Surgery

Depending on the type of cancer and other factors, you may have surgery to treat it.

Most surgery is done under general anaesthetic and will likely involve a hospital stay. You may feel groggy after waking, but these effects are temporary.

Your medical team will advise you on how long recovery may take post-surgery - this can vary depending on the type of surgery and also your individual make up.

BEFORE SURGERY

There can sometimes be a fairly long wait for surgery - several weeks is not uncommon. Reasons for this can include your medical team waiting for test results, or for the surgeon or operating theatre to be available. 

You will meet with the surgical team, and this is a good chance to ask lots of questions about your operation. Your medical team (which will include an anaesthetist and a specialist surgical nurse) can explain what they will do and how it should help.

It can sometimes be difficult to think of or remember questions that you want to ask, so we've put together this PDF (Questions to ask your doctor) which may be helpful.

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. Your medical team will let you know this in advance.

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. 

LARYNGECTOMY - Surgery removing the larynx or voice box
This surgery will undoubtedly be life altering. 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, as well as others. It is important to discuss the outcomes and recovery process of serious surgeries like this one with your medical team.

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 may not available at every hospital. Traditional surgery combined with radiotherapy and chemotherapy may be offered instead.

RECONSTRUCTIVE SURGERY - Surgery used to lessen the impact other surgeries and treatments have on your appearance
If you have undergone an operation that has left a permanent disfigurement, it is very likely you will undergo secondary reconstructive surgery to lessen it. This can 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 can include:

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 period of 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 challenging 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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