This article—the third in a three-part series—describes the side effects of this treatment. Other articles in the series provide an overview of surgery—including the various types—and address what to expect when undergoing surgery.
Cancer surgery, like all cancer treatments, comes with benefits, risks, and side effects. The types and intensity of side effects vary from person to person and with the type and location of the cancer, the type of surgery, and the person's health. If you and your doctor decide that surgery will be a part of your cancer treatment, you will be given information about all aspects of your treatment before you consent to surgery, including the side effects you may experience.
With recent advances and less invasive surgical techniques, the side effects of surgery are often milder, and patients usually recover faster. In addition, doctors have made major strides in recent years in reducing pain and other physical side effects from all types of surgery. Your health care team will work with you to ease or prevent side effects.
Common side effects of cancer surgery
Common side effects of cancer surgery may include the following:
Pain. It is common to have some pain after any surgery. The amount and location of the pain depends on many factors, including the site of surgery, the size of the incision, and the amount of tissue removed. Pain after surgery resolves gradually as the body heals. Pain medications are given after surgery to decrease the discomfort that the patient feels while the healing occurs.
Fatigue. Many patients feel very tired after major surgery, especially when the surgery involves the abdomen or chest. This is due to a combination of factors, including the anesthesia, the body's tendency to divert energy to the healing process after the surgery, the reduction in the amount of food eaten in the period immediately after the surgery, and the stress of the surgery. Fatigue usually resolves gradually within two to four weeks after the surgery is performed.
Loss of appetite. Poor appetite after surgery is very common, especially when general anesthesia was used. This generally lasts for two to four weeks after surgery and may be associated with a temporary weight loss. Most patients regain their appetite and return to their normal weight as the effects of the surgery wear off.
Swelling around the site of surgery. A surgical incision (cut in the skin) is a form of injury to the body, and the body's natural response to injury is the inflammatory process, which results in swelling. Swelling occurs because fluid containing chemicals from white blood cells accumulates in the injured tissues to attack foreign substances. As the healing occurs after the surgical procedure, the inflammation resolves, and the swelling goes down. It is natural to experience some swelling after any surgical procedure.
Drainage from the site of surgery. Sometimes the fluid that accumulates at the surgery site drains through the surgical wound. This is normal. However, if the drainage is foul smelling or associated with fevers and redness, it may be a sign of infection, and you should contact your surgeon's office to have it evaluated.
Ecchymosis (bruising) around the site of surgery. After any surgical incision, there may be some leakage of blood from the small blood vessels under the skin. This can cause bruising, which is a common occurrence after a surgical procedure. However, if there is a significant swelling associated with the bruising, contact your surgeon's office to have it evaluated.
Bleeding. In every surgical procedure, there is some blood loss. In most cases the amount of blood loss is minimal, and it does not affect the normal function of the body. In some surgical procedures, a larger amount of blood loss is expected, and the surgical team may have blood available for transfusion. Occasionally, you may experience some bleeding from the wound after a surgical procedure. If this occurs, cover it with a clean, dry dressing, and contact your surgeon's office. If there is a large amount of bleeding, it is helpful to apply pressure until you can be evaluated in your surgeon's office or the local emergency room.
Infection. This may occur at the site of the incision, or cut. Surgeons take great care to minimize the risk of infection during the operation, and your health care team will teach you how to care for yourself during recovery. Signs of infection in a surgical incision include redness, warmth, increased pain, and, in some cases, drainage from the wound. If these signs occur, contact your surgeon's office to have the wound evaluated. Antibiotics, in pill form or by injection, are effective in treating most infections.
Lymphedema. This is another common side effect that may occur after a lymph node dissection (the removal of lymph nodes). Lymph nodes are small glands that filter bacteria and other harmful substances from the lymph fluid, a colorless fluid in most tissues of the body. Sometimes, when the lymph nodes are removed, lymphatic fluid collects in the surrounding tissues, causing them to swell; this is called lymphedema, and it can result in discomfort and tightness. Lymphedema occurs in less than one third of all patients who undergo lymph node dissection procedures. Your surgeon will discuss the risk of lymphedema with you before a planned lymph node procedure.
Organ dysfunction. Cancer surgery in some areas of the body, such as the abdomen or chest, can sometimes cause temporary problems with the organs in that area. For example, when surgery is performed in the abdomen, the bowels may become paralyzed for a short time (also called an ileus), not allowing the contents of the bowels to pass through. This can result in nausea and vomiting until the bowels begin to function again. Organ dysfunction after surgery is usually temporary and resolves as the healing process proceeds.
Other Concerns after Cancer Surgery
Dietary concerns. During recovery, the body needs extra calories and protein for healing; however, eating your regular food may be difficult, depending on the location where the surgery was performed. Resection (removal) of any part of the mouth, throat, stomach, small intestine, colon, or rectum decreases appetite, limits the body's ability to absorb nutrients, and/or increases problems after eating, such as gas, cramping, or constipation. Some patients may have difficulty chewing or swallowing food. In addition, surgery for stomach cancer may affect the body's ability to absorb certain vitamins. Doctors usually prescribe vitamin supplements, some of which can be given only by injection, to help ease this problem.
Body image. Cancer surgery causes physical changes that may change the way your body looks and feels and how it functions. For example, surgery for bladder and colorectal cancers may affect the removal of waste products from the body. If the bladder is removed, a new way to store and remove urine is needed. A urostomy (connection between the urinary organs and the skin) may be created during the surgery to divert urine to the outside of the body. Similarly, if the lower part of the rectum is removed, a temporary or permanent colostomy may be needed. A colostomy is a surgical opening, or stoma, through which the colon is connected to the skin surface to provide a pathway for waste to exit the body. Such waste is collected in a pouch worn by the patient.
Some people may feel insecure about these changes and struggle with their body image. The emotional side effects of cancer surgery are as important to treat as physical side effects. Talk with your doctor about options for reconstructive surgery and prostheses. Some patients find it helpful to join a support group of other patients in similar situations.
Sexuality and Reproduction
Certain types of surgery can affect fertility (a woman's ability to conceive a child or maintain a pregnancy and a man's ability to father a child). Before treatment begins, talk with your doctor about the possible fertility-related side effects of your treatment and the available options for preserving fertility.
In addition, depending on the location of the surgery, both men and women may experience other sexual side effects. For example, men undergoing surgery for prostate, bladder, colorectal, or other types of cancer may experience changes in their sexual desire and production of semen. The ability to have an erection or the ability to ejaculate may be affected. Meanwhile, some gynecologic surgical procedures may affect sexual function for women, as well. And many women experience a range of feelings after such surgery, including loss, sadness, or anxiety. It is important to discuss the symptoms you experience with your doctor. There are various options available to help manage the sexual problems you may encounter.