You had cancer and now you don’t: What happens next?
By Laura Briedis
The best five words someone diagnosed with cancer can say are, “I am a cancer survivor.”
Oftentimes, however, once patients are cancer-free after months or years of treatment, they don’t know what to do next. The transition from post-acute care can result in anxiety, as patients experience a loss of the sense of safety that came from regular appointments with their oncologist.
To help bridge this transition, University Hospitals (UH) Geauga Medical Center, a campus of UH Regional Hospitals, takes a multidisciplinary approach as a team of experts works together closely with the UH Seidman Cancer Center team to optimize health outcomes of cancer patients.
According to David Sheyn, MD, a urogynecologist at UH Geauga Medical Center, the recovery phase is just as important as the treatment phase for a patient’s overall well-being. And, on occasion, cancer survivors can suffer from side effects from their cancer treatment.
Radiation therapy is often used as part of the treatment plan for cancers of the bladder, prostate, uterus and cervix. Although it is highly effective in treating cancer, radiation to the organs of the genitourinary systems can sometimes cause bothersome side effects, such as scar tissue, fistulas and sexual and urinary problems.
In the highly specialized field of female pelvic medicine and reconstructive surgery, UH urology experts work closely with oncologists and other specialists to help patients restore genitourinary function that has been compromised by cancer and/or cancer treatments.
“We have reached out to the Seidman Cancer Center here at the UH Geauga campus to screen patients for pelvic floor disorders that might arise during or after their cancer treatments,” says Dr. Sheyn. “We screen them for bladder issues, bowel issues and sexual dysfunction. Unfortunately, some cancer treatments can have unintended side effects and can lead to pelvic floor disorders.”
“The of two most common are urinary incontinence and sexual dysfunction,” he says. “Chemotherapy can affect nerves and tissues in the bladder and cause incontinence.”
The good news is a lot of these conditions are easy to treat. Overactive bladders can be treated with medications or minimally invasive procedures. These treatments include some novel procedures, such as injecting Botox into the bladder, and using sacral neuromodulation, which is like a pacemaker for the bladder.
Dr. Sheyn is also well versed in the sling procedure, a surgical implantation of a mesh sling that creates additional support of pelvic organs, which has been the gold standard when treating stress urinary incontinence. Another procedure that is ideal for cancer patients who have undergone radiation is urethral bulking. During this procedure, Bulkamid gel bulking agent is injected around the walls of the urethra near the bladder to narrow its width. This adds bulk to the urethra, supporting the closing mechanism and providing better control of urine.
For patients who have sexual dysfunction, UH Geauga Medical Center offers pelvic floor therapy and has experts in sexual medicine.
University Hospitals also offers specialized programs for other specific cancers, such as breast cancer.
“Because we are getting so good at treating cancer, people are living longer, so we want to make sure their quality of life is as high as possible,” says Dr. Sheyn. “Everyone is rightly focused on identifying successful treatments, but as a result, there are few studies on what happens after cancer. My hope is that this program we have set up, in addition to treating pelvic floor disorders in cancer patients and survivors, will help us better understand how often these issues arise and how to best care for them.”
UH Geauga Medical Center is located at 13207 Ravenna Road, in Chardon. You can schedule an appointment with a urogynecologist by calling 440-901-6816 or visiting UHhospitals.org/UrologyAppt.