Cancer Surgery: What you need to know before, during and after

cartoon image of medical equipment

Surgery remains one of the most common and effective methods for diagnosing and treating cancer but having an operation can be an overwhelming experience filled with uncertainty. Whether your operation is for diagnosis or treatment, understanding what lies ahead can help ease anxiety. In this guide, we’ll explore the different types of cancer surgery and what you can expect before and after your procedure, so you can approach this part of your journey with greater confidence.

What Is Cancer Surgery?

Cancer surgery is a medical procedure where a surgeon removes part or all of a tumour. You might undergo surgery for several reasons.

  • To diagnose cancer
  • To stage cancer
  • To cure or treat cancer
  • To relieve symptoms such as pain
  • To extend life expectancy

Depending on the situation, your surgery may be combined with other cancer treatment, such as chemotherapy or radiation therapy, to kill cancer cells, improve outcomes and reduce the risk of cancer returning. This combined approach is called adjuvant treatment when done after surgery, and neoadjuvant treatment when done before surgery.

Types Of Cancer Surgery

The type of surgery you might have depends on your cancer type, location, and stage, as well as your overall health. The surgical management of cancer depends on the assessment of a multidisciplinary team (MDT) of surgeons, nurses and other specialists who will have reviewed your medical history, scan results, blood tests and biopsy results.

Diagnostic Surgery:  Also known as a biopsy, this involves removing a piece of a suspected tumour. The tissue is then sent to a pathologist to examine under a microscope to determine if it is cancerous or not.

Curative Surgery: This surgery aims to remove the entire tumour and, in many cases, serves as the primary treatment when the cancer is confined to one area. Your surgeon will aim to remove the whole tumour as well as some healthy tissue around it, known as a clear margin

Staging surgery: During an operation, your surgeon may examine the organs around the tumour as well as nearby lymph nodes and glands to see how advanced the cancer is. If they find anything suspicious, they will remove it and ask a pathologist to check for any cancer cells.

Palliative Surgery: If you have advanced cancer, palliative surgery may be recommended to help relieve symptoms and improve your quality of life. For example, debulking surgery might be used to remove part of a tumour to reduce pressure or alleviate pain, making you feel more comfortable

Reconstructive Surgery: If you’ve had surgery that changed an important part of your body such as for bladder or breast cancer, reconstructive surgery may help restore your appearance or function. This can range from simple procedures to more complex operations, depending on what’s needed to help you feel yourself again.

Supportive Surgery: If you’re having ongoing cancer treatment, this surgery can help make your care easier to manage. For instance, your healthcare team might recommend placing a vascular access device (such as a port or catheter) to make it easier to have chemotherapy or a feeding tube if you’re having trouble eating.

Is Cancer Surgery Right for Me?

Surgery can be a powerful tool to treat cancer, especially when the disease is localised and can be fully removed. As with any treatment, it’s important that the benefits of surgery outweigh any risks and there are several factors to consider.

Cancer Type: Surgery is effective for solid tumours that are localised in one area. However, for cancers like leukaemia or lymphoma, surgery is not typically used because they tend to be spread throughout the body.

Cancer Stage: The size of your tumour and whether it has spread to other lymph nodes and other parts of your body are crucial in determining if surgery is suitable. If the cancer has spread treatments like chemotherapy or radiation therapy might be recommended instead.

Cancer Location: If a tumour is too close to vital organs or major blood vessels, surgery to remove all the cancerous tissue might be too risky. In such cases, other cancer treatments such as chemotherapy or radiotherapy might be safer and more effective.

Your General Health: Your overall health and ability to recover from surgery are important. Surgery is physically demanding, so if you have other health conditions that might complicate recovery, your doctor might suggest alternative treatments.

Ultimately, the decision about whether surgery is right for you is made by weighing these factors and discussing the potential benefits and risks with your healthcare team. It’s important to have a clear understanding of your options. If you’re unsure, you can ask for a second opinion.

Cancer Surgery: What To Expect

There are usually a few weeks between being told you need surgery and the day of the operation itself. Waiting for your operation day can be daunting, but understanding what to expect before, during, and after can ease anxiety and prepare you for the road ahead. Here’s what to expect at each stage of your cancer surgery experience.

Before Your Surgery

Before any operation, your doctors will want to make sure you are physically and mentally ready for the procedure. A couple of weeks before your surgery, you’ll have a pre-assessment appointment to assess your readiness for surgery. You may have extra blood tests, ECGs and extra scans or X-rays. Your surgeon will explain the procedure, potential risks, and what to expect during recovery. This is also the time to discuss any medications you’re taking, as some may need to be paused or changed before surgery.  You may also be given nutritional drinks like shakes to help you build up strength before the operation.

How to prepare for surgery

While you’re waiting for your surgery, there are a few things you can do to prepare yourself for the big day.

  • Write down any questions you might have about your surgery or condition
  • Speak with your surgeon or your specialist nurse if you have any concerns
  • Get books, magazines and personal items ready for your hospital stay
  • Ensuring you’re as healthy as possible – quitting smoking can reduce complications
  • Getting yourself strong through proper nutrition

On the day of your surgery

On the day of your surgery, you’ll arrive at the hospital where your surgical team will meet you to go over any final tests and details. You may be asked to change into a hospital gown and remove any jewellery or makeup. Your anaesthetist will discuss the type of anaesthesia you’ll receive, and you’ll have the opportunity to ask any final questions. Once you’re ready, you’ll be taken to the operating room. Depending on the type of surgery, the procedure can take a few hours or longer.

After your surgery

Immediately after surgery, you’ll be monitored closely in a recovery room. It’s normal to feel groggy or disoriented initially, and you might have tubes or drains in place to help with healing. Once you’re stable, you may be moved to a ward where your healthcare team will continue to check your progress. Your medical team will provide medications to help control any discomfort, nausea or vomiting. Physiotherapists will also encourage you to start moving as soon as it’s safe to do so, as early mobility can reduce the risk of complications like blood clots.

Recovering from surgery

The time it takes to recover depends on the type of surgery you had. For example, minimally invasive surgery or keyhole surgery may have a shorter recovery time. You may need to take time off work and avoid strenuous activities as your body heals. A physiotherapist will help you to regain strength and mobility, and a dietitian may give you nutritional advice to support your recovery. Facing surgery and its aftermath can be challenging, so don’t hesitate to ask for support from your team of healthcare professionals or any cancer support groups.

Cancer surgery: understanding your results

After cancer surgery, it’s only natural that your biggest concern will be finding out the results and knowing whether your surgery was successful – if the cancer was completely removed, and what the next steps will be. Here’s what you can expect

 

Biopsy Results

If a biopsy was taken during your surgery, it usually takes about one to two weeks to get your biopsy results, but this can vary depending on the complexity of the analysis. Your doctor will discuss the findings with you as soon as they are available, explaining what they mean and how they will impact your treatment plan.

Tumour removal (Excision)

When cancer is surgically removed, your surgeon aims to achieve “clear margins,” which means the entire tumour is removed and no cancer cells are present at the outer edge of healthy tissue that was removed. This is an important indicator that the cancer has been fully excised.  

The pathology report will detail whether the margins are clear, which typically takes about a week or two to be finalised. If the margins are not clear, further surgery or additional treatments like radiotherapy may be needed.

Achieving clear margins can depend on the type and location of the tumour. For instance, with certain cancers like prostate cancer, removing the entire organ may be feasible, while in cases like glioblastoma (GBM), it’s impossible to remove the whole tumour due to its location and invasive nature.

Spread of Cancer

In some cases, surgery may reveal that the cancer has spread further. This could be discovered during the operation itself or through the pathology report afterwards. For instance, your surgeon may find cancer in nearby lymph nodes or other organs that were not detected in earlier scans. If this happens, your doctor will be able to discuss the implications soon after your operation such as how it might affect your treatment. It could mean that additional treatments, such as chemotherapy or targeted therapies, will be recommended.

What If Further Treatment Is Needed?

If your results indicate that further treatment is needed, your cancer team will work with you to plan the next steps. This might involve additional surgery, radiotherapy, chemotherapy, or other cancer treatments.

In some cases, genomic sequencing can be offered to understand the genetic drivers of your cancer. This information may help your doctors identify targeted therapies, off-label drugs, or treatments tailored to your cancer’s unique profile. At Gena Health, we’re here to help streamline clinical trial enrollment and help you get valuable insights from your genomic data, ensuring you have access to the latest treatment options.

Surgery can be a vital step in your cancer treatment journey. By understanding the process and discussing your options with your healthcare team, you can make informed decisions about your care. At Gena, we’re here to help you navigate these choices. Reach out to us here for a chat.

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