Having your nasopharyngeal cancer operation | Cancer Research UK
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Having your nasopharyngeal cancer operation

Men and women discussing nasopharyngeal cancer

This page has general information about having an operation for head and neck cancer. You can find the following information

 

A quick guide to what's on this page

Having your nasopharyngeal cancer operation

Because surgery is rarely used to remove a nasopharyngeal tumour, this is general information about having an operation for head and neck cancer.

Before your operation

When you go into hospital for your operation, your surgeon, anaesthetist, physiotherapist, speech therapist, dietician and specialist nurse will each come to talk to you about what will happen. 

Your surgeon will explain the operation and tell you what to expect when you come round from the anaesthetic. It is important to ask as many questions as you need to.

After your operation

When you wake up, you will have several different tubes in place. These may include a drip in your arm, drains from your wound, and possibly a fine tube into your stomach to give you liquid food (a gastrostomy tube).

Coping with pain

You will almost certainly have some discomfort for the first week or so. It is important to tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you.

Eating and drinking

If you have had surgery to remove the tumour in your nasopharynx, you will probably need to have liquid food through a tube for while. If you have had a neck dissection, you will probably be allowed to eat and drink straight away if you feel like it.
 

CR PDF Icon You can view and print the quick guides for all the pages in the treating nasopharyngeal cancer section.

 

 

What happens before your operation

This will vary slightly depending on the type of operation you have. 

When you go into hospital for your operation, your surgeon, anaesthetist, physiotherapist, specialist nurse and dietician will each come to talk to you about what will happen. Your surgeon will explain the operation and tell you what to expect when you come round from the anaesthetic. If your operation might cause problems with speech, a speech therapist will talk to you about communicating after your surgery.

It is important to ask as many questions as you need to. It may help to make a list of questions before you go into hospital to have your surgery. There are some suggestions for questions at the end of this section. The more you know about what is going to happen, the less frightening it will seem. Don’t worry if you think of more questions later – just speak to your nurses. Your doctors will come and talk to you again, if needed.

You will have the chance to talk about your operation with your surgeon and find out exactly what is going to happen. Generally, before most head and neck cancer surgery, you will have

  • A detailed explanation of what to expect
  • Blood tests to check your general health and find out your blood type
  • A chest X-ray to check your lungs are healthy
  • An ECG to check your heart is healthy
  • To learn breathing and leg exercises

You may have had some of these tests when your cancer was diagnosed. If so, you may not have to repeat them. As well as the tests above, you might also need

These help to make sure you are fit enough to make a good recovery from your surgery. Your physiotherapist will teach you breathing and leg exercises. It is very important that you do these exercises as instructed because they will help you to get better.

The breathing exercises will help to stop you getting a chest infection. The leg exercises will help to stop blood clots forming in your legs. Both of these are complications of surgery and can happen because you are not moving around as much as you would normally. Your nurses will encourage you to get up and about as soon as possible after your operation. But if you have major surgery you may have to stay in bed for the first day or so.

Below is a short video showing breathing and circulation exercises after surgery. Click on the arrow to watch it.

 



 

View a transcript of the video showing breathing and circulation exercises after surgery (opens in new window)

If you have recently been finding eating and drinking difficult, you may have fluids through a drip (intravenous infusion) into your arm before your surgery. This will prevent dehydration before your operation. 

If you have body hair on your neck, chest or face, you will need a shave before your operation. This reduces the risk of wound infection after your operation. You may have your shave on the ward or in the operating theatre while you’re under anaesthetic.

 

Immediately after your operation

If you've had a big operation, you may wake up in intensive care or a high dependency recovery unit instead of the ward you were on before the surgery. This is nothing to worry about. These are places where you can have one to one specialist nursing care. You may have several different tubes in place. This can be a bit frightening. But it helps if you know what the tubes are all for. Depending on the operation you’ve had, you may have

  • Drips (intravenous infusions) – to give you fluids until you are eating and drinking again, and blood, if you need it
  • A fine tube into your stomach – so you can have liquid food straight into your stomach
  • One or more wound drains – these will come out of your neck or near your wound
  • A tube into your bladder (catheter) – so that your urine can be collected and measured

If you have surgery, eating and swallowing will be difficult until you recover and any swelling goes down. So you may need feeding through a tube into your stomach. If you have surgery to remove the tumour from your nasopharynx you’re most likely to have a gastrostomy (PEG) tube. This goes directly through the skin of your tummy into your stomach.

The wound drains collect blood and fluid. This is to stop the blood and fluid from collecting around the operation site. This helps to stop you getting an infection and aids healing. The wound drains connect to suction bottles, which help to gently draw out the fluid. When the fluid stops coming out, your nurse will take the drains out. It usually takes a few days for the wound to stop draining.

When you first wake up, you will have a little clip on your finger called a pulse oximeter. This is to measure your pulse and blood oxygen levels. Your nurse will measure your temperature and blood pressure often during the first few hours. They will also measure the amount of urine you produce. This will help the nurses to make sure you do not become dehydrated or have too much fluid in your body. You may also have an oxygen mask on for a while. 

You may have a couple of electronic pumps attached to one or more of your drips. These give you a constant, measured dose of painkillers or other drugs you might need to have through your drip.

As soon as your doctors are sure you are recovering well, you will go back to the ward. 

 

Painkillers

You will almost certainly have some discomfort for the first week or so. But it is possible to control your pain, and there are many different painkilling drugs you can have. So it is very important that you tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.

Many hospitals now use electric pumps, called PCA pumps (patient controlled analgesia) for pain relief after surgery. These pumps attach to your drip. You have a hand control with a button that you press to give yourself extra painkillers as you need them. Do use it whenever you need to. You can’t overdose – the machine is set to prevent that. The nurse will be able to check how often you press the button. If you need to press it a lot they will know that you may need a higher dose of painkiller in the pump.

We have a large section on pain control that you may find helpful.

 

Getting up after your operation

This may seem impossible at first. Moving about helps you to get better, but you will need to start very gradually. Your physiotherapist will visit you every day after your operation to help you with your breathing and leg exercises. Your nurses will encourage you to get out of bed and sit in a chair 1 or 2 days after your surgery. They will help you with all the drips and drains. Over the next couple of days, your nurse will take out most of the tubes and drains, so it will be much easier to get around.

 

Your wound

If you have had surgery to remove lymph nodes in your neck (a neck dissection) your surgeon may cover the wound with a dressing. The dressing may be left in place for a couple of days. Or you may have a clear protective film sprayed over your wound. This helps the doctors and nurses to see your wound clearly. If you have wounds inside your mouth or throat your surgeon will have used stitches that dissolve. So you will not have any dressings on these.

Your wound drains will stay in until they stop draining fluid. This is usually about 3 to 7 days after the operation. 

If you have stitches or clips, they will stay in for around 10 days. You will probably have them taken out before you go home. If your wound is not completely healed but you are well, your doctor may let you go home with your stitches still in. You can come back to the hospital to have them taken out. Or a district nurse can visit you at home to remove them.

 

Eating and drinking

Whether or not you can eat and drink after your operation depends on what operation you had. For example, if you have had surgery to remove the tumour in your nasopharynx, you’re most likely to have a gastrostomy (PEG) tube. The tube goes directly through the skin of your tummy into your stomach and you can have liquid feeds through it.

If you have had a neck dissection then you will most likely be allowed to eat and drink the same day or the day after your operation. It will depend on how sore your neck is and if you feel like eating or not.

Once you have fully recovered from your operation, there are usually no restrictions on what you can eat and drink. Often people have lost quite a bit of weight by the time they are diagnosed with a cancer of the head or neck. If this is the case and you have not managed to put the weight back on, you’ll need to build yourself up again with some high calorie liquid supplements.

 

Making progress

After a few days you will be up and about more. Gradually you will start to feel better. Soon you will be able to eat. At first you will find it easier to have lots of very small meals rather than 3 large meals a day. The hospital dietician will give you help and advice with managing your diet. If you have lost quite a lot of weight, your doctor or dietician will probably recommend that you try and boost your calorie intake with some high calorie liquid feeds. These usually come as small carton drinks.

These drinks have all the vitamins, protein and carbohydrate that you need for a balanced diet. If you’re trying to put weight on, you can sip these through the day as well as eating meals. They come in many flavours these days, both savoury and sweet. Available brands include Ensure, Fresubin, Fortisip, Complan and Build Up.

You can also get powdered protein or carbohydrate supplements to sprinkle on foods and drinks. A dietician will be able to help you plan a suitable diet and advise on supplements. We have some tips for adding hidden calories to your diet in our section on diet tips for putting on weight

You are likely to have times when you feel very down. Try to be patient with yourself while you fully recover from this operation. You had your cancer diagnosis to come to terms with – and you’ve been through a big operation. You may need a lot of support from your doctors and nurses, family and friends.

There is more about living with nasopharyngeal cancer in this section.

If you would like to talk to someone outside your own friends and family, you can contact our team of cancer information nurses. Or you can look at our counselling organisations page. Organisations that provide telephone support to people with head and neck disease are listed on our nasopharyngeal cancer organisations page. You can find out about counselling in our coping with cancer section.

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Updated: 27 August 2014