Gynaecological and Breast Cancer

Gynaecological and breast cancer can cause other related conditions, including:

• Axillary web syndrome (cording)
• Shoulder and scar stiffness
• Sexual dysfunction
• Vaginal stenosis

Our physiotherapists here at Sydney Pelvic Clinic can help you alleviate the symptoms of each one of the above.

What Is Axillary Web Syndrome?

Also known as cording, axillary web syndrome often develops as a side effect following a sentinel node biopsy or axillary lymph node dissection procedure in the treatment of breast cancer.

The condition is typically caused by the inflammation and development of scar tissue and hardened connective tissue, as a result of the removal of one or more lymph nodes in the axilla region under the armpit.

What are the Symptoms of Axillary Web Syndrome?

People experiencing axillary web syndrome typically see and/or feel a thick web of cord-like structures under the skin of the armpit. These cords usually start near the site of any scarring in the armpit and can extend down the inner arm to the inside of the elbow, and occasionally all the way down to the palm of the hand. They may come as a single large rope-like structure, double strands, or several distinct smaller cords, and develop anywhere between several days and several weeks following the surgery.

Axillary web syndrome can cause pain and tightness, making it difficult for the patient to lift their arm above shoulder height or fully extend their elbow, effectively limiting their daily function.

How is Axillary Web Syndrome Treated?

Physiotherapy treatment early in the post-surgery period can help alleviate the pain, assist in regaining the full shoulder range of movement, and prevent the onset of lymphoedema.

What is post-gynaecological cancer-surgery sexual dysfunction?

Post-gynecological cancer-surgery sexual dysfunction refers to any sexual issue experienced by a person who undergoes surgery for gynaecological cancer, such as vulvectomy or hysterectomy.

What are the symptoms of post-gynaecological cancer-surgery sexual dysfunction?

The most common symptoms of post-gynaecological cancer surgery sexual dysfunction are:

• Pain
• Loss of sensation
• Changes in body image
• Vaginal dryness
• Difficulty in reaching orgasm

How is post-gynaecological cancer-surgery sexual dysfunction treated?

Our physiotherapists here at Sydney Pelvic Clinic can prepare people scheduled for gynaecological cancer surgery by educating them on how postoperative changes may impact their intimate relationships. Once the surgery is completed, we ask them openly about any sexual concerns they may have and provide them with the appropriate solutions, which may include:

• Vaginal trainers
• Release wands
• Vibration therapy
• Pelvic floor strengthening/down training

A multidisciplinary approach to the management of sexual dysfunction is important, and your physiotherapist may recommend that you also consult with a sex therapist or psychologist.

What is Vaginal Stenosis?

Simply put, vaginal stenosis refers to the narrowing and shortening of the vagina, which causes it to become drier, less flexible, and more fragile. It is a potential side effect of local chemotherapy as treatment for cancer in the pelvic region.

What are the Symptoms of Vaginal Stenosis?

The most common symptoms of vaginal stenosis are:

• Dyspareunia (i.e., pain during sexual intercourse)
• Discomfort during pelvic exams

How is Vaginal Stenosis Treated?

Our physiotherapists here at Sydney Pelvic Clinic employ a variety of treatments to help alleviate the symptoms of vaginal stenosis. Examples include:

• Dilator therapy to gently stretch the walls of the vagina
• Vaginal pH optimisation
• Internal treatment of the pelvic floor to relieve tension
• Education regarding suitable personal lubricants and vaginal moisturisers