Surgery Preparation for Cancer

Pre-surgical tests

In my case, I had a large tumor that had basically engulfed my right ovary, which meant I had to have major abdominal surgery. They had to cut me open from the belly button straight down to my… ahem, nethers, move my intestines out of the way (like a Cesarean section), and remove that tumor. They also planned to stage me for cancer if the initial biopsy while I was under anesthesia showed the tumor was cancerous. Staging meant taking samples from a bunch of my other organs like my other ovary, uterus, cervix, lymph nodes… and a whole bunch more.

Not every surgery will be that extensive. Some will be more extensive. But no matter what type of surgery you’re scheduled to have, you’ll have to undergo pre-surgical testing. Typically, this includes things like blood tests and imaging scans. Doctors need to make sure your body is in good enough health for the surgery. They may also need some specific information or have to take specific steps to prepare for the surgery itself. For example, they may place a marker like a surgical clip inside your body to mark the spot of the tumor.

In my case preparation was mostly blood tests, but they also reviewed my most recent CT scan.

My Advance Directive

Yep, at 32 years young I was filling out an Advance Directive about what my wishes were should I emerge from surgery unable to make my own decisions. Who did I want to make my decisions for me? In my case, it was my spouse. We were in such a hurry that we couldn’t get close family to sign as witnesses. Instead, the friends who were letting us stay with them while we went to appointments did it for us. It was kind of them to participate in such a macabre ritual.

Before we move on, I think it’s worth pausing to consider the weight of the Advance Directive, not just on you, but on whomever you choose to be the decision-maker for you, should you need that. Your primary caregiver, whether it’s a spouse/partner, parent, child, or other, will already be under a tremendous level of strain. They also will likely face a lot of opinions from well-meaning loved ones and like you (assuming you are the patient), they will have to set healthy boundaries.

The good thing about the Advance Directive is that it makes it clear to everyone involved who you wish to have the legal right to make your decisions. When the stress of it all weighs on you both, remember that. It was your decision to choose someone. And you chose whomever you did. And that was your right, which is what makes the decisions your representative will make for you right, no matter what anyone else thinks or says.

Okay, now let’s move on.

Medication cessation

There are certain medications doctors may need you to stop taking prior to surgery, sometimes weeks in advance, when possible. These are often related to bleeding risk, for example, drugs that thin the blood for heart conditions like Warfarin (Coumadin), or non-steroidal anti-inflammatories like Ibuprofen. This makes sense when you think about it. After surgery you WANT your blood to clot well so your incisions both inside and out, can heal. Whatever doctors ask you not to take, you’ll want to follow their directions. Be sure to provide them with a full list of everything you take, including vitamins and herbal supplements.

Smoking cessation

You will typically be told to stop smoking cigarettes if you’re a smoker because smoking will interfere with the body’s healing process. That said, if quitting smoking were easy, it wouldn’t be the scourge on humanity that it is. Do your best to work with your doctors to stop before your surgery, if you possibly can. It will do you so much good and maybe help you to make the leap to quitting overall.

Bowel prep

Because I had abdominal surgery, I had to do bowel prep. If you are not going to have to do bowel prep, feel free to skip this delightful section. What’s interesting is that the bowel prep for my two surgeries—one for the original cancer and one for my recurrence—was quite different. Nothing shows how individual cancer treatment can be than the same person having different prep for two abdominal surgeries.

In the first, they wanted me to empty my bowels completely the night before using an enema. I had never used one before. They are um… powerful. Let’s just say I prefer not to repeat that experience. Oh, and you’ll probably want privacy to go through that if you must do it. (If this made you laugh, then good! Laughter is wonderful medicine. Besides, ask any six-year-old, “What’s funnier than poop jokes?” You know the answer. Nothing.)

My second time I didn’t have to do that, thank goodness. In fact, the second time my “prep” involved eating a bunch of high-fat foods. I’m not joking! My surgical oncologist was going to remove lymph nodes and he and his colleagues said that when people eat a bunch of fat, it makes their lymph nodes very visible. So, I was told to go ahead and eat ice cream or burgers the day before surgery. I did both with much glee.

Body prep

If you don’t have to do bowel prep, you will likely still have to do some “body” prep. By this I mostly mean getting squeaky clean. I was told to shower with special cleansers from the pharmacy. You also may be told to remove nail polish and to avoid all lotions, creams, and serums the day of surgery. (A male friend who read this asked if I meant the word “serum” or if that was a typo. LOL. I was like, “No, serums are a thing.” Many men are still playing catch-up on skin care trends, am I right, ladies?)

Removing clothing and jewelry

When you get to the hospital, you’ll be changing into a hospital gown. You will have been told to leave jewelry at home, if you can. In my case I was having surgery out of town and stayed at a hotel the night prior. We checked out so I had no option to leave the jewelry there.

In retrospect, I should have given my jewelry to a family member before I entered the hospital. Not because you can’t remove it there. You can. They will likely have labeled baggies or lockers or some other way to store your precious items, so they don’t get lost. The reason I wish I’d taken it off prior is that one of the moments emotions hit me unexpectedly was when I had to remove my wedding ring.

I never took off that ring except on rare occasions. Sliding it from my finger and placing it into a Ziploc brought home the seriousness of the moment and I admit, it rocked me. I had to take deep breaths and fight off tears. But I did it. Don’t be surprised if the stripping away of special things that remind you of your humanity is hard.

Other prep

You may or may not have other steps as well. In my case, I had to have an epidural. I’d never had one and it was scary, but it went well. They gave me something that made me pretty loopy first, then the epidural. Then we were ready to go to surgery.

Operating room

I’m not going to lie, being wheeled to the operating room is freaking crazy. I was loopy, but not so out of it I didn’t know what was going on. In fact, they want you to be able to talk to them and answer some questions before they put you all the way out. Which means you may get to see the actual operating room, as I did. There were a million monitors and machines and a whole team of (kind, friendly) people. It felt like a Space Shuttle launch or something.

But once they put the mask on my face and told me to count down from ten that was it… all went dark until I awoke in post-op.

Post-Op

I woke up groggy and in pain. I remember mouthing, “Ow,” quietly. Then I heard someone murmur, “CCs” and the pain disappeared. I knew my nurses had noted my pain and given me more medication. I was insanely grateful because “Ow” was an understatement brought on by being barely awake. But they were on it immediately. I didn’t suffer.

Don’t be surprised if you are super-nauseous as you come out of anesthesia. I was. It wasn’t even nausea really—it was more like my stomach was on strike. Everything wanted to come up instead of staying down. They have medications to help you with that. Otherwise coming out of surgery was relatively easy for me physically.

Emotionally, can be a different story. It was for me. But we don’t need to go there here. This is getting you ready for the day of surgery. 

Other treatments you may have to prepare for include:

• Chemotherapy

• Radiation

• Immunotherapy

• Surgery Recovery - In the Hospital

You may also want to check out my Hospital Stay Packing List (coming soon) for ideas to help you and loved ones get you ready and ease your stay after treatment.