Before your operation for nasopharyngeal cancer

Before surgery, you have tests to check your fitness and you meet members of your treatment team. You usually go into hospital on the morning of your operation. The length of your hospital stay depends on what operation you have.

Pre assessment clinic

Your pre assessment appointment prepares you for your operation. This usually happens in the 2 weeks before your surgery.

At your appointment the pre assessment team may:

  • ask you questions about your health and any medicines you are taking
  • tell you when to stop eating and drinking before your operation
  • tell you if you need to stop taking any medicines before the operation
  • check your weight, blood pressure, pulse and temperature
  • ask what help and support you have at home

The pre assessment team will tell you how to prepare for your operation. What you need to do depends on what operation you are having.

They may also give you a leaflet about breathing and leg exercises to do after your operation. This is to help prevent chest infections and blood clots.

It helps to write down any questions you have and take them with you. The more you know about what is going to happen, the less frightening it will seem. You can ask more questions when you go into hospital so don’t worry if you forget to ask some.

Enhanced Recovery After Surgery (ERAS) Programme

The pre assessment team might tell you about the Enhanced Recovery After Surgery (ERAS) Programme. This is for people having a big operation and is to help you recover quicker. It starts before you have your operation and continues for a short time after you have gone home.

For example, they might give you carbohydrate drinks to have before your operation. How many drinks you have depends on what brand of drink the hospital uses. And when you have them depends on what time of day your operation is.

After your operation your nurses will encourage you to do breathing exercises. They will help you with getting out of bed and walking as soon as you can. And start you eating and drinking as soon as possible. This depends on the type of operation you’ve had. But your doctor will tell you when you are ready to do this.

Who you might meet before your operation

You will see your surgeon before your operation. You may also see an anaesthetist, pharmacist or other members of your treatment team. You may see them during your pre assessment or at a separate appointment.

Pre assessment nurse

They will 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.

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 they look after you during the operation. The anaesthetic is the medicine that keeps you asleep during your operation. They make sure you’re fit enough for the surgery.

The clinical nurse specialist

Your specialist nurse is usually there to support you throughout your treatment. They can check what help and support you have, to see what you will need when you go home.

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.

The physiotherapist also teaches 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.

The speech and language therapist

Speech and language therapists don't just help people with speech problems. They also help people who have difficulty swallowing after surgery to the head and neck area. They assess you and can advise on the right texture of food or fluid to help you swallow safely.

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 your surgery.

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
  • a swab test to rule out some infections
  • an ECG Open a glossary item to check that your heart is healthy
  • breathing tests (called lung function tests)
  • an echocardiogram Open a glossary item 
  • a chest x-ray to check that your lungs are healthy
  • a cardio pulmonary exercise test (which checks your heart and lung function when you're resting and exercising)

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.

Going into hospital

You usually go into hospital on the day of your operation. Or you might go in the night before. Your doctor or nurse will tell you when to stop eating and drinking before your operation.

What to take with you.

Take in:

  • pyjamas or nightgown
  • underwear
  • dressing gown
  • slippers
  • contact lenses, solution, glasses and a case
  • wash bag with soap, a flannel or sponge, toothbrush and toothpaste etc
  • towel
  • small amount of money
  • medicines you normally take
  • magazines, books
  • 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)

You may also want to take in a notebook and pen. Some people may not be able to speak when they first wake up from the operation. So being able to write things down will be helpful.

Time in hospital

The length of your stay depends on the type of operation you have and your recovery. To remove lymph nodes Open a glossary item in your neck (a neck dissection), you may stay in hospital for up to a week.

Family and friends

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

  • 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.

Before you go into hospital

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

  • taking time off work
  • care for children or other loved ones
  • care for your pets
  • care for your house
  • cancelling your milk or newspapers

Smoking

If you smoke, your doctor will encourage you to stop smoking before the operation. Giving up smoking can be very difficult, especially if you have smoked for a long time. But it will help to lower the risk of a chest infection and wound infection after surgery. 

  • Routine preoperative tests for elective surgery
    National Institute for Health and Care Excellence (NICE), 2016

  • Enhanced recovery programmes in head and neck surgery: systematic review
    M Bannister and KW Ah-See
    The Journal of Laryngology and Otology, 2015. Volume 129, Issue 5, Pages 416-420

  • Improving outcomes in head and neck cancers 

    National Institute for Health and Care Excellence, November 2004 (updated June 2015)

  • The Royal Marsden Manual of Clinical and Cancer Nursing Procedures (10th edition, online)
    S Lister, J Hofland and H Grafton 
    Wiley Blackwell, 2020

Last reviewed: 
02 Apr 2024
Next review due: 
02 Apr 2027

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