How Cancer Surgery Affects People Age 65 and Older

Approved by the Cancer.Net Editorial Board, 02/2022

Most people diagnosed with cancer are age 65 or older. And, many will need surgery, which is one of the most effective ways to treat certain cancers. Adults with cancer age 65 and older have distinct needs before, during, and after surgery. Being aware of these needs and planning for them can improve recovery, prevent side effects, and help maintain quality of life.

Before cancer surgery

The doctor who will perform your operation is called a surgeon or a surgical oncologist. You will meet with them before your surgery to review your medical record, talk about why this surgery is recommended for you, discuss its possible risks and side effects, and get instructions for returning home after surgery.

A geriatric assessment is a way to evaluate your health and well-being before surgery. This is a set of tools that helps your doctors recommend the best type of cancer treatments for you, including surgery. A geriatric assessment will typically cover:

  • Daily living activities

  • Physical function

  • Risk of falls

  • Other medical conditions besides cancer

  • Mood, anxiety, and depression

  • Social activities and support network

  • Cognition and memory functioning

  • Nutrition

Your oncologist, surgeon, or other health care provider can provide a geriatric assessment. These results should be shared with others on your health care team.

The results from a geriatric assessment can help your health care team plan the medical care and support you need before, during, and after surgery. For example, the information learned during the assessment might show that you are at an increased risk of certain side effects. It can also help you and your health care team predict how much help you will need at home during your recovery.

Learn more about the importance of geriatric assessments and cancer care.

Types of cancer surgery

People with cancer, of any age, may undergo different types of surgery. Surgery can be used to diagnose, treat, or recover from cancer.

Different types of cancer-related surgery include:

  • A biopsy, when a surgeon takes a sample of tissue that will be examined to see if cancer is present

  • Staging, when a surgeon removes lymph nodes and other tissues to determine if cancer has spread

  • Tumor removal to treat cancer, also called surgical resection

  • Other surgical approaches to remove cancer, like laparoscopic surgery, endoscopy, and laser surgery

  • Palliative surgery to reduce side effects of a tumor, such as by removing a blockage to help with food digestion

  • Reconstructive surgery to build back tissue

It is important to talk with your doctor about all of your surgical options, including evaluating each option's risks and side effects. For instance, studies show that minimally invasive surgeries involve fewer complications, less pain, and shorter hospital stays. In the past, the safety of some minimally invasive surgeries for people aged 65 and older has been a concern. New research has shown that minimally invasive surgeries can be safe and effective for older adults with cancer.

If anesthesia is needed during your surgery, an anesthesiologist and certified registered nurse anesthetist will be part of your surgical team. Anesthesia is medication that keeps you from feeling pain. They take special precautions for older patients who may feel more severe effects from anesthesia or need more medication adjustments.

How surgery can affect people age 65 and older

There are specific ways that surgeries can affect older adults. Before surgery, you and your doctor should think about the following:

Heart function. If you have heart problems, be sure to talk with your surgical team about this in detail. Blood loss during surgery, changes in fluids, changes in blood pressure, and the effects of anesthesia and other drugs given during surgery can all affect the heart. These can cause problems with your heart during surgery, immediately after surgery, or in the weeks and months after surgery.

It is important for your surgical team to know about any heart problems so that is a factor as they plan your care. They will be able to monitor you closely for heart problems during and after your surgery.

Kidney function. Surgery can involve many drugs. You might also get a lot of fluids to keep your body working. Your kidneys need to process this large amount of drugs and fluids during and after surgery. If your kidneys do not work well, this can cause problems.

Liver function. As you get older, less blood flows to your liver to help it work. Your liver breaks down drugs. If it does not work as well as it should, you are more likely to have a reaction to the drugs needed for surgery.

Lung function. As you get older, your lungs do not hold as much air. And they might not work as well to move air in and out of your body. If you have a lung condition, such as emphysema or chronic obstructive pulmonary disease (COPD), recovering from anesthesia may be more difficult for you. This includes medications you get before and during surgery. Lung problems raise your risk of getting pneumonia after surgery, which can be very serious.

Recovering from surgery for adults aged 65 and older

Planning ahead of time for your after-surgery care is important. Having a detailed plan makes a successful recovery more likely. And, it can provide you and your loved ones with reassurance and a sense of control during a stressful time.

Older adults often need additional care and recovery time after surgery. Talk with your health care team about the expected level of care you will need and for how long. You may need specialized care during your recovery, based on your health before surgery, the extent of surgery, and other factors. Ask if you might need:

Also, ask how long your hospital stay after surgery is expected to be and what medical tests will be needed before you are discharged. Sometimes, people go to a another medical facility, such as a medical rehabilitation center or nursing facility, after cancer surgery to help support their recovery.

Recovering from surgery at home

It is helpful to think ahead to when you will be returning home and making sure you have the help you need.

Ask a family member or friend to be at your side after surgery and give you a ride home. If you live alone, you may need to ask a friend or family member to stay with you while you recover, called a caregiver. You can also hire home care services that can help with your recovery.

Your health care team will provide instructions and resources for taking care of yourself once you get home. These are often called discharge papers. Be sure to follow these instructions, which may include:

  • Complete list of all medications and dosages, along with medication side effects

  • Instructions on how to care for wounds, change dressings, and watching for possible side effects

  • Guidance about eating, drinking, and physical activity during recovery

  • Future appointments for follow-up care

  • When you should call a nurse or doctor and how to contact them

If something is not clear to you and your caregiver, be sure to ask questions so that you feel comfortable following the instructions provided by the health care team. This is also a good time to ask any other concerns you might have about your recovery after surgery.

Common concerns after surgery for older adults

There are problems or side effects from surgery that are more common in older adults. These include:

Cognitive problems. People aged 65 and older are more likely to experience mental confusion or delirium after surgery, which is a sudden change in the ability to think clearly and pay attention. It is preventable and treatable. Make sure your caregivers are aware of the signs of attention and thinking problems.

Pain. Managing pain after surgery is a very important part of your recovery. There are several medications used to manage pain, including opioids. People who are 65 or older may be more sensitive to opioids. Before surgery, discuss the use of opioids with your health care team to come up with the best pain management plan for you.

Nausea and vomiting. Nausea and vomiting are the most common side effects after surgery. Tell your doctor if you have a history of these complications post-surgery or experience motion sickness.

Nutrition and hydration after surgery. It is important that you get enough nutrition and hydration when you are recovering from surgery. Malnutrition, which is not having proper nutrition, is a common problem for older adults after surgery, due to appetite changes and other challenges. Dehydration, when your body does not get enough water or other fluids, is also common.

During your hospital stay and during recovery at home, ask nurses or caregivers to help keep track of your food and water intake. Identifying and treating such problems early can speed your recovery and prevent complications. It may also be helpful to talk with a food and nutrition expert, called an oncology registered dietitian nutritionist, as part of your plan for recovery.

Questions to ask the health care team

  • What will my surgery be like?

  • How long will the operation take?

  • Who will perform this surgery?

  • What type of anesthesia will I receive?

  • How does my health history affect how my surgery is being planned?

  • What are the possible complications from this surgery and/or anesthesia?

  • Will I need to stay overnight or longer in the hospital?

  • Will I need someone to drive me home after this surgery?

  • What side effects should I watch for after surgery?

  • Who should I contact about any side effects I experience? How soon?

  • Are there side effects I should tell you about right away?

  • What will my recovery be like?

  • Will I need someone to stay with me while recovering at home? For how long?

  • Will I need specialized medical care after this surgery? For how long?

  • Am I at a higher risk of falls during my recovery from surgery? How can I reduce that risk?

  • Are there things I can do at home to help with my recovery, such as nutrition, hydration, rest, and physical activity?

  • If I'm very worried or anxious about having this surgery, who can help me?

  • When will my first follow-up appointment be after my surgery?

Related Resources


How Do Geriatric Assessments Help Older Adults with Cancer?

How to Stay Safe and Independent During Cancer Treatment

Caregiving at Home

7 Tips Older Adults Can Use to Manage Their Cancer Care