Planning and preparation
Although each person’s situation is different, this section provides a general overview of what may happen before surgery. Procedures vary between hospitals and according to whether you have surgery as an inpatient or outpatient.
Your doctor will ask you to complete a questionnaire about your medical history, including any allergies and any medicines you take.
Depending on the surgery you are having and your general health, you may have to attend a pre-admission clinic a few weeks before the surgery. This is so your medical team can check your fitness for surgery and recommend any tests or other things you need to do to prepare for surgery and ensure the best outcomes.
Tell the doctor if you are taking over-the-counter medicines, vitamins, herbs or other supplements, as these could affect the surgery and your recovery. For example, they may increase the risk of bleeding during surgery or affect the way pain medicines work.
The health professionals you see at the clinic will vary depending on the type of cancer and surgery, but they could include:
- the surgeon or a resident medical officer or registrar
- the anaesthetist or another member of the anaesthesia team, such as a specialist nurse or registrar
- a physiotherapist to show you exercises to do before surgery to improve the chances of a smooth recovery
- other specialists depending on your medical history and the type of surgery, e.g. you may see a heart specialist.
You may also have blood tests (including compatibility testing in case you need a blood transfusion), urine tests, heart monitoring tests (ECG) and a chest x-ray, and imaging tests such as CT, MRI or PET scans. You probably won’t need to have all of these tests and scans.
You will be told whether you will have surgery as an inpatient or outpatient, what to take to hospital and other useful information. Your legs may be measured for stockings to help reduce the chance of developing a blood clot in your veins (deep vein thrombosis or DVT). You might wear these during surgery and for a short time afterwards.
You will be given referrals to any support services you need after surgery, such as a dietitian or social worker.
If you are having minor surgery, you may not need to attend a pre-admission clinic. Your doctor will discuss the surgery and how to prepare at one of your usual appointments, and you will usually receive admission instructions from the hospital.
If you are a smoker, you will be encouraged to stop smoking before surgery. Continuing to smoke can increase the risk of complications and delay your healing and recovery time. Quitting smoking can be difficult – for support, talk to your doctor, call the Quitline
on 13 7848 or visit quitnow.gov.au.
Enhanced recovery after surgery programs
Many hospitals in Australia have programs in place to reduce the stress of surgery and improve your recovery. These are called enhanced recovery after surgery (ERAS) or fast track surgical (FTS) programs. These programs encourage you to play an active part in your care through pre-admission counselling and education about pain, diet and exercise, so you know what to expect each day after the surgery.
Almost all medical procedures have risks. Factors to consider when weighing up the risks and benefits of surgery include:
- how long the operation will take
- the type of anaesthetic you will have
- the expected outcome
- what will happen if you don’t have the surgery
- your age and general health.
Although advances in surgical techniques have made surgery safer, there are still things that may be unknown or not go as planned. Complications may also occur during surgery and after surgery.
Surgery may cause permanent physical changes such as scarring or loss of a body part. It may also affect your fertility (your ability to conceive a child). If you are interested in having children in the future, talk to your surgeon about your options before the operation.
Overall, you and your surgeon should feel that the expected benefits are greater than the possible risks. Sometimes there are few options other than surgery. If you are unsure, ask for a second opinion from another specialist.
A surgeon needs your agreement (consent) before performing any medical treatment. Adults can give their consent – or refuse it – if they have capacity. Capacity means they can understand and remember the information about the proposed choices, make decisions based on this information, and communicate their decision.
Sometimes consent is not needed, such as in a medical emergency. However, if your surgery is planned, your surgeon will discuss why you need the surgery and its benefits; other treatment options; how they will perform the surgery; and possible side effects, risks and complications.
You will be asked to sign a document indicating that you understand this information and agree to treatment. This is known as giving informed consent.
Informed financial consent is an important part of decision-making if you are having treatment in the private sector. Your doctors must talk to you about likely out-of-pocket costs before treatment starts. If you are concerned about the cost of surgery, you may want to get a second opinion from another specialist or seek treatment as a public patient.
As part of the preoperative assessment, you will be given instructions about how to prepare for the surgery based on your health and medical history. Let your treatment team know if you have any concerns about what you are asked to do. The advice you receive will cover a range of issues.
Bathing and shaving – You will be told when to shower or bath. This may be the night before and/or morning of the surgery. If you have been told that hair near the surgical site needs to be shaved, you may be asked to do it yourself before you go to hospital, or it will be done when you are admitted. In cases where there is a lot of hair at the surgical site, you will be asked to avoid shaving the area yourself, as any cuts to the area can increase the risk of infection. You may also be asked not to wear any make-up or perfume.
Eating and drinking – Most people are told not to eat or drink for 6–12 hours before surgery. This may be called fasting or nil by mouth. It ensures that your stomach is empty before surgery, which reduces the risk of some complications. In some cases, you can continue drinking clear fluids until two hours before surgery – your surgeon, anaesthetist or a hospital nurse will advise you about this. You should not drink alcohol or smoke for at least 24 hours before the operation, or chew gum while you are fasting.
Medicines – Your doctor will tell you whether to keep taking any medicine you are on or to stop taking it in the days or weeks before surgery. If you have to take medicine while fasting, swallow it with a small mouthful of water. If you are on blood thinners, including minor ones like aspirin, non-steroidal anti-inflammatory drugs or clopidogrel, talk to your surgeon about whether you need to stop taking them.
Support person – You may want to ask a friend or family member to stay in the waiting room while you are in surgery. If you are having day surgery, you should arrange for someone to take you home when you are discharged. It’s not safe to travel alone or use public transport or a taxi, as you will still be under the effects of the anaesthetic.
What to take with you – Your treatment team will let you know what personal items to take to hospital with you and what to leave at home. For example, they may tell you to take all your current medicines with you, but suggest you leave valuables, such as jewellery, at home. You should also take your admission letter and any recent x-rays or scans with you. If you are staying in hospital after your operation, you might like to take some toiletries and night clothes.
What time to arrive – You will be told what time to arrive at the hospital, either in the letter confirming the surgery or during a phone call from the hospital on the day before the surgery. You may have to wait for surgery, which can be stressful. It’s a good idea to take a quiet activity with you to keep you occupied and feeling calm, e.g. a book or tablet device.
You will be asked to remove nail polish, including clear polish, before surgery. Checking your fingernails during surgery is one way the anaesthetist can check the level of oxygen in your blood.
This information is reviewed by
This information was last reviewed April 2019 by the following expert content reviewers: Prof Andrew Spillane, Surgical Oncologist, Melanoma Institute of Australia, and Professor of Surgical Oncology, The University of Sydney Northern Clinical School, NSW; Lynne Hendrick, Consumer; Judy Holland, Physiotherapist, Calvary Mater Newcastle, NSW; Kara Hutchinson, Cancer Nurse Coordinator, St Vincent’s Hospital Melbourne, VIC; A/Prof Declan Murphy, Urologist and Director of Genitourinary Oncology, Peter MacCallum Cancer Centre, VIC; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Prof Stephan Schug, Director of Pain Medicine, Royal Perth Hospital, and Chair of Anaesthesiology and Pain Medicine, The University of Western Australia Medical School, WA; Dr Emma Secomb, Specialist Surgeon, Hinterland Surgical Centre, QLD.