Cancer

Surgery

There are three main treatments for cancer and these are surgery, chemotherapy and radiotherapy. Which type of treatment is given depends on many things, particularly the type of cancer, where in the body the cancer is, what the cancer cells look like when examined microscopically and whether it has spread to other parts of the body.
 
In their interviews teenagers whose treatment included surgery talk about why they needed to have their surgery; their feelings and concerns before surgery; and how they felt whilst recovering from their surgery.
 
For most of the young people this was the first time they had been in hospital or had had surgery, so needless to say they found the whole experience quite scary. However, it helped that their parents were often able to stay with them in the hospital and visits from friends and family also provided a welcome distraction.
 
The diagnosis of cancer is often made by taking a surgical biopsy or sample of the tumour. The surgeon removes a small part of the tumour and it is tested to find out if it is cancerous and what sort of cancer it is. Surgery is often also the first and main treatment and surgeons may try to remove the whole tumour the first time around. It can also be used after courses of chemotherapy have shrunk the tumour.

Normally before having a general anaesthetic (being put fully asleep) for the operation, people are not allowed to eat or drink for around 12 hours before the op. The reason is so that the stomach is empty at the time of the operation, and should you be sick, then there is nothing for you to sick up. Many of the teenagers interviewed said that they were particularly worried about three things - having the general anaesthetic, the pain of the operation and finally the possibility of scarring from the surgical wound. Many found that talking to the surgeon before the operation was very reassuring. But occasionally the information that was given to young people about the possible surgical complications seemed unnecessarily detailed and alarming! But, in general, most of those interviewed were really impressed by their surgeon’s skills.

(See 'What makes a good doctor').

Young people with brain tumours sometimes had to have a surgical operation to have a catheter called a ’shunt’ put into the central area of their brains called the ventricles. These spaces are normally filled with cerebral spinal fluid and the shunt drains the fluid off to prevent pressure  building up. Sometimes, very occasionally these shunts can become blocked and emergency surgery is necessary but mainly they work well and can often be removed after a period of time.

Surgery for cancer is nearly always carefully planned ahead of time, but just sometimes there is an urgent need to operate quickly. Also on a few occasions a patient will think that they are going in for investigations or relatively minor surgery but then, during the operation the form of surgery has to change because of what is discovered during the operation itself.

When young people came round after surgery, they usually found themselves back on the ward where they were before the operation, but one or two found themselves in a ’high dependency unit’ when they became conscious again. These units are specialist units with more intensive nursing care. After having an operation it is quite common to have what is known as a ’drain’ in the surgical wound - to help drain off blood or fluid. These can be quite uncomfortable. 

 
These days it is not uncommon for people recovering from surgery to be given hand-held pumps with which they can administer themselves with morphine to counteract any pain that they may get. And that for the first couple of days after an operation most people feel quite woozy from the anaesthetic and painkillers and can find it hard to remember this period clearly.

As already mentioned - during the operation the surgeon frequently takes samples for further examinations, and people can be really quite anxious waiting for the results of these tests to come back as it may take several days. 
 
There are forms of cancer which require very major surgery. One such cancer is tumours affecting the bones. Sometimes false bones (prostheses) can be used to replace a bone containing a tumour that has had to be removed. Very occasionally a limb has to be amputated (removed) in part or as a whole. After the surgery an artificial limb can then be fitted.
 
What can be amazing is how quickly the body can recover from surgery. Strength can return and scars can heal surprisingly quickly. However, a few teenagers may be left with physical scars that it can take some years to come to terms with (see ’Body image during and after cancer’).

Last reviewed November 2014.

Last updated November 2014.

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