Surgery

For many types of cancer, surgery is the best way of removing the tumour.

Most surgery is done under general anaethetic, likely involving a hospital stay. Anaesthetic can be quite hard on the body so patients may well feel groggy after waking, but these effects are temporary.

The length of recovery period post-surgery depends on the type of surgery and the individual - your medical team will advise you on how long recovery may take.

BEFORE SURGERY

There can sometimes be a long wait for surgery - several weeks is not uncommon. There may be a few reasons for a delay: your medical team may have to wait for test results, or for the surgeon or operating theatre to be free. It can be a very difficult time for patients and their families. We have information available here about staying positive and coping with the stress that elements of your treatment may cause.

You will meet with the surgical team and this is a good chance to ask lots of questions about your operation. Surgery is a common part of a treatment programme, so your medical team (which will now include an aesthetist and a specialist surgical nurse) can explain what they hope to achieve and how it should help. Check out the document below for ideas of questions that may be useful to you:

TCF Questions to Ask Doctor pdf

THE SURGERY

If you are going under general anaesthetic, you will be required to not eat or drink for a period of time before the surgery. This may vary, but you can expect to not eat for 6 hours before, or drink for 2 hours before.

All surgeries carry inherent risks. Medical teams are highly-skilled and work extremely well, but even they understand that surgery may be risky. If they do not explain these to you, be sure to ask questions as this can put your mind at rest.

The exact surgery you undergo will depend on the type, stage and aggressiveness of your cancer. Your health and general fitness will be taken into consideration as these may affect which surgeries are available to you.

Here are some of the operations that are used to treat head and neck cancers:

EXCISION - Surgery removing the tumour from the body
This may also lead to the removal of glands, tissue or nerves that are close to the tumour.

NECK DISSECTION - Surgery removing some or all of the lymph glands in the neck
Lymph glands are removed if the medical team are worried that they contain cancerous cells which have not been detected by tests.

RADICAL NECK DISSECTION - Surgery removing more than the lymph glands
It can mean the removal of, for example, the sternocleidomastoid (a muscle at the side of the neck), the accessory nerve, or the internal jugular vein. There may be further side effects, but you will have access to support to aid your recovery.

LARYNGECTOMY - Surgery removing the larynx or voice box
This surgery will undoubtedly be life-altering. It is important to discuss the outcomes and recovery process of serious surgeries like this with your medical team. Support is widely available to aid your recovery and to help you adapt to living after a laryngectomy. This organisation will be able to help, amongst others.

THYROIDECTOMY - Surgery removing part or all of the thyroid
If there is a tumour in the thyroid, your medical team may opt to remove it. In addition to the thyroid, lymph glands close-by may also be removed. Thyroidectomy side-effects may be found here.    

TRANSORAL LASER SURGERY - Surgery using laser beams to remove cancerous tissue while minimising damage
This surgery is not available at every hospital. Due to how new this operation is, some doctors will prefer to use traditional surgery combined with radiotherapy and chemotherapy instead.

RECONSTRUCTIVE SURGERY - Surgery used to lessen the impact other surgeries and treatments have on your appearance
If you have undergone a large scale operation that has left a permanent disfigurement, it is very likely you will undergo secondary reconstructive surgery to lessen it. This may involve prosthetics, skin grafts or bone grafts.

POST-SURGERY AND RECOVERY

After surgery, you will be taken from theatre to the recovery room, and later back to your ward. The general anaesthetic effects will pass as they leave your system. Your nurses will administer pain control drugs to help manage any post-surgery pain.

You may be attached to tubes and drips when you come round from the anaesthetic, potentially including a catheter (inserted into your bladder to allow you to urinate), drips (attached to arm veins to allow you to receive fluids and medicines), and drains (attached to the area around the wound to remove fluid from it and keep it clean).

After a few days of rest, you will be encouraged to be as active as possible by your medical team. This will allow your circulation to get back to normal as soon as possible. If you are lying in bed for long periods of time you can be at risk of blood clots. Some gentle exercises can lower this risk significantly.

POTENTIAL SIDE-EFFECTS

Side-effects suffered post-surgery will vary, but issues which commonly arise include the following:

SWELLING OF THE FACE, HEAD OR NECK
This is very common as the body heals itself and will usually subside after a few weeks.

PROBLEMS WITH EATING, TALKING AND SWALLOWING
There are dozens of muscles in the neck and throat, and some may be damaged during surgery. This can lead to issues with speaking and swallowing, but there are specialist medical staff who can help patients recover these functions. It can take a long time, but Speech and Language Therapists will run you through exercises to strengthen the damaged muscles and restore your abilities.

APPEARANCE
Because of the area being treated, physical changes in appearance after surgery can be hard to adjust to. Scarring or nerve damage may alter your facial appearance depending on the surgery being performed. Reconstructive surgery may be available. 

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