Watch the Cancer.Net Video: Basics of Cancer Surgery with Robert Sticca, MD, adapted from this content.
- If you need to have surgery, you will likely interact with several different types of health professionals.
- Before surgery, you will meet with the surgeon to learn about the surgery and give your permission to undergo the procedure. You will also learn about any tests you may need beforehand and how to prepare for the surgery.
- During surgery, you will receive some type of medication to block the awareness of pain.
- The time it takes to recover after surgery varies depending on the procedure. It is important to follow the recovery instructions provided by your health care team, and ask a friend or family member to help.
The surgical team
When a person with cancer needs surgery, a team of highly trained medical professionals works together to provide the best possible care. A surgeon—often a surgical oncologist—leads this team. However, the type of surgeon will vary based on the type and stage of cancer. For example, urologists and urologic oncologists specialize in treating urologic cancers, including prostate, bladder, and kidney cancers, with surgery. Neurosurgeons treat brain cancers, thoracic surgeons treat lung cancers, and dermatologic surgeons treat some types of skin cancer. In addition to specialists, general surgeons also perform a variety of cancer surgeries.
Additional members of your health care team may include the following medical professionals:
Anesthesiologist. An anesthesiologist is a doctor who cares for patients immediately before, during, and after surgery by giving anesthesia, which is medication that blocks your awareness of pain during surgery and, in some cases, makes you unconscious. An anesthesiologist also monitors your vital signs, such as breathing, heart rate, and blood pressure, and identifies and treats any medical problems that may arise during the surgery or recovery period.
Certified registered nurse anesthetist (also called a CRNA). A nurse anesthetist may monitor your vital signs and modify the anesthesia when necessary to ensure your safety and comfort, caring for you under the direction of an anesthesiologist. This type of nurse has received specialized training in anesthesia and has passed a national certification exam.
Operating room nurse (also called an OR nurse or circulating nurse). OR nurses assist the surgeon during surgery.
Recovery room nurses and staff. Recovery room nurses care for and monitor patients who have undergone major or minor surgery.
Other health care professionals. Other specialists who work to meet the full spectrum of your physical and psychological needs during treatment may include pharmacists, social workers, nutritionists or dietitians, and physical therapists.
Learn more about the oncology team.
Consultation and informed consent. Before treatment, you will meet with the surgeon or surgical team who will review your medical record, perform a physical examination, evaluate the need for surgery, and discuss the potential risks and benefits of the surgery, as well as possible alternatives to surgery. You will be asked to provide written permission for your doctor to perform surgery after you have been told about your treatment options. This process is called informed consent, and it gives you the opportunity to ask questions about the surgery. Your consent also means that you understand that there is no guarantee that the surgery will achieve the intended results.
Preoperative tests. Before surgery, you may need certain tests. For example, you may have a blood test to identify your blood type in case a blood transfusion is needed, assess your risk of bleeding or infection, and check liver and kidney function. In addition, you may be asked to give a urine sample or have an electrocardiogram (EKG) or imaging scans. Imaging scans may include a computerized tomography (CT) scan, magnetic resonance imaging (MRI), an ultrasound, a bone scan, or a positron-emission tomography (PET) scan. Talk with your doctor to learn which tests you will need.
Restrictions. If you smoke, you are encouraged to quit smoking at least two weeks before surgery, which can help your body recover more quickly after surgery. In addition, talk with your doctor to learn what you should or should not eat or drink during the 24 hours before surgery. And, mention any medications and dietary or herbal supplements you are taking, including prescription drugs and over-the-counter drugs. Your doctor and anesthesiologist will tell you whether to continue taking those medications before surgery.
What to wear and bring. When you arrive at the hospital, you may need to change into a hospital gown or remove clothing or jewelry that could interfere with the surgery. Leave jewelry and other valuables at home or with a family member in the waiting area. In addition, wear your eyeglasses on the morning of your surgery, rather than contact lenses, because it is easier to remove your glasses before surgery. You may choose to bring your contact lenses, case, and solution to use once you are recovering from surgery. Usually, you will also be asked not to wear makeup on the day of the surgical procedure.
- Check with your insurance provider to learn whether you need to get preapproval of insurance coverage before the surgery.
- If there is a risk of blood loss during the operation and your procedure is more than four weeks away, you may want ask your surgical team if it would be helpful to have your blood drawn and stored in case it is needed during your operation.
- Consider bringing a family member or friend on the day of surgery. After the surgery, your doctor will provide him or her with an update about how it went.
- Arrange for care during your recovery phase, including transportation home from the hospital.
- If you have any questions, clarify instructions with the surgical care team.
You will likely receive some type of anesthesia during surgery. Local anesthesia is an injection that numbs the area where the procedure is being done. Most procedures that take place in a doctor's office, such as the removal of a mole, are done with local anesthesia. Regional anesthesia blocks pain in one larger part of the body, often by numbing the nerves in and around the area where surgery is needed. Patients receiving local or regional anesthesia are often given conscious sedation, also called monitored anesthesia care, which helps them relax and sometimes sleep during the procedure. General anesthesia makes a person unconscious during a major procedure. Learn more details about these types of anesthesia.
Initially, general anesthesia is delivered through a face mask, an intravenous (IV) needle that is placed in a vein in your arm, or a combination of both. The anesthesiologist then usually places a tube in your throat to assist with breathing, provide oxygen, and sometimes deliver anesthesia. The anesthesiologist carefully monitors your heart rate, blood pressure, and oxygen during the operation. Generally, you are not aware of anything until the anesthesia wears off after the operation.
After the anesthesia has been given and before the surgery begins, the area of your body around the location of the surgery will be thoroughly cleaned and any hair will be shaved or trimmed to reduce the risk of infection. Once the operation is finished, you will be moved to the recovery area or another appropriate area depending on how much care you need after surgery.
Recovery time usually depends on the type of surgery and the type of anesthesia given during surgery. For example, patients who have received local anesthesia may be able to go home shortly after the procedure. Patients who have received regional or general anesthesia are monitored carefully in a recovery room until the anesthesia wears off, which usually takes about one to two hours.
After procedures done under general or conscious sedation anesthesia, you may feel groggy for some time after surgery. If you have had general anesthesia, you may gradually become aware of soreness in your throat from the anesthesia tube, the tubes at the site of surgery for draining excess fluid, and perhaps a catheter, which is a tube placed in the bladder to allow urine to exit your body. You may also become aware of pain as you awaken, and you may be given medication to relieve it. When your condition is stable, you will be either transported to your hospital room or discharged home.
Before you leave the hospital, schedule follow-up appointments so that your doctor can monitor your ongoing recovery.
In addition, it is important to follow recovery instructions from your doctor or nurse, and contact your health care team if you have any questions. The following suggestions may help speed recovery:
- Ask your doctor about engaging in physical activity after your surgery. It is important to walk as soon as you can to circulate blood and prevent clots. In addition, physical therapy may be an important part of your recovery because it can help build strength and flexibility, and it may begin as early as the day following surgery. Some patients are given a home exercise program to continue their progress, but it is important to follow the specific directions given by your doctor.
- Perform deep breathing exercises to help re-expand your lungs and lower the risk of pneumonia if your doctor recommends it.
- Do not smoke during recovery. If you do smoke, talk with your health care team about resources to help you quit smoking.
- Talk with your nurse or hospital dietitian about getting the right nutrition and returning to your regular foods.
- Let your doctor and nurse know if you are in pain so they can help you to manage it.
- Monitor your condition for complications, such as bleeding, infections, and allergic reactions to anesthesia or drugs, including nausea, shortness of breath, and dizziness. Your health care team will explain the signs and symptoms to watch for and when to contact your health care team about them.
- If you develop a fever, excessive drainage from your surgical incision, redness or excessive swelling at your incision site, or persistent nausea and vomiting, contact your health care team.
- Ask your doctor or nurse when and how to change your bandage, also called the dressing. Although a bandage is used to help a surgical incision heal and guard against infection, leaving it on too long may delay healing or lead to infection.