Cancerbackup Factsheet

Surgery

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Urdu

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UrduCancerbackup Factsheet

SURGERY

This factsheet gives you some basic information about surgery for cancer.

Surgery means treating illness by cutting away body tissue. It is one of the main treatments for cancer. Usually a surgical knife (scalpel) is used. Another way is to use high-energy light beams (lasers) that can cut through body tissue. Sometimes a small metal rod (probe) which freezes cells is used to destroy tissue and this is known as cryotherapy.

What is cancer?

The organs and tissues of the body are made up of tiny building blocks called cells. Cancer is a disease of these cells. Although cells in each part of the body may look and work differently, most repair and reproduce themselves in the same way. Normally this takes place in an orderly and controlled way, but if the process gets out of control the cells will divide much more rapidly than normal cells and will form a lump called a tumour. Tumours can be either benign or malignant. Cancer is the name given to a malignant tumour. Many people with cancer will have radiotherapy as part of their treatment.

What is surgery used for?

Cancer surgery can be used for a number of purposes:

Diagnosis To confirm the diagnosis of cancer and find out about the type of cancer, the surgeon may remove a small piece of tissue. The sample is then examined in the laboratory. This is called a biopsy.

Treatment Where possible, surgery is used to remove the tumour and surrounding tissues that might contain cancer cells. Occasionally, surgery is used to remove cancer cells that have spread from an original tumour into another part of the body, such as the lung or liver.

Staging This is the process that doctors use to work out whether the cancer is just in the place in which it first started, or whether it is likely to spread to other parts of the body. Staging can be done at the same time as surgery to remove a tumour. Information about the stage of the cancer is used to plan treatment.

Reconstruction Surgery can be used to restore: a part of the body: for example, to create a new bladder the appearance of part of the body: for example, breast reconstruction after a mastectomy (an operation to remove the breast).

Palliation If the cancer cannot be completely removed or cured, surgery can sometimes still help by removing or bypassing a tumour to reduce its effects, such as blockage, discomfort or other complications.

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If your cancer has spread by the time you are diagnosed, you may not be offered surgery as your main treatment. This is because surgery alone will not cure you. Depending on the type of cancer you have, you may be offered a treatment that treats cancer cells throughout the body, such as chemotherapy, hormonal therapy or immunotherapy. Radiotherapy may also be used to help to control a cancer that cannot be treated surgically. Sometimes treatment can be given to reduce the size of a cancer so that less surgery is needed.

The right surgeon for the job To diagnose your cancer, you may be seen by a specialist surgeon at your local hospital. For example, you will see a breast surgeon if you think you may have breast cancer or a gastrointestinal surgeon if you think that you may have stomach cancer. For some types of surgery you may need to see a specialist surgeon who is expert in the particular type of surgery that you need. This may mean that you have to have your treatment at a specialist cancer centre, which may be at some distance from where you live. If you want to know where you will be treated, you can talk to your GP. He or she can explain the procedure and if necessary arrange for you to see another doctor for a second medical opinion. You can also ask your surgeon if he or she specialises in your type of cancer. Can the surgeon cure my cancer? The surgeon will remove the tumour and a surrounding area of normal tissue. It is not possible to say whether an operation will definitely cure a cancer. Although scans may look clear, cells could have broken away from the main tumour before surgery and spread to another part of the body. When these groups of cells are very small they do not always show up on a scan. Sometimes a surgeon will find during the operation that a cancer cannot be completely removed. Scans do not always give the true picture and surgeons will not always know the extent of the cancer until they operate. How is the surgery carried out? It is important for the surgeon to obtain ‘clear margins'. This means a border of healthy tissue, with no cancer cells in it, should have been taken away from all around the tumour. The tissue that is removed during the operation will be examined under the microscope to make sure this has been done. It is important because a clear margin minimises the risk of any cancer cells being left behind and helps to reduce the risk of the cancer coming back. Your surgeon will also often remove the lymph nodes that are nearest to your tumour. This is done because this is where cancer cells are most likely to spread to. A pathologist, who is a doctor that specialises in diagnosing disease by examining tissues under a microscope, will test to see whether the lymph nodes contain cancer cells. If they do, there may be an increased risk of the cancer coming back in the future and you may need more treatment after your operation.

Cancerbackup can send you factsheets about chemotherapy and radiotherapy in your language

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Before your operation Your surgeon and anaesthetist are responsible for your well-being during and after your surgery. The surgeon is the person who performs the operation. The anaesthetist is the person who makes sure you are asleep during the operation. They must be sure you are fit enough to undergo the operation. You may have tests such as a chest x-ray and (ECG) to assess your lungs and heart. How well your kidneys are working may be checked with blood tests if you are likely to have a long operation, as this may put strain on the kidneys. If you are not thought to be fit enough for a general anaesthetic, it may still be possible for you to have surgery. Some operations can be done under local anaesthetic or epidural (spinal anaesthetic). If these techniques are used, you will be awake during the operation. It is important that you understand all about your operation. You should be given an opportunity to discuss the operation with the surgeon. When you speak to the surgeon, it is a good idea to take someone with you who speaks both English and your language. You can also ask for an interpreter to be present to help you understand. You will need to sign a consent form to say that you agree to the operation. Consent forms should be available written in your language. No operation will be done without your consent. For safety reasons you will be asked to remove any jewellery or metal objects before going to the operating theatre for the operation. Under some circumstances it may be possible for you to continue to wear your jewellery throughout the operation. If you have to remove any items, you should usually be able to wear them again soon after the operation. Before any operation you will be asked not to eat or drink anything for a few hours. You may also need to bathe and shave body hair from the area of the operation. The nurse looking after you will give you more details about this. Body hair is only shaved if it is essential. It is done using a disposable razor. The hair will begin to grow back after the operation. The nurse looking after you will give you more details about this. Some people like to speak to the religious leaders of their community before an operation. Most hospitals can arrange this for you. If you would like to speak to someone, let the nurse know. After your surgery Information about operations for specific types of cancer is available in the Cancerbackup booklets about individual types of cancer. These booklets are only available in English. The recovery period will vary depending on the extent of the surgery. You may have some pain after surgery but will be given painkillers to minimise this. Good pain control will help you to get up and about as soon as possible. You may also feel sick and should be given anti-sickness drugs to help control this. If you still have pain or feel sick, tell the nurse looking after you. You should be able to get up and about fairly soon after your operation and the ward staff will help you. Moving around will help you to recover more quickly and help to

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reduce the risk of complications. Breathing and leg exercises can also help reduce the risk of chest infections and blood clots. Your nurse or physiotherapist will teach you these exercises. You may be given antibiotics to help prevent wound infection. Depending on the type of operation, you may have tubes placed into the wound to drain away fluid. The amount of fluid draining usually reduces quite quickly - often within days. In the first few days after your operation you may need some help to wash and go to the toilet. Speak to your nurse if you would prefer to be helped by a nurse of the same sex. Once you are moving about again freely, you will probably be able to manage these activities for yourself. Longer-term complications Most people do not have long-term complications after cancer surgery. However, some do and before you have surgery you may wish to ask your surgeon about the risk of permanent complications. Occasionally patients may have nerve pain, which is more common after some operations such as the opening of the rib cage (thoracotomy).

Some operations can occasionally cause permanent side effects due to nerve damage. Removal of the prostate gland (radical prostatectomy), for example, can result in impotence and loss of bladder control in some people because the nerves controlling these functions may have to be removed to clear the cancer.

Impotence may also sometimes occur after operations for cancers in the lower part of the bowel (rectum).

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This factsheet has been compiled using information from a number of reliable sources including The Oxford Textbook of Oncology, Cancer

and its Management and The Textbook of Uncommon Cancers. Each Cancerbackup factsheet is regularly reviewed and updated by cancer

doctors, specialist nurses, other relevant health professionals and people with cancer.

© CANCERBACKUP 2006, SURGERY. All rights reserved. No parts of this publication may be reproduced or transmitted, in any form or by any

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Occasionally, if most, or all, of the glands in an area of the body have had to be removed, and particularly if you have had radiotherapy to that area as well, you may get swelling of limbs or the trunk. This is known as lymphoedema. The lymph nodes are the drainage system of the lymphatic system, so removing lymph nodes can cause fluid build-up. It is most likely to affect an arm or leg, although it can happen to other parts of the body, such as the trunk. The earlier lymphoedema is picked up, the easier it is to control. So always contact your doctor if you notice swelling in your hands (after surgery to the armpit) or feet (after groin surgery). Some operations will change the way your body looks. This may affect the way you feel about yourself physically and emotionally. Please talk to the nurses or your doctor if you have any concerns. They should be able to help you or arrange for you to see a counsellor. You can also call the nurses at Cancerbackup. It is natural to be anxious about surgical operations. However, surgery can be one of the most successful treatments for cancer. Nowadays these operations are usually carried out by surgeons with a great deal of experience in treating the particular type of cancer. This gives the best chance of a good outcome. For some conditions, such as cancer of the breast or bowel, there may be specialist nurses looking after you too. They also have a great deal of experience in the particular type of cancer. The nurse or surgeon will explain to you before the operation what scarring and other effects are likely, and what procedures will be followed to make sure you get the best possible care. Support services If you would like to talk to someone in your language, about your situation or how you are feeling, please contact Cancerbackup’s Cancer Support Service. The nurses will be able to talk through any concerns you have and suggest where you can get any other support that you may need. The freephone number is 0808 800 0140 and the lines are open from Monday to Friday 9am until 7pm. Interpreters are also available for over 100 other languages by ringing Cancerbackup’s main helpline number, 0808 800 1234. As well as this factsheet, Cancerbackup can send you factsheets in Urdu on chemotherapy, radiotherapy and breast. We can also send you booklets and factsheets written in English about most types of cancer, other cancer treatments and living with cancer. Please call Cancerbackup on 0808 800 0140 if you would like a copy of any of them. This factsheet has been compiled using information from a number of reliable sources including The Oxford Textbook of Oncology, Cancer and its Management and The Textbook of Uncommon Cancers. Each Cancerbackup factsheet is regularly reviewed and updated by cancer doctors, specialist nurses, other relevant health professionals and people with cancer.