What to Expect With Cancer Surgery

Surgery, used to treat cancer, is a procedure in which a surgeon removes cancer from your body. Surgeons are medical doctors with special training in surgery.

Surgery works best for solid tumors that sit in one area. It is a local treatment. That means it treats only the part of your body with the cancer in it. It is not used for leukemia, a blood cancer, or for cancers that have spread. Sometimes surgery is the only treatment you need. More often you will have other cancer treatments too.

Surgery removes the cancer, and it works best for solid tumors in one place.

Surgery can be used in several ways. It depends on your cancer and how advanced it is.

• Remove the entire tumor when the cancer sits in one area.
• Debulk a tumor — remove part of it, when taking the whole thing might damage an organ or the body. Removing part can help other treatments work better.
• Ease symptoms by removing tumors that cause pain or pressure.

Surgeons often use small, thin knives called scalpels, along with other sharp tools. Surgery often needs cuts through skin, muscles, and sometimes bone. That can be painful, and it takes time to heal. There are also ways to do surgery without scalpels. These include cryosurgery (extreme cold), lasers, hyperthermia (heat), and photodynamic therapy.

Surgery may be open or minimally invasive.

• In open surgery, the surgeon makes one large cut. They remove the tumor, some healthy tissue, and maybe some nearby lymph nodes.
• In minimally invasive surgery, the surgeon makes a few small cuts. They put a long, thin tube with a tiny camera, called a laparoscope, into one of them. The camera shows the inside of the body on a monitor. Special tools go through the other small cuts to remove the tumor and some healthy tissue.

Minimally invasive surgery uses smaller cuts. So it usually takes less time to recover from than open surgery.

Anesthesia keeps you from feeling pain during surgery. The word covers drugs or other substances that make you lose feeling or awareness. There are three types.

• Local anesthesia causes loss of feeling in one small area.
• Regional anesthesia causes loss of feeling in a part of the body, such as an arm or leg.
• General anesthesia causes loss of feeling and a complete loss of awareness. It seems like a very deep sleep.

Before surgery, a nurse may call to tell you how to get ready. You may need tests such as blood tests, a chest x-ray, or an electrocardiogram (ECG). You may not be able to eat or drink for a set period beforehand. Follow those instructions closely, or your surgery may be rescheduled. You may also be asked to have wound-care supplies at home.

During surgery, once you are under anesthesia, the surgeon removes the cancer. They usually take some healthy tissue around it as well. That improves the chance that all the cancer comes out. The surgeon may also remove lymph nodes or other nearby tissues. Those get checked under a microscope to see whether the cancer has spread. That information helps guide your treatment plan.

After surgery, the nurse will tell you how to look after yourself before you go home. That covers how to control pain, which activities to do or avoid, how to care for your wound, how to spot signs of infection, and when you can go back to work. You will see the surgeon again a week or two later, and possibly more often after complex surgery.

Surgeons are highly trained and work hard to prevent problems. But problems do happen sometimes. The most common is pain, which your team helps you manage. Next is infection, which you can help prevent by following the wound-care instructions. Other risks include bleeding, damage to nearby tissues, and reactions to anesthesia.

You will need time off work to recover. It may be as little as one day, or as long as many weeks. How long depends on the type of anesthesia, the type and extent of the surgery, and the kind of work you do. If your job is active, you may need more time than someone who sits at a desk. Ask your doctor how long you will need. Talk with your employer about medical leave if your recovery will be long. Surgery also raises your need for good nutrition. Tell your team if you have trouble eating, and consider speaking with a dietitian.

Most of recovery is slow and dull. These are the exceptions.

• Call 911 or go to an emergency department if blood soaks through a dressing and keeps coming, or you get sudden chest pain or breathlessness, which can signal a clot in the lung.
• Call your surgeon's office the same day if your temperature is 100.4°F (38°C) or higher, the wound edges gape open, or redness, swelling and pain around the cut are getting worse rather than better.
• Call your surgeon's office within a day or two if drainage from the wound increases, changes color or smells bad, or the pain medicines you were given are no longer holding the pain down.

Source: MedlinePlus (National Library of Medicine, NIH) — Surgical Wound Care: Open.