Understanding Cancer Surgery: A Guide for Patients and Families

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What are the risks and side effects of cancer surgery?

There are risks that go with any type of medical procedure and surgery is no exception. Success partly depends on the type of surgery you are having and the surgeon’s experience with it. The length of the surgery and the type of anesthesia (an-es-THEE-zhuh) used are other important factors. The patient’s physical health affects the process and outcome a great deal too. What’s most important is whether the expected benefits outweigh the possible risks.

Doctors have been performing surgeries for a very long time. Advances in surgical techniques and our understanding of how to prevent infections have made modern surgery safer and less likely to damage healthy tissues than it has ever been. Still, there’s always a degree of risk involved, no matter how small.

Before you decide to have any medical procedure done, it’s important that you understand the risks. Different procedures have different kinds of risks and side effects. This section cannot list all of the possible problems (complications) of every type of surgery. Be sure to discuss the details of your case with your doctor, who can give you a better idea about what your actual risks are.

During surgery

Possible complications during surgery may be caused by the surgery itself, the drugs used (anesthesia), or an underlying disease. Generally speaking, the more complex the surgery is the greater the risk.

Minor operations and taking tissue samples (biopsies [by-op-sees]) usually pose less risk than major surgery. Pain at the surgery site is the most common problem. Infections at the site and reactions to the drugs used to numb the area being treated (local anesthesia) are also possible.

Complications in major surgical procedures are not common, but can include:

Bleeding: Bleeding during surgery that may cause you to need blood transfusions. There’s a risk of certain problems with transfusions, some of them serious. Doctors try to minimize this risk by checking your blood counts beforehand and being careful when working near blood vessels. Still, some operations involve a certain amount of controlled blood loss.

If you have concerns about needing a blood transfusion, talk to your doctor before surgery. You may be able to save (bank) some of your own blood in the weeks before surgery so it can be given back to you during the operation if needed. This is called autologous transfusion (aw-tahl-uh-gus trans-few-zhun). For more information, see Blood Transfusion and Donation, which you can read online or get by calling our toll-free number.

Damage to nearby tissues: Damage to internal organs and blood vessels can happen during surgery. Again, doctors are careful to allow as little damage as possible.

Drug reactions: Some people have reactions to the drugs used (anesthesia) or other medicines needed during surgery. Although rare, these can be serious because they can cause dangerously low blood pressures. Your doctors will watch your heart rate, breathing rate, blood pressure, and other signs throughout the surgery to look for this.

Damage to other organs: Surgery can lead to problems with other organs, such as the lungs, heart, or kidneys. These problems are very rare but can happen and can be life-threatening. They are more likely to happen to people who already have problems with these organs. This is why doctors get a complete medical history and do tests to look for possible risks before an operation is done.

After surgery

Some problems after surgery are fairly common, but are not usually life-threatening.

Pain: Almost everyone has some level of pain after surgery. Some pain is normal, but it should not be allowed to slow down your recovery. There are many ways to deal with surgical pain. Medicines for pain range from aspirin and acetaminophen (Tylenol®) to stronger drugs, like codeine and morphine.

You can get more information in our booklet called Guide to Controlling Cancer Pain.

Infection: Infection at the site of the wound is another possible problem. Doctors take great care to reduce this risk by cleaning the area and keeping the area around it sterile, but infections do happen. Antibiotics, either as a pill or given through a vein in your arm (IV), are able to treat most infections.

Other problems are rare, but may be more serious.

  • A lung infection (pneumonia) can occur, especially in patients with reduced lung function, such as smokers. Doing deep breathing exercises as soon as possible after surgery helps lessen this risk.
  • Other infections can develop within the body, especially if the stomach or intestines were opened during the operation. Doctors take great care to try to prevent this. But if it happens, antibiotics will be needed.
  • Bleeding can happen either inside the body (internally) or outside the body (externally). Bleeding can occur if a blood vessel was not sealed off during surgery or if a wound opens up. Serious bleeding may cause the person to need another operation to find the source of the bleeding and stop it.
  • Blood clots can form in the deep veins of the legs after surgery, especially if a person stays in bed for a long time. Such a clot can become a serious problem if it breaks loose and travels to another part of the body, such as a lung. This is a big reason why you will be encouraged to get out of bed to sit, stand, and walk as soon as possible.
  • Slow recovery of other body functions, such as activity in the bowels, can sometimes become serious problems, too. Getting out of bed and walking around as soon as possible after surgery can decrease this risk.

Other life-threatening complications are very rare and hard to predict, but sometimes do happen. Your surgical team will take many steps to reduce your risk of complications. This includes things like shaving and cleaning the area before cutting the skin to avoid infection, use of special leg pumps and low-dose blood thinners to avoid clots, and breathing treatments (respiratory therapy) to help prevent pneumonia.

Long-term side effects depend on the type of surgery done. For example, people who have colorectal cancer surgery may need an opening in the belly to which the end of the colon is attached (a colostomy [kuh-lahs-tuh-me]). Men having their prostate removed (radical prostatectomy [rad-ick-uhl pros-tuh-TECK-tuh-me]) are at risk for losing control of their urine (incontinence [in-kon-tuh-nence]) or becoming unable to get or keep an erection (impotence [im-puh-tens]). Your doctor should talk to you about all of these long-term outcomes before surgery. You can get more information on long-term effects by calling the American Cancer Society at 1-800-227-2345.

Last Medical Review: 08/19/2013
Last Revised: 08/19/2013