Planning and preparation

During a preoperative assessment appointment, your medical team will check your fitness for surgery. The health professionals you see will vary depending on the type of cancer and surgery and your general health, but they could include:

• the surgeon or another member of the surgical team, such as a resident medical officer or registrar 
• the anaesthetist or another member of the anaesthesia team, such as a specialist nurse or registrar
• a physiotherapist to show you exercises to do before surgery to improve the chances of a smooth recovery.

You will be asked about your medical history and any medicines you are taking. You may also have tests such as blood tests, urine tests and a chest x-ray, and imaging tests such as CT, MRI or PET scans. You probably won’t need to have all of these tests and scans.

You will be told whether you will have surgery as an inpatient or outpatient, what to take to hospital, and other useful information. Your legs may be
measured for stockings to help reduce the chance of developing a blood clot in your veins (deep vein thrombosis or DVT). You might wear these during surgery and for a short time afterwards.

If you will need support services after surgery, such as the advice of a dietitian or social worker, you will be given referrals for these.

If you are having minor surgery, you may not need to attend a preoperative assessment appointment. Your doctor will discuss the surgery and how to prepare at one of your usual appointments.

Tell the doctor if you are taking any over-the-counter or herbal medicines, as these could affect the surgery and your recovery.

A doctor needs your agreement (consent) to perform any medical treatment. Receiving and understanding information about treatment before agreeing is called informed consent.

Adults can give their consent – or refuse it – if they have capacity. Capacity means they can understand the information about the proposed choices and make decisions based on this information.

Sometimes consent is not needed, such as in a medical emergency. However, if your surgery is planned, your doctor will discuss:

• why you need the surgery and its benefits
• other treatment options
• how they will perform the surgery
• possible side effects, risks and complications.

For more information about consent, read Cancer Council’s booklet Cancer Care and Your Rights. Call Cancer Council 13 11 20 and ask for a free copy, or download a digital version below.

At the preoperative assessment appointment, you will be given instructions about how to prepare for the surgery based on your health and medical history. Let your treatment team know if you have any concerns about what you are asked to do.

Smoking can delay your healing and recovery time. If you smoke, try to quit before you have surgery. Giving up smoking can be difficult. For help, talk to your doctor or call the Quitline on 13 7848.

The advice you receive will cover the following issues:

• Bathing and shaving – You will be told to shower or bathe either the night or morning before surgery. If you have been told that hair near the surgical site will need to be shaved, you may be asked to do it yourself before you go to hospital, or it will be done when you are admitted. In cases where there is a lot of hair at the surgical site, you will be asked to avoid shaving the area yourself, as any cuts to the area can increase the risk of infection.

  You will be asked to remove nail polish, including clear polish, before surgery. Checking your fingernails during surgery is one way the anaesthetist can monitor the level of oxygen in your blood.

• Eating and drinking – Most people are told not to eat or drink for 6–12 hours before surgery. This may be called fasting or nil by mouth, and it ensures that your stomach is empty before surgery. This reduces the risk of some complications. In some cases, you can continue drinking clear fluids until two hours before surgery – your surgeon or anaesthetist will advise you on this. You should also avoid drinking alcohol and smoking for at least 24 hours before the operation.

• Medicine – Your doctor will tell you whether to keep taking any medicine you are on or to stop taking it in the days or weeks before surgery. If you’re instructed to fast and have to take medicine, swallow it with a small mouthful of water.
• Support person – You may want to ask a friend or family member to stay in the waiting room while you are in surgery. If you are having day surgery, you should arrange for someone to take you home when you are discharged. It’s not safe to travel alone or use public transport or a taxi, as you will still be under the effects of the anaesthetic. If your treatment centre has a social worker, they can help organise transport if necessary.
• Personal items – Your treatment team will let you know what personal items to take to hospital with you and what to leave at
  home. For example, they may tell you to take all your current medicines with you, but suggest you leave valuables, such as jewellery, at home.