Many female pelvic cancer survivors suffer from urinary and fecal incontince as a consequence of pelvic radiotherapy, affecting social life including physical activity levels (1-3). The aim with the study was to investigate wether an individually designed nurse-led rehabilitation intervention, at a pelvic cancer rehabilitation unit, could improve both incontinence and physical activity levels among pelvic cancer survivors.

Swedish female pelvic cancer survivors (n=266, mean age 64 years) were, after giving informed consent, included consecutively in a longitudinal study. The survivors answered a study-specific questionnaire, 6-48 months after pelvic radiotherapy, at baseline, before rehabilitation interventions at the pelvic cancer rehabilitation unit started. The study-specific questionnaire included questions on sociodemographic and clinical characteristics, as well as questions regarding frequency of physical activity. The women also answered question on self-perceived experience of urinary and fecal incontinence.  Three months after participation in the nurse-led individualized rehabilitation program, the women answered a follow-up questionnaire with the same questions regarding level of fecal- and urinary incontinence and physical activity level. The level of fecal- and urinary incontinence and the level of physical activity at baseline and at three months follow up was compared and evaluated by Wilcox signed rank test.

The women reported a significant lower level of fecal incontinence (p< 0.001), a clear tendency of lowered levels of urinary incontinence (p=0.0589) but no change in physical activity levels (p= 0.932) three months after the individually designed nurse-led rehabilitation interventions.

Three months after individualized nurse-led rehabilitation interventions, cancer survivors reported reduced levels of fecal incontinence, a clear tendency of lowered levels of urinary incontinence but no increase in physical activity level. Our findings indicate that additional rehabilitation measures are needed to increase female pelvic cancer survivor’s physical activity levels.

We hypothesize that complementary physiotherapeutic rehabilitation in the form of physiotherapy-led pelvic floor muscle training, could contribute to further decrease in incontinence level and increased physical activity level among female pelvic cancer survivors with fecal- and urinary incontinence. However, radiotherapy and surgery in cancer treatment may induce damage to pelvic floor tissue such as muscles and nerves. Therefore, the effect of pelvic floor muscles training on incontinence among female pelvic cancer survivors need to be studied before pelvic floor muscle training can be implemented as a routine in existing pelvic cancer rehabilitation.

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