This article—the second in a three-part series—outlines what you will experience before, during, and after treatment. Other articles in this series provide an overview of surgery—including the various types—and describe side effects of the treatment.
Watch the Cancer.Net Video: Basics of Cancer Surgery with Robert Sticca, MD, adapted from this content.
The surgical team
When a patient with cancer undergoes surgery, a team of highly trained medical professionals works together to provide the best possible care. This team is led by a surgeon, often a surgical oncologist. 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 cancer—with surgery. Meanwhile, neurosurgeons treat brain cancers, thoracic surgeons treat lung cancers, and dermatologic surgeons treat some types of skin cancer. General surgeons also perform many cancer surgeries, including surgeries for breast cancer, skin cancer, colorectal cancer, and many other gastrointestinal cancers.
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. The anesthesiologist gives you anesthesia (medication that blocks the awareness of pain during surgery and, in some cases, makes you unconscious) and monitors your vital signs (breathing, heart rate, and blood pressure) while identifying and treating any medical problems that may arise during the surgery or recovery period.
Certified registered nurse anesthetist (CRNA). A nurse anesthetist (a nurse who has received specialized training in anesthesia and passed a national certification exam) may also care for you before, during, and after surgery, often under the direction of an anesthesiologist. This nurse monitors your vital signs and modifies the anesthesia when necessary to ensure your safety and comfort.
Operating room (OR) nurse/circulating nurse. OR nurses are registered nurses who 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 can 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 a surgeon who will review your record, perform a physical examination, evaluate the need for surgery, and discuss the potential risks and benefits of surgery. You will be asked to provide written permission for your doctor to perform surgery after you have been informed 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 necessary), assess your risk of bleeding or infection, and check liver and kidney function. In addition, you may be asked to give a urine sample, have an electrocardiogram (EKG), or undergo imaging scans, such as computerized tomography (CT), magnetic resonance imaging (MRI), ultrasound, bone scan, or positron-emission tomography (PET). Talk with your doctor to learn what 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/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, as 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. In most cases, 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 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 to bank (store) your own blood for use 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 doctor or nurse.
You will likely receive some type of anesthesia during surgery. Local anesthesia means that the area near the site of the operation is numbed. Most procedures that take place in a doctor's office, such as the removal of a mole, are done with local anesthesia. Regional anesthesia is used to block sensation from a larger area, such as an arm or leg. It often involves blocking specific nerves. Patients receiving local or regional anesthesia are often given a sedative to help them relax and sometimes sleep during the procedure. General anesthesia causes a person to feel no pain and to be unaware of the surgery. This is the type of anesthesia most people think of when having an operation.
Initially, general anesthesia is delivered through either a face mask or an intravenous (IV) needle (a needle placed in a vein in your arm). The anesthesiologist then 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.
In the operating room, after the anesthesia has been given, the area of your body around the location of the surgery will be thoroughly cleaned and shaved to reduce the risk of infection. Once the operation is finished, you will be moved to the recovery area.
Recovery time usually depends on the type of surgery performed and the type of anesthesia given during surgery. For example, patients who received local anesthesia may be permitted 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, usually in one to two hours.
After procedures done under general or sedation anesthesia, you may feel groggy for some time after surgery. 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 (tube) in your bladder, which allows urine to exit your body. You may also become aware of pain as you awaken and 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. The following suggestions can help speed recovery:
- Walk as soon as you can to circulate blood and prevent clots.
- Work with your doctor and/or nurse to manage pain.
- Perform deep breathing exercises to prevent pneumonia if your doctor recommends it. And do not smoke during recovery.
- Talk with your nurse or hospital dietitian about getting the right nutrition and returning to your regular foods.
- Be alert for complications, such as excessive bleeding, infections, and allergic reactions to anesthesia or drugs, including nausea, shortness of breath, dizziness.
- If you develop a fever, excessive drainage from your surgical incision, redness or excessive swelling at your incision site, or persistent nausea and vomiting, call your surgeon's office.
- Ask your doctor about engaging in physical activity after your surgery. Physical therapy (PT) may become an important part of your recovery because it can help build strength and flexibility, and it can 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.
- Ask your doctor or nurse when and how to change your dressing (bandage). Although a dressing is used to help a surgical incision heal and to guard against infection, leaving it on too long may actually delay healing or lead to infection.
Don't hesitate to contact your health care providers if you have questions.