Can Chemo Cause Incontinence?

A cancer diagnosis of any kind can be a scary, life-altering moment, and treatments like chemotherapy and radiation come with unpleasant side effects. They can cause hair loss, low energy, and nausea for starters, but chemotherapy is also a known cause of bladder leaks and other forms of pelvic floor dysfunction.

Dr. Rachel Gelman, a clinical specialist at the Pelvic Health and Rehabilitation Center in San Francisco, talked with us about the best practices for taking care of your body and addressing bladder irritation and leaks after treatment. The biggest takeaway? Our bodies are incredibly resilient.

Why cancer causes bladder leaks

It’s important to know that cancer doesn’t have to be below the belt to cause pelvic floor dysfunction — more often, it’s treatment for cancer that’s the real cause of bladder problems. Rachel says there are many reasons treatments might lead to bladder leaks, including:

• Neuropathy, the clinical term for damage to the nerves that control bodily functions.

• Radiation therapy or surgery around/on your bladder, can cause bladder irritation and inflammation.

• Treatments that trigger early menopause or lower your hormone levels. Rachel explains that many people treated for breast cancer are given hormone suppressants that trigger menopause, which in turn makes your hormone levels drop, and means your pelvic floor muscles get a little lax.

• Medications that act as diuretics can make you feel the urge to pee more often, contributing to an overactive bladder.

• Abdominal or pelvic surgeries like hysterectomies or colectomies, can impact your vaginal tissue and the function of your pelvic floor.

• Chemotherapy drugs can directly or indirectly contribute to bladder incontinence by irritating the bladder's lining or altering nerve function associated with bladder control, leading to increased urination frequency, urgency, and, in some cases, urge incontinence. 
• Hormone therapy for breast cancer and prostate cancer can weaken the pelvic floor muscles and cause urinary problems.

Rachel also explains that cancer has a biopsychosocial impact: Your health is affected by biological factors (like your bodily response to the disease and treatment), psychological (because illness is mentally stressful), and social factors (like support — or lack thereof — from others during treatment). Because the effects of cancer are multi-pronged, there is no one way to recover your health. In fact, taking a diverse approach to your recovery can be beneficial.

Eat well

One of the most common side effects of chemotherapy is appetite loss, which also often translates to loss of basic nutrition by the time you’ve finished treatment. Nourishing your body is always important — especially when facing a serious illness. The good news? If you’re also experiencing bladder leaks, it just so happens that many bladder-friendly foods are nutrient-rich and nourishing for your *whole* body. Rachel recommends working with a nutritionist who can give you an individualized diet plan to promote healing and boost your energy levels.

Talk to your doctor

If you’re experiencing painful sex, urinary incontinence, or other symptoms of pelvic floor dysfunction after cancer, don’t be afraid to speak up. Your oncologist or primary care doctor can help diagnose your symptoms, refer you to an expert, or walk you through treatment options.

Try pelvic floor physical therapy

Pelvic floor physical therapy can help you reconnect with your body after treatment and start addressing issues like urinary incontinence, urine leakage, and pelvic pain. Rachel says pelvic floor PT isn’t always the end-all solution, but it can be a great option to improve your symptoms, including strengthening the bladder muscles for better control. You can start your PT search here.

Give your brain a break

Mindfulness and meditation are proven tools for lowering stress and anxiety, which can free you up to devote more energy to recovering your health. Anxiety also has a feedback loop with bladder leaks, which means that reducing your stress level can also benefit your pelvic health.

Lean on your support system

In addition to spending time with close friends and family, Rachel says most hospitals and medical groups can connect you with cancer support groups and other resources. If you’re feeling shy, there are databases like this one that allow you to search for groups in your area.

Have you been through cancer treatment? Share your advice for recovery in our comments section.