Read about what happens before surgery, the people you’ll meet and the exercises you need to do.
Tests to check you are fit for surgery
You have tests before your operation to check:
- your fitness for an anaesthetic, if you need one
- that you’ll make a good recovery from surgery
You might not need all of these tests if you had them when you were diagnosed. Tests include:
- blood tests to check your general health and how well your kidneys are working
- an ECG to check that your heart is healthy
- breathing tests (called lung function tests)
- an echocardiogram (a painless test of your heart using sound waves)
- a chest x-ray to check that your lungs are healthy
Pre assessment clinic
Your pre assessment appointment prepares you for your operation. You usually have it 1 to 2 weeks before your surgery.
You meet members of your treatment team at this appointment and you can sign the consent form to agree to the operation.
Ask lots of questions. It helps to write down all your questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.
You can ask more questions when you go into hospital so don’t worry if you forget to ask some. At the hospital you might meet:
A member of the surgical team will tell you about:
- the operation you are going to have
- the benefits of having surgery
- the possible risks
- what to expect afterwards
Your surgeon will also explain whether you are going to have a hole made into your neck (a tracheostomy) - and what this involves.
The anaesthetist gives you the anaesthetic and looks after you during the operation. They make sure you’re fit enough for the surgery.
The clinical nurse specialist
The nurse checks your:
- general health
- blood pressure
The nurse also checks what help and support you have to see what you will need when you go home. They are your point of contact and care for you throughout your treatment.
In case you need to have a tracheostomy, the clinical nurse specialist will also tell you how you can look after it.
The dietitian gives you help and advice about managing your diet. They:
- help you get as well as possible before your operation
- explain how the surgery affects your diet
- give useful tips on how to increase your nutrients and calories
- might give you nutritional supplement drinks to have before surgery
Some people need a feeding tube in their stomach or small bowel. This makes sure you get the nutrition you need before your surgery.
The physiotherapist assesses how well you can move around. They let the doctors know if there is anything that could affect your recovery.
The physios also teach you leg and breathing exercises to do after your operation to help with recovery. Learning how to do the exercises beforehand makes it easier afterwards.
The speech and language therapist
Sometimes having surgery to the mouth and oropharynx can cause problems with speech. A speech and language therapist will talk to you about how to communicate afterwards.
Learning breathing and leg exercises
Breathing exercises help to stop you from getting a chest infection. If you smoke, it helps if you can stop at least a few weeks before your operation.
Leg exercises help to stop clots forming in your legs. You might also have medicines to stop the blood from clotting. You have them as small injections just under the skin. They are heparin, tinzaparin or dalteparin.
You start the injections just before your operation. You might also wear compression stockings.
This 3-minute video shows you how to do the breathing and leg exercises.
Breathing and circulation exercises after surgery
These exercises help prevent you developing a chest infection or blood clots in your legs after surgery. These problems are more likely when you are not moving around as you would normally.
You can do these breathing exercises while sitting up in a chair or in a bed or whilst lying down.
Relax your shoulders and upper chest.
Take a slow, deep, comfortable breath in and hold for a couple of seconds, then slowly breathe out.
Repeat this 3 times.
You can start these breathing exercises as soon as you come round from your anaesthetic.
You should try to do them every hour when awake until you are fully mobile.
If you need to cough, support your wound with your arms, a pillow or a rolled up towel.
If you are struggling to clear any phlegm, try a hu. This is where you breathe out in a short, sharp manner as if you were trying to steam up a mirror.
You should move about as soon as possible after your operation. But while you are not as mobile, try to keep your legs moving to encourage better circulation.
You can do these exercises in a bed or in a chair.
One foot at a time point your toes away from you then pull your toes towards your chin.
Try to do 10 of these on both feet at least 2-3 times an hour.
The next exercise is circling your ankles. One at time circle your ankles, clockwise and then anticlockwise. Repeat this 10 times with each ankle 2-3 times an hour.
Smoking is a main risk factor for mouth and oropharyngeal cancer. And continuing smoking increases your risk of the cancer coming back. Smoking can also slow down wound healing and make complications more likely after surgery.
Your doctor will encourage you to stop smoking before the surgery. But it can be difficult if you have smoked for a long time.
The evening before
Your nurse may give you a carbohydrate rich drink to have the evening before the operation. You might also have it on the morning of surgery. The drink gives you energy and can speed up your recovery. Your nurse will check your blood pressure, pulse and breathing rate.