Radiation Fibrosis In the Pelvic Region: A Comprehensive Overview

Radiation therapy is a common adjuvant treatment for cancers affecting the pelvic region, such as cervical, endometrial, prostate, colorectal, and anal cancers. While it plays a crucial role in reducing the risk of recurrence and controlling advanced cancer locally, its application in the pelvic region can lead to significant side effects, both acute and chronic.

One long-term consequence is Chronic Pelvic Radiation Disease (PRD). Chronic PRD manifests with various symptoms, including radiation fibrosis, tissue atrophy, pelvic pain, spasms, sensory changes, weakness, loss of joint range of motion, bone loss (osteopenia/porosis), and lymphedema.

Radiation fibrosis, a notable symptom, profoundly impacts the quality of life for individuals with a history of pelvic cancer. This condition can develop months, years, or even decades after the completion of radiation treatment. Inflammatory processes and edema progress to a dense fibrotic extracellular matrix, resulting in damaged endothelial and connective tissue cells. This, in turn, leads to neuromuscular musculoskeletal restrictions, pain, and functional disorders, with no current cure available.

Recognizing the importance of rehabilitation in addressing these challenges, general oncology practitioners and pelvic floor specialists play a vital role in providing holistic care. Here are key aspects of the rehabilitation process:

1. Client Education: Side Effects of Radiation
• Providing comprehensive information about potential side effects to empower patients.

2. Stretch for Life – Daily Functionality
• Emphasizing the significance of regular stretching exercises for maintaining daily function.

3. External and Internal Manual Techniques
• Implementing appropriate manual techniques, both externally and internally, as indicated by the individual’s needs.

4. Client Education: Vaginal Dilator PRN
• Educating clients on the use of vaginal dilators as needed to address specific concerns.

5. Treatment for Urinary and Fecal Incontinence
• Developing interventions to manage and improve urinary and fecal incontinence.

6. Sexual Dysfunction Education
• Offering education and support for individuals facing sexual dysfunction challenges.

7. Intervention for Pelvic Pain
• Implementing strategies to address and alleviate pelvic pain.

8. Distress Management and Coping Strategies
• Providing tools and support for managing emotional distress associated with chronic conditions.

9. Relaxation Techniques and Mindfulness Training
• Introducing relaxation techniques and mindfulness training to enhance overall well-being.

In conclusion, a comprehensive rehabilitation approach is essential for individuals affected by radiation fibrosis in the plevic region focusing on education, therapeutic interventions, and emotional well-being to improve their quality of life.

Pelvic Radiation Side Effects

For further details regarding radiation fibrosis – encompassing precautions and guidelines for all side effects visit our website: https://specialtyrehab.thinkific.com/courses/oncology-rehab-cancers-impacting-pelvic-floor-function

References

1.Barcellini Amelia, Dominoni Mattia, Dal Mas Francesca, Biancuzzi Helena, Venturini Sara Carla, Gardella Barbara, Orlandi Ester, Bo Kari Sexual Health Dysfunction After Radiotherapy for Gynecological Cancer: Role of Physical Rehabilitation Including Pelvic Floor Muscle Training Frontiers in Medicine VOLUME=8, 2022 Christian, A. (Ed.) (2021)Breast Cancer and Gynecologic Cancer Rehabilitation, 2021, Elsevier, Cambridge, MA.
2. Cyr MP, Dostie R, Camden C, Dumoulin C, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Mayrand MH, Morin M. Improvements following multimodal pelvic floor physical therapy in gynecological cancer survivors suffering from pain during sexual intercourse: Results from a one-year follow-up mixed-method study. PLoS One. 2022 Jan 25;17(1):e0262844. doi: 10.1371/journal.pone.0262844. PMID: 35077479; PMCID: PMC8789131. 
3. Doherty, D., Wilson, C., Boright, L. (Ed) Oncology Rehabilitation: A Comprehensive Guidebook for Clinicians (2023) Elsevier 
4. Executive Committee of the International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the International Society of Lymphology. Lymphology. 2020;53(1):3-19. PMID: 32521126. 
5. https://www.macmillan.org.uk/cancer-information-and-support/treatment/types-of- treatment/radiotherapy/pelvic-radiotherapy/pelvic-radiotherapy-side-effects 
6. National Comprehensive Cancer Network-(NCCN) Clinical Practice Guidelines in Oncology-Distress Management (2022). https://www.nccn.org/professionals/physician_gls/pdf/distress.pdf 
7. National Comprehensive Cancer Network-(NCCN) Clinical Practice Guidelines in Oncology. Survivorship (2022) https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf 
8. Stubblefield, M.D.(Ed). (2019). Cancer Rehabilitation, Principles and Practice. Springer Publishing Company.