when appropriate, also incorporates an exercise program of aerobic exercise and resistance training to combat reduced fitness, reduce the potential loss of muscle and bone mass and improve general well-being.”

How long treatment should take place varies for each individual, however a typical patient would be seen for six weeks pre-operatively and three months post-operatively.

“Patients benefit from physiotherapy as we can teach them to perform their pelvic floor exercises correctly with use of Real Time Diagnostic Ultrasound.

“This technique is known as biofeedback, and it provides patients with a way to actually see their pelvic floor contraction - something which is very useful given the challenging location of the pelvic floor.

“The techniques used provide an excellent image for patients to see, which demonstrates the relevant structures important for continence and allows an improved patient understanding of how to perform the correct pelvic floor contraction.

“As therapists, this means our exercise program is more targeted to the appropriate muscles and ultimately facilitates a quicker return to continence post-operatively for patients.”

While recognition of the benefits of physiotherapy for prostate cancer survivors is growing, more understanding is required, says Mr Crow.

“There is growing number of passionate health care professionals promoting the great work physiotherapists can do for prostate cancer survivors.

“Awareness of pelvic floor physiotherapy has previously been strongly associated with women’s continence issues, with many female physiotherapists doing fantastic work to support women in this area.

“It is fantastic to see these physiotherapists increasingly promoting the importance of men’s pelvic floor health, and importantly, there are an increasing number of male physiotherapists broadening their skills and undertaking additional training to provide support to prostate cancer survivors as well.”

Pelvic floor physiotherapy can decrease the amount of time men suffer from urinary incontinence and decrease the severity of their leakage.

“Seeing a physiotherapist can help to optimise the quality of life of men recovering from prostate cancer.

“There is already strong evidence to support the benefits of pelvic floor physiotherapy in all stages of prostate cancer treatment, and the body of evidence continues to grow.

“On a personal level, the men we meet tell us they feel enormous benefit when supported by a physiotherapist during their cancer treatment.”