Holland Hospital performs surgery for cancer with a variety of purposes. Most often, the goal is to remove the cancerous tissue. Other reasons include analysis of the cancer's type, size and possible metastasis (spread). Patients may undergo surgery either by itself or in combination with other therapies.
Surgical procedures for cancer fall into seven broad categories:
- Curative surgery removes a cancerous tumor. It works best on cancers that haven't yet spread to other parts of the body. To make sure all cancerous cells have been eradicated, this procedure is often followed by radiation therapy or chemotherapy.
- Preventive surgery is intended to keep cancer from occurring. For example, many colon cancers can be prevented by removing precancerous polyps before they become malignant. Or, a woman at very high risk for breast cancer may decide to have her breasts removed rather than worry about getting breast cancer later in life.
- Diagnostic surgery (biopsy) removes some or all of a tumor to determine whether the growth is cancerous. Two common biopsy procedures include:
- Fine needle aspiration withdraws cells from the tumor for inspection under a microscope.
- Incisional or excisional biopsy removes a larger section of tumor through a small incision (incisional), or the entire mass (excisional), for further examination. The patient may be put under either general anesthesia or local anesthesia, which numbs the area.
- Staging surgery determines the extent of a cancer. This procedure can sometimes be done without an incision by using tiny cameras (scopes) attached to a flexible tube, which are inserted into natural body openings. An endoscope is used in hollow body cavities and organs such as the lungs, intestinal tract and urinary tract. Besides allowing surgeons to view the suspicious area, these devices can take a tissue sample. A laparascope is used to view the abdominal cavity. Laparotomy involves a small incision in the abdominal cavity, done under general anesthesia. Laparotomies are used when the suspicious area cannot be examined by less invasive procedures.
- Supportive surgery helps other cancer treatments do their job. For example, some chemotherapy devices require a port (connecting device) to be inserted under the skin.
- Reconstructive surgery returns the body to normal or near-normal appearance or function following cancer treatment. The most common restorative surgery is reconstruction of a breast after a mastectomy.
- Palliative surgery eases pain, disability or other complications that come with advanced cancer. Palliative surgery may improve quality of life, but is not a cure or anti-cancer treatment.
Since patients experience different types and amounts of discomfort after surgery, the goal of pain management is to assess your own level of discomfort and take medication as needed. You will have better results controlling your pain if you take your medication before your pain is severe. Your doctor will prescribe the right type of pain medication for you. Ibuprofen or acetaminophen can be added to your prescription narcotic for more pain relief. Eventually, ibuprofen or acetaminophen will be used in place of your prescription narcotic as you begin to feel better. Icepacks may be helpful in decreasing the discomfort and swelling at your surgical site, particularly under the arm after a lymph node dissection. A small pillow may also help make you feel more comfortable.
Your doctor will provide you with specific instructions to follow in preparation for your surgery. These instructions will depend on the type of surgery you are having, the type of anesthesia being used, your age and other factors. General pre-op guidelines include:
- Not taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) for one week prior to your surgery
- Not eating or drinking for twelve hours prior to surgery
- Not applying perfumes, colognes or body lotion prior to surgery
- Removing all nail polish and jewelry, including piercings
- Arranging for someone to drive you home from the hospital
Depending on your procedure, your incision may have stitches, steri-strips (small strips of white tape) or both. The site is usually covered with gauze. Do not remove the gauze or steri-strips, but if they fall off, you do not need to replace them. If necessary, stitches will be removed in seven to ten days. You may also have a drain in place after your surgery. This drain is a plastic tube that runs from your internal surgical site to the outside your body and has a bulb at its end. Your nurse will teach you how to empty the bulb two to three times a day or when it's full. You may remove your gauze dressing two days after surgery to shower. Gently pat your incision dry. Be careful not to touch or remove the steri-strips or stitches. If you have drains, you may shower after they are removed. Bruising, slight swelling and a low-grade fever under 100 degrees Fahrenheit are normal the day after surgery.