Getting Ready for Cancer Surgery
Surgery can be an overwhelming experience. It is important to learn as much as you can beforehand. Your experience will depend on many things, including the disease being treated, the type of operation being done, and your overall health. There are many different surgical procedures and each case is different.
There are parts of the surgical experience that are the same in almost all types of operations. They include pre-operative testing and preparation, the surgery itself (usually including some type of anesthesia to get you through the surgery), and a recovery period. Knowing what to expect can help you feel more comfortable and reduce stress about your surgery.
It’s not unusual for patients to wait a few weeks after learning they have cancer to have surgery, although this depends on the type of cancer and other factors. In most cases, you will have time to:
- Learn more about the cancer and your treatment options
- Talk to others who have had cancer
- Organize your thoughts
- Find the right health care team for you
Does surgery cause cancer to spread?
It's very rare for surgery to cause cancer to spread. Still, there are some important situations when this can happen. Doctors who have a lot of experience in treating cancer with surgery are very careful to avoid these situations.
If a small needle is used to remove a piece of the tissue (called a needle biopsy), the chances of it causing a cancer to spread are very low. In the past, larger needles were used for biopsies, and the chance of spread was higher.
Most types of cancers can be safely sampled by an incisional biopsy, where the surgeon cuts through the skin to remove a small part of the tumor. But there are a few exceptions, such as certain tumors in the eyes or in the testicles. Doctors may treat these types of cancer without first looking at a piece of the tumor (biopsy) or may recommend removing the entire tumor if it’s likely to be cancer. Sometimes, a needle biopsy can be used safely, and then if the tumor is found to be cancer, the whole tumor is removed.
One common myth about cancer is that it will spread if it’s exposed to air during surgery. Some people may believe this because they often feel worse after surgery than they did before. But it’s normal to feel this way when recovering from any surgery. Another reason people may believe this is because during surgery the doctor may find more cancer than was expected from scans and x-rays. This can happen, but it’s not because of the surgery – the cancer was already there – it just didn’t show up on the tests that were done. Cancer does not spread because it has been exposed to air. If you delay or refuse surgery because of this myth, you may be harming yourself by not getting effective treatment.
Questions to ask before having cancer surgery
Before having surgery, find out all you can about the benefits, risks, and side effects of the operation. You might want to ask your health care team or doctor the questions listed here. The answers could help you feel better about your decision.
- What’s the goal of this operation? To take out the cancer? To remove some of the tumor to test for cancer? To help with a problem the tumor is causing?
- What are the chances it will work?
- Is there any other way to treat the cancer or relieve the problem?
- Will I need other cancer treatments (like chemotherapy or radiation) before or after surgery?
- Am I healthy enough to go through the stress of surgery and the drugs used to do it (anesthesia)?
- Are you certified by the American Board of Surgery and/or Specialty Surgery Board?
- How many operations like this have you done? What’s your success rate? Are you experienced in operating on my kind of cancer?
- Exactly what will you do in this operation? What will you take out? Why?
- How long will the surgery take?
- Who will update my family?
- Will I need blood transfusions?
- What can I do to get ready for surgery?
- What can I expect afterward? Will I be in a lot of pain? Will I have tubes (drains or catheters) coming out of my body?
- How long will I need to be in the hospital?
- How will my body be affected by the surgery? Will it work or look differently? Will any of the changes be permanent?
- How long will it take for me to get back to my usual activities?
- What are the possible risks and side effects of this operation? What’s the risk of death or disability?
- What will happen if I don’t have the operation?
- If this surgery doesn’t work, are there other cancer treatments I can get?
- Will my insurance pay for this surgery? How much will I have to pay?
- Do I have time to think about other options or get a second opinion?
Here are some tips to help you remember your doctor’s answers:
- Take notes. Don’t feel shy about asking your doctor to slow down if you need more time to write. Ask questions if you don’t understand something.
- If you can, record your visit so you won’t miss anything. But first ask your doctor if it’s OK to record your talks.
- Consider taking a friend or relative with you to help you understand what your doctor says during the visit and refresh your memory afterward.
You might want to read After Diagnosis: A Guide for Patients and Families for more ideas about the things you and your family may want to know.
Giving informed consent
Informed consent is one of the most important parts of getting ready for surgery. It’s a process during which you are told about all aspects of the surgery before you give your doctor written permission to do it. The details of the informed consent form may vary from state to state, but it usually says that your doctor has explained these things:
- Your condition or diagnosis and why surgery is an option
- The goal of the surgery
- How the surgery is to be done
- How it may benefit you
- What the risks are
- What side effects to expect
- Your other treatment options
Please see Informed Consent if you’d like to learn more about this process.
Getting a second opinion
One of the ways to find out whether a suggested operation is the best choice for you is to get the opinion of another surgeon. Your doctor should not mind this. In fact, some health insurance companies make you get a second opinion. You might not need to have tests done again because you can often bring the results of your original tests to the second doctor.
Check with your insurance company before planning surgery and before getting a second opinion. Get all of the information you need to feel sure you are making the right choice. Making an informed decision about your health is almost always better than making a quick one.
Tests before cancer surgery (pre-operative tests)
You’ll probably need many tests in the days or weeks before your surgery, especially if it is a major operation. These tests are done to help doctors better understand your overall health status and help them plan the surgery. You may not need all of the tests listed here (especially if you are having a minor procedure in a doctor’s office). But the tests most often used include:
- Blood tests to check on measures such as your blood cell counts, blood sugar level, your risk of bleeding, how well your liver and kidneys are working, and other tests. Your blood type may also be checked in case you need blood transfusions during the operation.
- Urine test (urinalysis) to look at how well your kidneys are working and check for infection.
- Chest x-ray to check your lungs.
- EKG (electrocardiogram) to check your heart’s electrical system.
- Other tests as needed, such as CT scans, MRIs, or PET scans to look at the size and location of the tumors and see if the cancer looks like it has spread to nearby tissues. You can learn more about these scans in Imaging (Radiology) Tests for Cancer.
Your doctor will also physically examine you and ask about your medical history. Questions will cover subjects like high blood pressure, heart disease, diabetes, alcohol and tobacco use, and anything else that could affect surgery.
Your doctor also should know about all the medicines you take, including vitamins, herbs, and even the drugs you only take every now and then. It’s also important that you let your doctor know about any allergic reactions you’ve had in the past, including reactions to foods or other substances.
If you use tobacco:
Using tobacco tightens (constricts) blood vessels and reduces the supply of nutrients and oxygen to body tissues. Smoking can delay healing and recovery. It can also increase the risk of complications after surgery. .
Your surgeon may change some of the medicines you take and ask you to stop smoking, stop drinking alcohol, try to improve your diet, lose weight, or actively exercise before surgery.
Remember: If you don’t tell your doctor about a possible problem you have (for instance, a bleeding disorder or heart problems) or medicines you are taking (including herbs and supplements), it could lead to dangerous problems during surgery.
If you are going to be given drugs to put you into a deep sleep (general anesthesia), you will probably also see a doctor who specializes in giving anesthesia, called an anesthesiologist. Other specialists may be consulted or other tests done if you have any other problems that could affect the surgery.
Getting physically ready for surgery
Depending on the type of operation you’re going to have, there may be things you need to do to be ready for surgery.
Emptying your stomach and bowels is important if you’ll be given drugs to make you sleep during surgery (anesthesia). Vomiting while under anesthesia can be very dangerous because the vomit could get into your lungs and cause an infection. Because of this, you’ll be asked to not eat or drink anything starting the night before the surgery. You may also be asked to use a laxative or an enema to make sure your bowels are empty.
You may need to have an area of your body shaved to keep hair from getting into the surgical cut. The area will be cleaned before the operation to reduce the risk of infection. Other special preparations may be needed, too. Your doctor will tell you what you need to do.
It’s normal to be anxious about surgery and anesthesia. Let your doctors know about these concerns. They may give you medicine to help you relax before surgery.
During the operation
Although each type of surgical procedure is different, they usually have certain things in common. For example, during surgery you will get some type of drug to block your awareness of pain. This is called anesthesia. They are different types of anesthesia depending on the scope of the operation.
Under anesthesia the surgical site on the body will be carefully cleaned. If hair is present at this site expect it to be shaved or trimmed in order to reduce the risk of infection. After the surgery is completed you will be moved to a recovery area where you will stay until the effects of anesthesia wear off and it is safe for you to go home or be moved to a hospital room or care unit. Ask your doctor what to expect.
Last Medical Review: April 12, 2016 Last Revised: February 23, 2017