Common questions about surgery
Surgery is one of the main treatments for many types of cancer.
Learn more about:
- How is surgery done?
- Will COVID-19 affect my surgery?
- How long should I have to wait before surgery?
- Will I stay in hospital?
- How much does surgery cost?
- Can surgery spread the cancer?
- What questions should I ask?
- What is a surgical margin?
- What is the role of my GP?
- Can I use telehealth?
The way the surgery is done (the approach or technique) depends on the type of cancer, its location in the body, the surgeon’s training and the equipment in the hospital or operating theatre.
Each method has advantages in particular situations – your doctor will advise which approach is most suitable for you. Some people have a combination of approaches.
During open surgery, the surgeon makes one or more cuts (incisions) into the body to see and operate on the organs and remove cancerous tissue. The size of the cut can vary depending on the type of surgery. Your surgeon can talk with you about the size of the cut before surgery.
Open surgery is a well-established technique and widely available. It is often used for cancers in the abdomen (belly) or the pelvic area, when it is known as a laparotomy. When open surgery is done on the chest area, it is called a thoracotomy.
Also called minimally invasive surgery, this is when the surgeon makes a few small cuts in the body instead of the large cuts used in open surgery. The surgeon will insert a thin instrument with a light and camera into one of the cuts. The camera projects images onto a TV screen so the surgeon can see the inside of your body. The surgeon inserts tools into the other cuts and removes the cancerous tissue, using the images on the screen as a guide.
Keyhole surgery in the abdomen or pelvic area is called a laparoscopy. When keyhole surgery is done on the chest, it is called a thoracoscopy or video-assisted thoracoscopic surgery.
In many cases, keyhole surgery can lead to a shorter stay in hospital and reduce pain and recovery time.
This is a type of keyhole surgery performed with help from a robotic system. The surgical instruments are moved by robotic arms controlled by the surgeon, who sits at a computer console next to the operating table. The console lets the surgeon see a three-dimensional view of the surgical site.
This procedure uses a laser beam instead of a knife to vaporise or remove cancerous tissue. A laser beam is a strong, hot beam of light.
Also called cryosurgery, cryotherapy is often used to treat skin cancers. Liquid nitrogen is sprayed onto the cancerous tissue to freeze and kill it.
Will COVID-19 affect my surgery?
To help stop the spread of COVID-19, your hospital may have put in place some extra procedures. You may need to have a negative rapid antigen test (RAT) before arriving at the hospital on the day of the surgery, hospitals may limit the number of people that visit, and you may have to wear a mask that covers your nose and mouth while you are in hospital.
If you have COVID-19 or are recovering from a recent COVID-19 infection, planned surgery may be delayed for a few weeks. This is to ensure you have recovered and the surgery can be carried out safely. Your hospital will let you know if there are any specific precautions you need to follow.
How long should I have to wait before cancer surgery?
It’s common to have to wait for surgery. How long you have to wait depends on the type of cancer, its stage, the surgery you are having, and the hospital’s schedule.
The waiting list is organised by how urgently people need surgery. This ensures that people are treated in turn but without waiting for periods of time that would be harmful.
Although most cancer surgery is elective surgery, it usually falls into the most urgent category, which means it is recommended to take place within 30 days of you and your surgeon agreeing on the procedure.
The recommended time frames for treatment to start are set out in the Guides to Best Cancer Care.
Waiting for surgery to begin can be a stressful time – if you are anxious or concerned, speak to your surgeon or call Cancer Council 13 11 20.
Will I stay in hospital?
Often you will be admitted to hospital to have surgery. This is called inpatient care. The length of your hospital stay depends on the type of surgery you have, the speed of your recovery and whether you have support after you are discharged.
For many procedures, it is common to have surgery and go home on the same day, provided there are no complications. This is called day surgery or outpatient surgery. Your doctor will tell you whether you will have surgery as an inpatient or outpatient.
How much does surgery cost?
The cost of surgery varies, depending on the cancer type and stage, the operation you are having, the length of stay in hospital, and whether you have treatment as a public or private patient.
You have a right to know what you will have to pay for surgery and whether there will be any additional costs not covered by Medicare or your health fund. There may be fees you hadn’t expected (e.g. if you have surgery as a private patient, there will be separate fees for your surgeon, anaesthetist, operating room and hospital stay).
When you are booked in for surgery, ask your surgeon, anaesthetist and hospital for a written quote that shows what you will have to pay. Talk to your health insurer to see what is covered.
If you are concerned about the cost, you may want to ask your surgeon if there is any way to reduce the costs, get a second opinion from another specialist, or seek surgery as a public patient.
For more on this, see Cancer care and your rights.
Can surgery spread the cancer?
In most cases, surgery does not cause cancer cells to spread to other places in the body. Surgeons take steps to prevent this. However, for a few cancers, there is a higher risk. For example, most men with testicular cancer have the entire affected testicle removed. This is because removing only part of the testicle can cause cancer cells to spread during surgery. Talk to your surgeon if you are concerned.
What questions should I ask?
It’s important to ask questions about the type of surgery recommended to you, including the risks, possible complications and how long it will take to recover. Also remember to ask your surgeon about their training and experience. Here are some suggested questions to ask your doctor.
If you speak a language other than English, you can ask your doctor or hospital to arrange an interpreter. Interpreter services can be provided in person or by phone.
What is a surgical margin
The surrounding tissue that is removed with the cancer is known as the surgical margin. A specialist doctor called a pathologist checks the margin under a microscope to make sure the cancer has been completely removed. If there aren’t any cancer cells at the edge of the removed tissue, it is called a clear, negative or clean margin. If there are cancer cells, it is a positive or close margin, and you may need to have more surgery or other treatments.
What is the role of my GP?
Your general practitioner (GP) will arrange the first tests to assess your symptoms. If these tests do not rule out cancer, you will usually be referred to a specialist, for example, a surgeon.
It is a good idea to build a relationship with a GP. They can assist you with treatment decisions and follow-up care after surgery. For example, GPs can help with pain control, prescriptions for medicines, or referrals for follow-up blood tests and scans.
Can I use telehealth?
You may be able to have some appointments with your surgeon and other health professionals at home by phone or video call. This is known as telehealth and it can reduce the number of times you need to travel to appointments. This may be particularly helpful if you have to travel a long way to see your doctors. Telehealth can also reduce the risk of catching an infection.
Although telehealth can’t replace all face-to-face appointments, you can use it to talk about a range of issues including test results, prescriptions, help with side effects, and nutrition and exercise advice.
Podcast: Making Treatment Decisions
Prof Elisabeth Elder, Specialist Breast Surgeon, Westmead Breast Cancer Institute and University of Sydney, NSW; Chanelle Curnuck, Dietitian – Dietetics and Nutrition, Sir Charles Gairdner Osborne Park Health Care Group, WA; Department of Anaesthetics, Perioperative Medicine and Pain Medicine, Peter MacCallum Cancer Centre, VIC; Jessica Feeney, Nurse Unit Manager, Breast, Endocrine and Gynaecology, Royal Adelaide Hospital, SA; A/Prof Richard Gallagher, Head and Neck Surgeon, Director of Cancer Services and Head and Neck Cancer Services, St Vincent’s Health Network, NSW; John Leung, Consumer; Rohan Miegel, Senior Physiotherapist – Cancer Care, Flinders Medical Centre, SA; A/Prof Nicholas O’Rourke, University of Queensland and Head of Hepatobiliary Surgery, Royal Brisbane Hospital, QLD; Lucy Pollerd, Social Worker, Peter MacCallum Cancer Centre, VIC; Suzanne Ryan, Clinical Nurse Consultant, Department of General Surgery, Sunshine Coast University Hospital, QLD; Rebecca Yeoh, 13 11 20 Consultant, Cancer Council Queensland.
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