Before your operation for rectal cancer

Tests to check you are fit for surgery

You have tests before your operation to check:

• your fitness for an anaesthetic

• that you'll make a good recovery from surgery

• if there is anything you can do to improve your fitness or general health before surgery

Your treatment team also use the tests to think about the level of care you might need after surgery. This might be ward care, ​high dependency care​ or ​intensive care.​

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 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 your lungs are healthy

• cardiopulmonary exercise tests to check your level of fitness - this is for people having a large operation

Pre assessment clinic

One or two weeks before your surgery you have an appointment at the hospital pre assessment clinic.

Your pre assessment appointment prepares you for your operation. You meet members of your treatment team at this appointment.

The doctor will tell you what to do on the day of your operation. This includes instructions about when to stop eating and drinking, and whether to stop taking any of your medicines. Do not stop taking your regular medicines unless the doctor tells you to.

Your doctor might invite you to join a clinical trial as part of your treatment.

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.

The length of your hospital stay depends on what operation you have. Ask your treatment team how long they think you might be in hospital for.

You can ask more questions when you go into hospital so don’t worry if you forget some. At the hospital you might meet:

The surgeon 

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 

The anaesthetist 

The anaesthetist gives you the anaesthetic and looks after you during the operation. They make sure you are fit enough for surgery.

The nursing team

The nurses check your:

• general health 

• weight 

• blood pressure 

• pulse 

• temperature 

They also check what help and support you have, to see what you will need when you go home. A clinical nurse specialist (CNS) is your point of contact and care for you throughout your treatment. 

The stoma nurse

The stoma nurse provides support and advice about having a stoma if you need one after your operation.

The dietitian 

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 

They 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 surgery. 

The physiotherapist 

The physiotherapist assesses how well you can move around. They let the doctors know if there is anything that could affect your recovery.

Helping you recover

Your doctor and nurses might tell you about the enhanced recovery programme. This is a way of caring before, during and after your surgery to help you recover more quickly after a big operation. It includes advising you about:

• being physically active

• stopping smoking

• drinking less alcohol

• how to eat well before your surgery

Learning breathing and leg exercises

Breathing exercises help to stop you from getting a chest infection after surgery. If you smoke, it helps if you can stop at least a few weeks before your operation.

Leg exercises help to stop blood clots forming in your legs. You might also have medicines to stop the blood from clotting. You have them as small injections under the skin.

You start the injections after your operation. You might also wear anti embolism stockings or have pumps on your calves to help the circulation.

Your nurse and physiotherapist will get you up out of bed quite quickly after your surgery. This is to help prevent chest infections and blood clots forming.

This 3-minute video shows you how to do the breathing and leg exercises.

Going into hospital

You’ll probably go into hospital on the day of your operation or the day before.

What to take with you

Take in:

• nightgowns or pyjamas

• underwear

• dressing gown

• slippers

• contact lenses, solution, glasses and a case

• wash bag with soap, a flannel or sponge, toothbrush and toothpaste etc

• sanitary wear or tampons

• towel

• small amount of money

• medicines you normally take

• magazines, books, playing cards

• headphones and music to listen to

• a tablet or smartphone for web browsing, entertainment and phone calls

• chargers for electronic devices

• a copy of your last clinic letter (if you have one)

Time in hospital

The length of your stay depends on the type of operation you have and your recovery.

You might be in hospital from a few days to a week. In rare cases you may need to stay longer. 

It’s worth sorting out a few things before you go into hospital. These might include:

• work

• care for children or other loved ones

• care for your pets

• care for your house

• cancelling your milk or newspapers

It may help to prepare or buy some meals in advance that you can just heat up once you are at home.

Family and friends

Before you go into hospital, it might be worth checking:

• whether the ward is allowing visitors

• if they have set visiting times

• the best number for friends and family to phone, to find out how you are

The letter you receive before your operation may contain this information. But if not, you can phone the ward or hospital reception to find out.

You can use your mobile phone in hospital. But there may be some time before and after your operation when you won’t have your mobile nearby. And you may not feel like talking.

Find out more about what happens on the day