You have a pre assessment appointment 1 or 2 weeks before your neuroendocrine tumour (NET) surgery. This appointment prepares you for the operation and checks that you are fit for surgery. You also meet some of the members of your treatment team.
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 have some or all of the following tests:
- 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
- a test to check your heart and lung function when you're resting and exercising (called a cardio pulmonary exercise test)
Who you might meet before your operation
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 gives you the anaesthetic and looks after you during the operation. They make sure you’re fit enough for the surgery.
Nurse or health care assistant
They will check your:
- general health
- blood pressure
They also check what help and support you have to see what you will need when you go home.
Specialist cancer nurse
Your specialist nurse can talk through your treatment plan and try to answer any questions that you have. They are usually your main point of contact, and care for you throughout your treatment.
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 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.
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 compression stockings and pumps on your calves or feet 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.
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.
The evening before
You might go to hospital the day before your surgery. If you are in hospital the evening before your operation, your nurse will check your blood pressure, pulse and breathing rate. They may also give you fluids through a drip (intravenous infusion) into a vein of your arm. This will prevent dehydration before your surgery.