Surgery is one of the main treatments for cancer. It usually means having an operation to remove all or part of the cancer.
Sometimes an operation to remove the cancer might be the only treatment you need. But very often treatments such as chemotherapy and/or radiotherapy are used along with surgery.
The operation you have will depend on the type of cancer you have and other factors like where it is and its size.
Surgery isn’t only used to remove cancers. Here are some examples of minor operations that are sometimes done:
a biopsy, which is when a sample of tissue is removed
having a central line put in, which is then used to give chemotherapy treatment.
The thought of having any type of operation can be a bit scary. But knowing a bit more about what to expect can help you feel more prepared.
This section contains general information about surgery. We also have information about specific operations to treat certain cancer types. You can find this info in the individual cancer sections.
Before the operation your surgeon will explain to you and your parents what’s involved, the benefits and risks of surgery and any other treatments that could be used instead.
Surgery techniques have improved a lot over the years. Your surgeon will try to make sure the operation doesn’t damage any healthy tissue and that any possible side effects and risks are reduced.
Make sure you talk everything over with your surgeon, and don’t be afraid to ask any questions, no matter what they are. When you’ve fully understood what’s going to happen and everything that’s involved, you or your parents sign a consent form. This means you agree to have the operation.
Pre-operative (pre-op) assessment
You might have an appointment with a nurse or doctor a few days before the operation. This is sometimes called a pre-op assessment. You'll be asked some questions about your health and home circumstances. They’ll weigh you (to work out the dose of anaesthetic drugs you need), do some blood tests and check your temperature, blood pressure and pulse. This is to make sure you’re fit for the operation. You’ll also be given information about what to do to prepare for your operation. This will cover things like:
what to bring with you into hospital
how long you’re likely to be in for
whether you need to stop eating and drinking in the hours before your operation
what you should do about any prescribed medicines you take.
You'll also be told to remove all make-up before your operation, including nail varnish. Doctors and nurses need to see your skin and nails during and after your operation to make sure your blood circulation is healthy.
Not eating or drinking before your operation
If your doctor or nurse has told you not to drink or eat (called fasting) before your operation, it's very important that you follow their instructions exactly. Your stomach needs to be empty during surgery so you don’t vomit (be sick) while you’re under a general anaesthetic (when you’re asleep and can’t feel anything). If there’s anything you don’t understand, make sure you ask.
The day of your operation
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You’ll go into hospital the day before or on the day of your operation. When you arrive, a nurse will go over everything with you, give you instructions about fasting, and put on your name bracelet. You'll wear this bracelet until you leave hospital, and the doctors and nurses will always check it before they do anything to you.
On the day of your operation you’ll usually see your surgeon. You can ask any questions or talk to them about any worries you have about the operation. You’ll also see the anaesthetist, who’s the doctor is in charge of giving you the anaesthetic drugs so you don’t feel any pain during the operation. The anaesthetist will ask you some questions about your health. You can have someone with you while all this is happening.
When it’s time to get ready, a nurse will give you a hospital gown and some white support stockings to wear. These help with your blood circulation. The nurse will tell you what you should expect when you wake up after the operation.
Your nurse or doctor might put a fine tube called a cannula into your arm or hand. This can be attached to a drip to give you fluids or any medicines you need during and after the operation. Sometimes you’re given a tablet or injection to help make you a bit sleepy before the operation. If you want, your parent or someone else can go with you to the anaesthetic room. They can often stay with you until you’re asleep.
There are different types of anaesthetic. The one that's used will depend on the type of operation you’re having.
Most operations are done under a general anaesthetic. The anaesthetist will give you the anaesthetic drugs as an injection into your cannula, or as gas that you breathe through a mask. Throughout the operation you’ll be deeply asleep and won’t feel any pain. The anaesthetist will keep a very careful check on you and make sure you’re getting the right level of anaesthetic drugs.
This can be used for some minor types of surgery. For example:
having a central line put in
having a biopsy (when a sample of tissue is removed) from a small area of the body
having a bone marrow biopsy.
Usually your doctor gives you a small injection into the skin to numb the area of the body they’re going to do the procedure on. Occasionally sprays or creams are used instead of an injection. You can also usually have some medicine that helps relax you and make you feel a bit sleepy.
Your doctor then waits a few minutes until the local anaesthetic has worked. You won’t feel any pain during the operation or procedure, but you might feel some pressure.
If you’ve had a general anaesthetic, immediately after the operation you’ll be taken into the recovery area. A nurse checks you’re okay and takes your blood pressure, pulse and temperature. You can have a parent or close friend with when you’re coming round from the anaesthetic.
You’ll feel a bit groggy or even dizzy at first. Some people need to have oxygen through a mask or tube for a short while. Your mouth will probably feel dry and you might have a sore throat. Let the nurse know if you feel a bit sick, which sometimes happens after you’ve had a general anaesthetic. The nurse can give you an injection to help with this.
Once the anaesthetic has worn off you’ll be taken back to the ward or high dependency unit, depending on the type of operation you’ve had. The surgeon will let you and your parents know how the operation went.
How you feel and your recovery will depend on the type of operation you had. If you had minor surgery you’ll probably be up and about quickly, and go home on the same day or the next day. If you’ve had a major operation, you’ll need more time in hospital. The nurses will keep a careful check on you, especially for the first few days.
Drips and drains
You might have some of the following drips and drains in place when you wake up, but usually only for a short time. You’re not likely to have all of these, and some people won’t have any - it depends on the operation you’ve had.
A drip that goes into a vein in your arm or the back of your hand, or that's attached to your central or PICC line. This gives you fluids until you’re able to eat and drink again, and it can also be used to give you painkillers.
A wound drain - a fine a plastic tube that allows fluid and blood from the wound to drain into a small plastic bottle.
A fine tube into your bladder (called a catheter), which drains your urine into a collecting bag.
A fine tube going through your nose into your tummy (called a nasogastric tube). The nurses attach a syringe to the end of the tube and remove any fluid in your tummy so you don’t feel sick.
The nurses will encourage and help you to get up out of bed and move around as soon as possible. This helps prevent problems such as getting a blood clot or a chest infection. If you have to stay in bed, a nurse or physiotherapist will show you leg exercises and breathing exercises to do.
If you’ve has surgery to a limb (an arm or a leg), you’ll see a physiotherapist who will show you the exercises you need to do to help you get back to using your limb as much as possible.
After your operation you’ll probably need to take painkilling drugs for a few days. You can have them as tablets, or they can be given into a vein (intravenously). This is sometimes done through a syringe connected to an electronic pump that’s set to give you a continuous dose of painkiller. You can control the pump yourself using a handset with a button you can press when you need more of the painkiller. But the pump’s designed so that you can’t give yourself too much painkiller (called an overdose), so it’s okay to press it whenever you have pain.
Some people are given painkillers into the space around the spinal cord, through a fine tube that’s put in their back during or after surgery (called an epidural). The tube connects to a pump, which gives a continuous dose of painkillers.
Let your nurses and doctors know as soon as possible if you’re in any pain. This will help them give you the dose of painkillers that’s right for you.
You’ll have a dressing covering the place where you had your operation. It might stay on for the first few days, but the nurses will keep a check on it. After this they’ll change the dressing regularly and make sure the wound is healing. You might have a wound drain in place, which is usually removed a few days after your operation.
How quickly you recover will depend on the type of operation you’ve had. After a minor operation you’ll usually get back to your usual self quickly. If you’ve had a major operation it will take longer, so you’ll need to be patient. But there are things you can do to help your own recovery - both in hospital and when you go home.
Keep active and do your exercises
Being active by just walking around can reduce the risk of problems after your operation. It also gives you more energy. You can gradually build it up the amount of activity you do as you get stronger.
If you’ve been given exercises to do, make sure you carry them out as you’ve been shown. This will help the part of your body that was operated on to recover and work as well as possible.
Once you’re told its okay, the sooner you start eating and drinking after your operation, the better. Eating well helps your body heal.
When you’re in hospital your family may be able to take in some of your favourite foods, but ask the nurses what’s okay first. Hospitals have guidelines about foods which can and can’t be brought in to you.
Try to make sure you eat healthily with plenty of fresh fruit and vegetables. You can get help and advice from a dietitian if you’re having problems eating or are losing weight
Get enough rest
Try to pace yourself and don’t overdo things. You can build up your activities gradually. You might not be up to seeing all your friends straight away. Ask them to keep in touch through text, email or social networking sites so you don’t feel you’re losing touch.
Ask for help
You can sometimes feel low, irritable or tearful after an operation. This can depend on whether the operation you’ve had has any long-term effects.
It’s important to let people know how you’re feeling so that they can support you. You can talk things over with someone in your family, with a friend, or with your cancer nurse or doctor. You can also usually be referred to a counsellor.