Recovering From Cancer Surgery at Home

After surgery you wake in a recovery area, then go to a ward or home. Bigger operations take longer. 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. ACS says pain control is important, so tell your team if pain keeps you from moving or breathing deeply. 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 soon after surgery helps digestion and circulation and lowers the risk of blood clots, according to ACS. You may be given an incentive spirometer to fully inflate the lungs and lower the risk of pneumonia. Use it as often as your team instructs. Inflatable leg stockings may gently squeeze your legs to help blood flow.

You may go home with one or more drains. ACS says drains remove fluid from the surgical area, and your team will teach you or a caregiver how to empty and care for them. NCI says you will be taught how to spot signs of infection and what to do. Ask when dressings can come off, when the wound can get wet, and whether stitches or staples need removing.

The digestive system is the last to recover from anesthesia, ACS notes. Bowel activity needs to restart before you eat solid food, so your team may build up your diet in steps. Narcotic pain medicines can cause constipation. Increasing fluids and eating fruit, vegetables and high-fiber foods may help. Ask for a bowel plan before you need it.

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. NCI says you will have at least one more visit with the surgeon a week or two after you go home. 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. Recovery varies with the type of surgery and your health, so be patient with yourself. NCI also notes that cancer treatment can cause fatigue that rest does not fully relieve. 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. These can be signs of a blood clot, which is why walking and clot prevention matter.
• 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
• American Cancer Society - Recovering from Cancer Surgery
• CDC - Fever during cancer treatment
• NCI - Fatigue and Cancer Treatment