Inclusion Criteria:

• 1. Female
• 2. ≥ 18 years old at the time of informed consent
• 3. Ability to provide written informed consent and HIPAA authorization
• 4. Primary diagnosis of cervical, vaginal, vulvar, uterine, or anal cancer
• 5. Candidate for curative pelvic radiation with external beam, with or without brachytherapy, per radiation oncologist's discretion
• Notes:
• * Can have prior and/or current modalities of treatment to address diagnosis including surgery and chemotherapy
• * Can receive radiation at any facility provided patient is able to perform Physical Therapy visits at IUH North/Schwarz Cancer Center

Exclusion Criteria:

• 1. Major medical illnesses or psychiatric impairments, which in the investigator's opinion will prevent administration or completion of the protocol therapy and/or interfere with follow-up.
• 2. Not a candidate for curative radiation therapy per radiation oncologist's discretion
• 3. Prior radiation therapy to the pelvis
• 4. Women who are pregnant or nursing