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If you¡¯re a spouse, partner, family member, or friend providing physical and emotional help to a cancer patient, then you are a vital part of the cancer care team. Taking care of someone who¡¯s having cancer surgery may involve helping them get ready before the procedure, being their advocate during recovery, and then helping them get back to daily life again.

Surgery can be used to prevent, diagnose, stage, or treat cancer. It can also be used to lessen pain, discomfort, or other problems related to cancer. After a diagnosis, the patient may have surgery as the first treatment, or not until after they receive certain types of chemotherapy or radiation. Sometimes the person may need more than one operation at different times.

Every person¡¯s situation is different, and the specifics of their surgery and recovery depends on the type of cancer they have, their overall health, and their own preferences.

Getting ready

Before surgery is called the pre-operative phase or pre-op for short. At appointments leading up to surgery, be an extra set of eyes and ears. The health care team will give you a lot of information and ask the patient to fill out informed consent forms that give permission to do the surgery. You can take notes to help you both remember details.

Bring a list of all medicines and over-the-counter drugs, vitamins, and supplements the patient takes and let the doctor know. This is to make sure they aren¡¯t taking anything that could affect the surgery and their recovery. Tell the doctor if the patient has any allergies or had any problems with anesthesia in the past.

Ask the health care team about anything you don¡¯t understand or that you want more information about. One question caregivers often have is how soon surgery will be scheduled. This can be a concern because of work schedules or life commitments. Also, you or the patient might feel anxious about waiting too long for surgery. Be sure to ask about this. ?

You may also want to ask:

• What exactly will you do in this operation?
• Will all the cancer be removed, or just some of it?
• What are the chances the surgery will work?
• Are you experienced in operating on this kind of cancer? How many operations like this have you done?
• Will this surgery be the only cancer treatment?
• Is the patient healthy enough to go through the stress of surgery and anesthesia?
• How long will the surgery take?
• Will blood transfusions be needed?
• How much pain should they expect? Will tubes (drains or catheters) be needed?
• How long will they need to be in the hospital? Will they need rehab or therapy afterwards?
• Will this surgery result in physical changes? Will they be permanent?
• How long before it¡¯s OK to get back to usual activities?
• What are the possible risks and side effects of this operation?
• Will they need more than one surgery?
• What will happen if you don¡¯t do the operation?
• If this surgery doesn¡¯t work, are other cancer treatments available? What are they?
• Will insurance pay for this surgery? How much will the patient have to pay?
• Are you certified by the American Board of Surgery and/or a Specialty Surgery Board?
• Is there time to get a second opinion?

Be sure you understand any pre-op instructions and help the patient follow them. This could be making healthy lifestyle changes such as stopping smoking, losing weight, avoiding alcohol, eating healthier, or exercising more. It could be stopping certain prescription or other medications for a short time before the surgery. The patient might need pre-op testing, such as x-rays and bloodwork. ?The doctor may also give instructions for the day before surgery such as showering with a special soap, stopping solid foods and liquids at a certain time, and in some cases doing a bowel preparation.

Recovering

How long someone stays in the hospital after surgery depends on the type of surgery and their health. While the patient is in the hospital, you can help by encouraging them to follow all the doctor¡¯s instructions. These may include getting up and walking around, taking prescribed pain medication, or taking deep breaths and coughing. Tell a nurse or doctor if the pain medication isn¡¯t working.

Before you leave, talk to the doctors and nurses about what to expect after the patient gets home. Be sure you understand:

• How to take care of the wound and any drains
• What to look for that might need attention right away
• What activities are limited, such as bathing, driving, working, or lifting
• Any diet restrictions
• What medicines to take and how often to take them, including pain medicines
• Who to call with questions or problems if they come up, including after hours or on the weekend
• Whether any home health care or rehabilitation is needed (physical activity or physical therapy)
• When to see the doctor again

Recovery is different for everyone. Wounds heal at different rates, and some operations are more involved than others. If you feel overwhelmed or unable to handle all the help at home that¡¯s needed, let the health care team know. They may be able to arrange for a nurse or nurse¡¯s aide for a short while.

If the patient is having a lot of trouble with side effects or begins to feel upset or sad, encourage them to talk to the doctor. The cancer care team can help with side effects.

When to call the doctor

Some surgery side effects may come and go quickly, but others may be a sign of serious problems. Call the doctor or nurse right away if you see any of the following symptoms after surgery:

• A fever (instructions for this can vary so check to be sure what fever is high enough to call about)
• Intense (shaking) chills
• Bleeding or new drainage from the surgical site or drain site, or unexplained bruising and bleeding anywhere else
• Pain or soreness at the surgical site that¡¯s getting worse or doesn¡¯t get better with the pain medicine
• Unusual pain anywhere, including in the legs, chest, belly, and?intense headaches
• Shortness of breath or trouble breathing
• Having trouble urinating; pain when urinating; or bloody, bad smelling, or cloudy urine
• Any other signs mentioned by the doctor or nurse

Let the doctor know about any new problems you notice or concerns you have. It¡¯s always best to find out the cause of a problem so it can be dealt with right away.

Follow-up care

It¡¯s important for the patient to go to all the medical appointments scheduled for after surgery. The health care team will check how they are doing and help them deal with any problems. The surgeon will take out any drains, stitches, or staples after a certain period of time, and check to see how the patient is healing. They might need bloodwork and x-rays during follow-up care.

If the patient needs more treatment after surgery, the cancer care team will talk about options, help you both make decisions about it, and teach you about what it will be like and when the treatments will start.