Surgery, like all other cancer treatments, has its benefits, risks, and side effects. The type of side-effects and their intensity depend on the type of surgery, the type and location of the cancer, and the patient’s overall health status. Fortunately, thanks to recent advances in surgical techniques, including the advent of minimally invasive surgery, the side effects of modern surgery are often milder than they were in the past, allowing patients to recover faster. Doctors have also made stellar strides in reducing pain and other physical side effects from surgery.
Relieving side-effects, also known as palliative care, supportive care, or symptom management, is an important part of cancer care and treatment.
Common Side Effects
What You Can Do
Pain is probably the most common side-effect after surgery. The amount of pain and the location of the pain will depend on various factors, including:
- Where you had surgery
- The size of the incision
- The amount of tissue removed
- Whether there was pain before surgery.
Pain after surgery will lessen in time as the body heals; in the meantime pain medication can ease your child’s discomfort and make them more comfortable
Fatigue is a common side-effect after surgery, especially if the surgery involved the chest or abdomen. This is due to a variety of factors, including:
- The anaesthesia
- The body’s tendency to divert energy to the site of the surgery to help with the healing process
- The reduction in the amount of food eaten in the period immediately after the surgery
- The stress of the surgery
Fatigue usually abates gradually within a few weeks after surgery, and the best thing to do is to just let your child sleep more while building up their body and immune system with a nutritious diet. They should slowly start exercising to build up muscle again – speak to your oncology team about which exercise is best to achieve this.
A lack of appetite after surgery is quite common, especially when general anaesthesia was used, and it may be lead to temporary weight loss.
Most patients will regain their appetite after the effects of the surgery wear off, and their weight should return to normal. In the man time you can feed them a nutritious diet and try to get them to eat by making their favourite meals.
Swelling @ Site of Surgery
Some swelling after a surgical procedure is natural, as an incision is a form of injury to the body and the body’s natural response to injury is the inflammatory process, which results in swelling, which occurs because fluid containing chemicals from white blood cells accumulates in the injured tissues to attack foreign substances.
There is not really anything one can do about this except to allow the body to complete its healing – the swelling will subside as this occurs.
Drainage from Site of Surgery
Sometimes fluid that accumulates at the surgery site drains through the surgical wound.
This is normal and nothing need be done unless the
Drainage smells bad; or
Is accompanied by a fever and redness
These could be signs of infection, in which case you should contact your child’s oncologist immediately.
Bruising around Site of Surgery
There may be some leakage of blood from the small blood vessels under the skin after surgery, which can create bruising. This is a common occurrence and will go away after a while.
If the bruising is accompanied by significant swelling, however, contact your child’s oncologist to have it checked out.
Some blood loss during a surgical procedure is normal, but certain surgical procedures can result in the loss of a larger amount of blood; the surgical team will generally have blood for transfusion on hand should it be needed.
There may also be some bleeding from the wound after a surgical procedure. If your child experiences bleeding from the wound once at home, cover the wound with a clean, dry dressing, and contact your child’s doctor.
If the wound is bleeding a lot, cover and apply pressure to the site and take your child to their doctor or the emergency department at your local hospital immediately.
Infection can sometimes occur at the site of the surgery, as well as elsewhere in the body, even though surgeons take great care to minimise the risk of infection during the operation.
Signs of infection in a surgical incision include:
- Increased pain
- Foul smelling drainage from the wound
Should any of the above occur, contact your child’s doctor – antibiotics typically work well to treat most infections.
Lymphedema is another common side-effect of cancer surgery, especially if lymph nodes (tiny, bean-shaped organs that help fight infection by filtering bacteria and other harmful substances from the lymph fluid, which is a colourless fluid containing white blood cells that travels through most tissues of the body) are removed.
The removal of lymph nodes can cause lymphatic fluids to collect in the surrounding tissues, causing them to swell. Lymphedema can result in:
Discomfort and tightness
A limitation of movement and function of the affected area, usually the arms or legs
A massive build-up can result in extreme pain
Specific therapy is required to manage this side-effect. This can include the wearing of pressure-stockings or special lymph-drainage massage.
Lymph-drainage massage is a very specific type of massage which only those trained in this specific modality should do, so make sure that the therapist to whom you take your child is suitably qualified.
Organ dysfunction is not a normal occurrence, but sometimes during cancer surgery to certain areas of the body like the abdomen or the chest, temporary problems with the organs in that area could occur:
Abdominal surgery can sometimes cause the intestine to become paralysed for a short time, which results in the food fluid and gas not being able to pass through the bowels. This is called bowel or ileus construction and can result in bloating, nausea and vomiting and stomach cramps until the bowels start to function again.
Organ dysfunction is generally temporary and usually goes away as healing takes place – there is not really anything you can do about it except keep your child comfortable.
The body needs extra calories and protein for healing during recovery from any type of surgery, but consuming regular food may not be possible, or may be difficult, depending on the type and location of the surgery.
Surgery to remove any part of the mouth, throat, stomach, small intestine, colon, or rectum decreases appetite, limits the body’s ability to absorb nutrients, and increases problems after eating, such as gas, cramping, or constipation.
Some patients may experience difficulty in chewing or swallowing food. Surgery for stomach cancer may also affect the body’s ability to absorb certain vitamins.
The best way to deal with these problems is to ensure that your child has a nutritious diet and speak to his or her oncologist about vitamin supplements.
Cancer surgery may change the way your child’s body looks, feels and functions, which may make them feel insecure and struggle with their self-image. This forms part of the emotional side effects of cancer surgery, which are as important to treat as the physical side effects.
It is important to talk to your child’s oncology team about reconstructive surgery or prostheses before any surgery that may require them before the surgery, and to organise for a counsellor to speak with both you and your child to help them cope with these changes to their body.
Some patients also find it advantageous to join a support group of other patients in similar situations.