Healing Below the Belt: The Missing Piece in Cancer Care with Alex Hill Podcast Por arte de portada

Healing Below the Belt: The Missing Piece in Cancer Care with Alex Hill

Healing Below the Belt: The Missing Piece in Cancer Care with Alex Hill

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 "We have to do better for our patients." – Alex Hill Episode Summary In this enlightening conversation, Kristen Parise speaks with Alex Hill, a specialized pelvic health and oncology physiotherapist, about the critical yet often overlooked connection between cancer treatment and pelvic health. Alex shares her journey into this specialized field, the importance of lymphedema management, why exercise during cancer treatment is essential, and how healthcare providers can better serve cancer survivors through improved education and collaborative care. This episode offers valuable insights for healthcare professionals, cancer survivors, and anyone interested in comprehensive cancer care. Chapters 00:00 - Introduction to Pelvic Health and Oncology02:18 - Alex's Journey into Pelvic Health and Oncology05:24 - Understanding Lymphedema and Its Treatment10:45 - The Importance of Exercise During Cancer Treatment14:32 - Addressing Hormonal Changes and Pelvic Health19:45 - Education and Collaboration in Oncology Rehabilitation24:40 - Late Effects of Cancer Treatment30:24 - Connecting with Alex Hill Alex's Path to Pelvic Health & Oncology Alex's journey into this specialized field combines professional curiosity with personal experience: Discovered pelvic health and oncology during PT school clinical rotationsMinimal formal education on these specialties (only a few hours in a 3-year doctoral program)Personal history with misdiagnosis fueled her passion for patient advocacyCurrently practices in both hospital and private settings through OncoPelvic PTFocused on validating patient experiences that are often dismissed "I had one orthopedic surgeon tell me that it was in my head and it ended up being an actual labral tear... I have felt not heard when I was in pain and I knew something was wrong with my body." Understanding Lymphedema: Beyond Cancer Lymphedema is one of the most common yet misunderstood side effects in cancer care: What It Is Buildup of protein-rich lymphatic fluid that doesn't resolve without treatmentDifferent from typical swelling (like a sprained ankle)Can affect specific body areas based on lymphatic system damage Common Causes Lymph node removal during cancer surgeriesRadiation therapy damage to lymphatic vesselsSome cases develop from congenital lymphatic system issues Treatment Approach Complete Decongestive Therapy (gold standard treatment): Compression bandaging and garmentsManual lymphatic drainage massage techniquesSpecific therapeutic exercisesComprehensive skincare regimen to prevent infection Access Challenges Approximately one certified lymphedema therapist per 1,000 patients who need treatmentEven fewer therapists specialize in genital lymphedema Exercise During Cancer: Myth-Busting Alex passionately advocates for appropriate physical activity throughout cancer treatment: Old Misconception Cancer patients should rest and avoid physical activity Current Evidence Exercise improves treatment outcomesHelps manage treatment-related fatigueMay reduce cancer recurrence ratesSafe even for patients with metastatic cancer (with proper modifications) Clinical Considerations Timing matters (avoid 2 hours before/after radiation or chemotherapy)Monitor blood counts and adjust intensity accordinglyTelehealth options for high-fatigue daysIndividualized programming based on specific needs "If we as providers under-dose exercise, we are part of the problem. We have to really look at what our patient needs who's in front of us and individualize their plan of care." Hormonal Changes & Pelvic Health Cancer treatments frequently cause significant hormonal disruptions with profound pelvic health impacts: Common Triggers Tamoxifen and other hormone therapiesChemotherapy-induced menopauseSurgical removal of ovaries or testes Resulting Pelvic Health Issues Vaginal dryness and atrophyPain with intercourseTissue fibrosis (especially after radiation)Pelvic floor muscle dysfunction Therapeutic Approaches Dilator Therapy Medical devices in graduated sizesMaintains vaginal tissue flexibilityEnables comfortable pelvic examinationsSupports sexual function recovery Pelvic Floor Rehabilitation Often focuses on relaxation rather than strengtheningAddresses trauma responses in the nervous systemRetrains coordination and function "A lot of times we'll need to work on relaxing the pelvic floor, getting it more coordinated before we then start strengthening if we do need to do that." Understanding Radiation Fibrosis Alex provided a clear explanation of how radiation affects tissues: Radiation can be delivered externally or internally (brachytherapy)Creates a "scattering effect" that impacts surrounding tissuesResults in scarring, hardening and thickening of tissue (fibrosis)Reduces tissue flexibility and elasticityCan cause pain with movement, urination, bowel movements, and sexual activityEarly intervention helps minimize progression Timeline of Treatment Effects Cancer treatment effects follow distinct ...
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