It can be the source of embarrassment, discomfort and a loss of power. For men with prostate cancer, the urinary incontinence that sometimes follows treatment can change life dramatically.
But at City of Hope, a team of physical therapists offers one-on-one sessions with prostate cancer patients to help them retrain their pelvic muscles to stop leaky bladders. The Continence Recovery Program, begun just last year, can mean the world to patients who want to return to their comfortable, everyday routine.
“This program has been so popular that one of our physical therapists and two physical therapy assistants are working on this almost full-time now,” said Jennifer Brown, O.T.R., director, Rehabilitation Services.
Over the last decades, prostate cancer treatment has improved significantly. When prostate cancer is caught at an early stage and is confined to the prostate gland, patients have a high chance at cure.
At City of Hope, surgery for prostate cancer (called prostatectomy) is done with minimally invasive techniques, using the da Vinci Surgical System robot to help avoid harming delicate nerves. City of Hope urologists are among the few nationwide to offer this procedure robotically.
Regardless of expertise, though, physicians know there is a chance that procedures may irritate the urethra or bladder or affect the sphincter muscles, which may lead to side effects such as incontinence.
“The continence rehabilitation program by the physical therapy department is one of several key components for a comprehensive prostate cancer program, said Kevin Chan, M.D., surgeon in the Department of Urology & Urologic Oncology. “It not only helps those patients who do not have good urinary control, but also accelerates the process of regaining urinary control in those patients who will ultimately be continent.”
About two weeks after surgery, patients begin the Continence Recovery Program, which consists of biofeedback and specialized exercises twice a week for six weeks.
In biofeedback, the patient lies on a table and practices engaging various muscles of the pelvis, while a sensor detects which muscles the patient is using. By looking at a computer screen, the patient can directly see, feel and learn whether he is engaging the correct muscles (ones deep in the pelvis) or other more superficial muscles, such as the abdominals, which are not as helpful for bladder control.
Physical therapists also teach patients key strengthening moves known as Kegel exercises. In addition, they boost patients’ muscles by using Pilates, a method of exercise incorporating core strength, posture and mind-body connections.
The rehabilitation gym is located on the first floor of the Medical Center. For information about the Continence Recovery Program is available from Rehabilitation Services at 626-256-HOPE ext. 62412.