After surgery for neuroendocrine cancer

When you wake up from your operation

You usually wake up in the recovery unit before moving back to your ward.

If you have had a big operation, you may wake up in intensive care (ICU) or a high dependency recovery unit. You usually move back to the ward within a day or so.

In the ICU you have one to one nursing care. And in the high dependency unit you have very close nursing care. Your surgeon and anaesthetist also keep an eye on your progress.

These units are busy and often noisy places that some people find strange and disorienting. You'll feel drowsy because of the anaesthetic and painkillers.

At first you'll probably be wearing a mask or have small tubes into your nose (nasal cannulae) to give you oxygen. You may feel dizzy and sluggish to begin with.

You have a blood pressure cuff on your arm and a little clip on your finger to measure your pulse and oxygen level.

Your nurse measures your blood pressure and checks your dressings regularly.

Tubes and drains

When you wake up, you may have several tubes in you. This can be frightening, so it helps to know what they are for.

You are likely to have a drip into your arm (intravenous infusion) to give you fluids until you are eating and drinking again. You might also have a:

• tube into your bladder to drain urine (catheter)

• fine tube near the wound to drain away any fluid that collects and help it to heal (wound drain)

• tube down your nose into your stomach (nasogastric tube) for 24 hours, to drain fluids and stop you feeling sick

Electronic pumps may control any medicines you have through your drip. 

If you have wound drains, they stay in until they stop draining fluid. This is generally 3 to 7 days after your operation.

Your wound

You have dressings over your wounds. After a couple of days your nurse changes the dressings and cleans your wounds. 

Some surgeons use stitches that dissolve slowly during the couple of weeks after your operation. So you don’t need to have the stitches taken out. Or you may have stitches or clips that have to come out after about 7 to 10 days. A nurse might take them out:

• in your own home

• at your GP practice

• back at hospital

Before you go home your nurse gives you information about how to care for your wound. If you have a ​stoma​ (ileostomy or colostomy) after bowel surgery, they will show you how to care for this.

Painkillers

It’s normal to have pain for the first week or so. You have painkillers to help.

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.

Immediately after surgery you might have painkillers through a drip into the bloodstream that you control. This is called patient controlled analgesia (PCA). Analgesia is another word for painkillers. 

Or you might have painkillers through a small thin tube that is put into your back. This tube connects to a pump that gives you a constant dose of painkillers. This is called an epidural.

You get painkillers to take home. Your nurse will talk to you about:

• how often to take them

• when to take them

• what side effects you may get 

Contact your doctor if you still have pain or if it gets worse.

Preventing carcinoid crisis

Some ​neuroendocrine tumours (NETs) make large amounts of hormones. This can cause a collection of symptoms called carcinoid syndrome. Carcinoid crisis is a more serious version of carcinoid syndrome. 

Sometimes surgery can set off a carcinoid crisis. Your doctors will assess your risk of this. To prevent carcinoid crisis, you might have a ​somatostatin analogue​ medicine called octreotide. You can have it as an injection, or as a continuous drip into your vein. You might have this before, during and after surgery.

Read more about carcinoid crisis

Eating and drinking

You usually just drink sips of water to begin with. If you manage this, you can then move on to other drinks such as tea.

Your nurse will remove your drip once you are drinking well without feeling or being sick.

Depending on the operation you’ve had, you can usually start eating when you feel up to it. This could be within a few hours of your operation. It can be helpful to have plain, bland foods at first because strongly flavoured foods are more likely to make you feel sick.

If you’ve had surgery to your stomach or bowel, you may not be able to eat or drink straight away. You can usually start sips of water within 24 to 48 hours. You gradually build up what you can eat and drink. Most people are able to eat small amounts within a week.

Some people may need a feeding tube at first to help get the nutrition they need.

You might see a dietitian most days while you are in hospital. You can contact them once you get home if you have any problems.

Getting up

Your nurses and physiotherapists help you to move around as soon as possible. They check you’re doing your breathing and leg exercises. This helps you recover.

You might be sitting in a chair within 12 hours of your operation. The day after, you’ll be walking around your bed. And within a few days you’ll be able to walk along the hospital corridor.

Making progress

During the first few days after your operation you gradually start to feel better and less sore. You may find things slightly easier once your nurse takes out any drips or wound drains.

You usually go home within a week of your surgery. How long exactly depends on the type of surgery you had and your recovery.

Going home

You're likely to feel very tired for several weeks and sometimes months after your surgery. It helps to do more every day. Try: 

• sitting for less time each day

• walking around the house a bit more each day

• building up to walking outside 

What you can do depends on how fit you were before surgery and any problems you have afterwards. Talk to your physiotherapist or your doctor if you're unsure about what you should be doing. 

Your nurse will make you an outpatient appointment before you leave the ward. The appointment is usually 6 weeks after your operation. If you had a colostomy or ileostomy, your stoma nurse might arrange to see you at home.

Contact your doctor or specialist nurse if you have any problems or symptoms you are unsure about.

Find out about possible problems after surgery in our general surgery section

Follow up appointments

You'll have follow up appointments to check your recovery and sort out any problems. They're also your opportunity to raise any concerns you have about your progress.

Read more about follow up