Recovering From Cancer Surgery at Home

After general anesthesia most people spend one to two hours in recovery. Then they go to a ward or home. Bigger operations take longer. Grogginess, a dry throat from the breathing tube, nausea and shivering are common, and they pass quickly. What tends to surprise people is how much of early recovery is active work rather than rest.

Stay ahead of the pain. That is the guiding rule. Pain that is allowed to build takes more medicine to settle. It also makes it harder to breathe deeply and walk, and that is where most avoidable complications begin. Tell the team when your pain is not controlled. Do not wait to be asked. Ask what your medicine is, how often you can take it, and what to do if it is not enough. Before discharge, ask whether you have a plan for stepping down off stronger painkillers.

Getting out of bed early is standard. Walking lowers the risk of blood clots, pneumonia and a sluggish gut. You may be given an incentive spirometer to fully inflate the lungs and lower the risk of chest infection. It only works if you use it as often as instructed, usually several times an hour while awake. Compression stockings or inflatable leg sleeves squeeze and release to prevent clots. Blood-thinning injections may carry on after you go home.

You may go home with one or more drains. The team will show you how to empty them, record the output and care for the skin around them. A urinary catheter comes out as soon as possible, to lower infection risk. You will be told when dressings can come off. You will also be told when the wound can get wet, and whether stitches or staples need removing.

Diet is usually built up in stages. It starts with ice chips, moves to clear fluids, then to solid food, once the bowel is working and you are passing gas. Constipation from strong painkillers is close to universal. It is much easier to prevent than to treat. So ask for a bowel plan before you need it, not after.

How long recovery takes depends on several things: the type of anesthetic, how big the surgery was, your general health, and what your job demands. Minimally invasive surgery usually means less recovery time than open surgery. Expect at least one follow-up visit within one to two weeks. Before you leave, get specific answers on driving, lifting limits, showering, exercise, returning to work and sex.

Fatigue is the effect people most often underestimate. It commonly lasts weeks after the wound looks healed. It is a normal part of recovery, not a setback. Plan help at home for longer than you think you need. If family cannot cover it, ask about home care services before discharge.

Go to an emergency department, or call 911, for any of the following. Do not wait for a call back.

• Chest pain, sudden shortness of breath, coughing up blood, or pain and swelling in one calf. A clot that has travelled to the lungs is why walking and clot prevention are pushed so hard in the first weeks.
• A fever with shaking chills, especially with a fast heartbeat, a racing pulse, confusion, or feeling faint. Together these can mean sepsis.
• An incision that splits open, or any wound where you can see tissue bulging through the gap. Cover it with a clean damp cloth and go in. Do not push anything back or manage this at home.
• Bleeding from the incision or drain that soaks a dressing and does not slow with steady pressure, or drain fluid that suddenly turns to blood.
• Severe abdominal pain with a hard, rigid or board-like belly, especially with vomiting and no gas passing. A leak at a surgical join is a surgical emergency.
• A severe, sudden headache, or new confusion.

Call your surgical team the same day for a fever without those other signs, and ask before discharge what temperature they want you to call about, since thresholds vary. Also call the same day for pain that is getting worse rather than better or is not relieved by your medicine, spreading redness, swelling, warmth or new drainage from the wound, persistent nausea and vomiting, dizziness, or trouble passing urine. If you are also on chemotherapy, treat any fever as an emergency rather than a same-day call, because your infection-fighting cells may be low.

One thing does not wait for the same day. If chemotherapy is part of your treatment, a fever is a medical emergency in CDC's words: telephone the oncology team the instant you see it whatever the hour, and go to an emergency department if nobody answers.

• NCI - Surgery to Treat Cancer
• Memorial Sloan Kettering - Caring for Your Jackson-Pratt Drain
• NCI - Fatigue and Cancer Treatment